A full overhaul of your organization’s financial health can be a daunting task, but often a few simple, strategic tweaks can make the difference to improve your organization’s operations and augment your reimbursements.

By seeing how reimbursement programs like Medicare disproportionate share hospital (DSH), Worksheet S-10 Uncompensated Care, and Medicare bad debts are related, hospitals can save time, alleviate strain on their IT departments, free up staff to focus on high-priority work, and potentially improve their financial health.

Recent regulatory changes, like Transmittal 18, provide hospitals a unique opportunity to reassess their reimbursement practices and strategy, showing the value of completing three reporting types in tandem rather than one at a time.

Implement a United Approach

A united approach to DSH, S-10, and Medicare bad debt can help hospitals synchronize their operations and produce more optimized reimbursement practices. To implement this, hospitals need to understand what each program is for, what’s needed, and how it relates to the other programs. 

On their own, each program can provide important payments for hospitals. Yet, when integrated, the programs utilize nearly the same data, and assessing the overlap could save time and money.

Below are three practices executives can implement using the integrated data to unify their approach to DSH, S-10, and Medicare bad debt reimbursement.

Assess Your Vendors

Are your vendors meeting your needs? When it comes to DSH, Worksheet S-10, and Medicare bad debt logs, more vendors can lead to more headaches, especially if the vendors aren’t aligned.

Some hospitals waste time and energy by pulling unnecessary, duplicated data sets because different vendors require different data. Are your current vendors making the most of your data and helping your team succeed? Below are a few questions to consider:

• Do our vendors’ deliverables comply with the new Transmittal 18 requirements?
• Are our vendors making us work harder by using numerous data templates and requests?
• Do our vendors understand how government reimbursement programs are related? Are they optimizing our data accordingly?
• Could our hospital benefit by shifting to one vendor that has a unified approach to DSH, Worksheet S-10, and Medicare bad debt services?

Assess Your Time and Effort

Executives should assess how their reimbursement departments leverage their most valuable resource—time. Whether you complete your reimbursement work in-house or use an outside vendor, consider these questions to determine if your team is being strategic with its time.

If you do not rely on a vendor for reimbursement services, consider the following questions:

• How long does it take to gather data for each program, prepare the reports, and all supplemental exhibits required for cost report filing?
• Have we assessed the time and effort required by our team to support the audit of these programs?
• Are our processes efficient?
• Is the time we’re spending worth it? Is there something else we could do with our time that would be more strategic?

If you do rely on a vendor for reimbursement services, consider the following questions:

• Are our vendors helping or hurting our team’s efficiency?
• Do we find ourselves waiting on our vendors, either for information, details, deliverables, or next steps?
• Is one vendor waiting for another vendor to complete their portion of the cost report?

Improve Your Policies and Data

The new reporting requirements of Transmittal 18 provide a perfect opportunity to double-check your policy and data needs. Here are a few steps executives should consider:

• Review your financial assistance policy. Due to the Medicaid redeterminations occurring in each state, it’s likely patients in your community are losing Medicaid eligibility and could fall through the cracks of your current policy. A broad, clear policy is the most effective tool for ensuring these patients are captured and reported as uncompensated care reimbursement for the services you provide.
• Understand the Transmittal 18 reporting requirements. Do you know how to comply with Centers for Medicare & Medicaid Services (CMS) requirements? Does your vendor? If you’re not sure, you can learn more here.
• Identify common data points. Reduce strain on your IT department by identifying the common data points you need for DSH, Worksheet S-10, and Medicare bad debt reimbursements.

We’re Here to Help

For more information about reimbursement programs, contact your Moss Adams professional.

Additional Resources

• Health Care Practice
• Provider Reimbursement Health Care Consulting Services