Medicare and Medicaid Cost Reimbursement

Successfully preparing Medicare and Medicaid cost reports in compliance with continuously evolving federal and state regulations can be a difficult task. And the burden is on the provider, which means you’re in the unenviable position of needing to comprehend and apply complex, multifaceted legislation at expert levels, on an ongoing basis. The time constraints of operating a successful health care facility make this level of expertise challenging to sustain internally.

Moss Adams has the experience, resources, and expertise to handle your ongoing cost-report and related reimbursement issues. Each year, our professionals prepare dozens of cost reports for our clients, giving us a level of insight and efficiency that would be difficult to attain within your own facility, where this task takes place just once a year.

We've worked with all types of health care organizations, including large health care systems, rural hospitals, critical access hospitals, skilled nursing facilities, home health agencies, and rural health clinics. We can:

  • Prepare cost reports for submission to Medicare Administrative Contractors (MACs) and state-specific reports such as OSHPD and Medi-Cal (California), YEC (Alaska), HMSA (Hawaii), and DMAP (Oregon)
  • Act as a liaison with MACs and state agencies to help resolve cost report issues
  • Support you with Medicare, Medicaid, and Medi-Cal audits, including preemptive services such as pre-audits and consultations
  • Develop strategies for the successful arbitration of appeals and reopenings of issues related to finalized cost reports
  • Prepare Medicare position papers related to appeals filed with the Provider Reimbursement Review Board
  • Assist you with OIG and MAC investigations regarding Medicare services
  • Formulate third-party reserves for financial-reporting purposes
  • Help analyze monthly contractuals
  • Help critical access hospitals capture appropriate reimbursement for services and perform interim settlement analyses
  • Support hospitals with federally qualified health clinic (FQHC) and rural health clinic (RHC) billing and reimbursement issues
  • Train your staff on billing and coding issues and help establish or revise billing for services to improve compliance with government regulations
  • Assist with interim reimbursement management

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