Optimizing your organization’s reimbursement requires a deep understanding of the cost report and coordination across people, systems, and processes.

As you navigate Medicare and Medicaid’s ever-changing landscape, our professionals can deliver reimbursement solutions that support the overall strategy and operations of your health care organization—whether you’re looking for full enterprise outsourcing solutions, or help in a specific area.

Our full enterprise support includes:

• Medicare and Medicaid cost reimbursement
• Medicare Disproportionate Share Hospital (DSH) reimbursement analysis for initial cost report filings and retrospective reviews
• Medicare cost report and DSH appeals 
• Medicaid eligibility matching, including identifying patients eligible for medical assistance under state-approved plans under Title XIX for inclusion in the as-filed Medicare cost report
• SSI ratio recalculations
• Worksheet S-10, including bad debt and charity care reporting for uncompensated care
• Medicare bad debt logs
• Provider-based licensure and certification
• Medical education programs
• Wage index reviews

In addition to staying alert to the latest regulations, our professionals have a deep understanding of how the operations of your organization, whether revenue cycle operations or billing practices, impact reimbursement.

We deliver insight on areas including:

• Revenue cycle processes such as payer mix management, charge master, and billing
• Regulatory interpretation of federal and state provider-based and outpatient service line assessments
• Clinical pathway reviews for inpatient and outpatient service lines
• Application of overhead rates including indirect cost for federal grant funding, managed care plans, and the correlation to FFS calculations