Medicare DRG Transfer Analysis
We provide an analysis of Medicare post-acute care transfers cases (DRG transfer cases) to determine additional Medicare DRG reimbursement due your organization. This includes a review of all potential Medicare claims for additional reimbursement and quantification of the financial impact. We provide detailed tracking of adjudicated claims.
Medicare Disproportionate Share
We perform an analysis of issues related to acute care Medicare DSH and the processes that directly impact the calculation of DSH reimbursement. We provide Medicaid eligibility analysis for inpatient rehabilitation patients to assist in the Low Income Payment (LIP) calculation. We also identify additional Medicaid eligible days that could result in reimbursement by the Medicare program.
Cost Report Analysis
We review the work papers and Medicare cost report as compiled by your organization. We provide management with written recommendations specific to reimbursement issues contained within the report consistent with current Medicare regulations and/or policies. We identify increased reimbursement opportunities in addition to insuring compliance with existing regulations.
Provider Based Analysis
We assist in reviewing any Provider-Based units, as defined by your organization, to determine if you meet the Provider-Based Final Rules. Our analysis provides a matrix of providers, cost centers, clinics, management contracts and existing provider number consolidations and identifies compliance or non-compliance with the existing provider-based criterion. Our analysis provides a narrative identifying deficiencies and a corrective action plan in addition to identifying opportunities to increase Medicare\Medicaid reimbursement on a line item basis.
Square Footage Analysis
We provide a detailed analysis of provider square footage for both management use and for documentation of Medicare cost report statistical basis for cost allocation. Using computer-assisted drafting (CAD) technology, we will obtain accurate measurements of the facilities. If not included on the CAD, we will convert to-scale blueprints provided by the Hospital to CAD, to obtain accurate measurements of any departments to be included on the Medicare Cost Reports.
Wage Index Review
We will review each Hospitals wage index data and occupational mix data to be utilized in the development of federal fiscal year wage indices. The review can be
completed for your individual hospital or for all hospitals within a Core-Based Statistical Area. We will provide individual written management letters outlining
recommendations where data should be modified to obtain appropriate reimbursement and comply with current regulations.