Reimbursement & Cost Report Services Strategies for enhanced reimbursement
With the increasing pressure on hospital margins, it is imperative that providers obtain accurate reimbursement from Medicare and Medicaid as well as other third-party payors.
You can benefit from our experience preparing cost reports since the inception of Medicare for hospitals and health systems of all sizes and types, including critical access hospitals (CAHs). We have a team dedicated to preparing cost reports and defending them through reviews and appeals. Our cost reporting team keeps up with changes in reporting requirements to better serve you and includes members who have hands-on experience with reimbursement issues on both sides - Medicare and hospitals.
We have helped numerous clients increase their reimbursement by assisting them with conversion to special Medicare status such as sole community provider, regional referral center, and critical access hospital.
We’ve also assisted them with various Medicare prospective payment systems (PPS) reimbursement issues such as:
- Wage index analysis
- Disproportionate Share Hospital (DSH)
- Medicare bad debt optimization
For academic medical centers, we’ve assisted in proper reporting for post acute transfer issues, graduate medical education (GME), independent medical examiners (IME), and organ transplant costs. On behalf of hospitals and health systems, Plante Moran also has negotiated with various third-party payors including state Medicaid programs.
As part of our cost report preparation service, we provide a summary of observations and recommendations about the data provided for the cost report as well as opportunities to enhance reimbursement in the future. We’ll help you interpret the results of your cost reports so you know if you make or lose money on individual service lines.
As a result of our client service, we enjoy a high retention rate with our reimbursement clients. We would be happy to discuss our service in more detail with you.