Disproportionate Share Reimbursement

Our Medicare disproportionate share reimbursement review is designed to find Medicaid-eligible days missed when your original cost report was filed. We employ technology that allows us to analyze all of your inpatient accounts, ensuring that we capture all of your Medicaid patient days, but also preventing any overstatement.

To perform disproportionate share analysis, we use data extracted from your patient accounting system, data obtained from fiscal intermediaries, and eligibility information obtained from state agencies. All work is completed in our offices with almost no interruption of your time.

After we complete our data analysis, we provide you with a detailed report that includes:

• A list of accounts and days that we have identified as subject to additional reimbursement.

• Our conclusions about the reasons the accounts and days were missed on the original filing.

• Our recommendations for system changes to enable you to capture similar accounts and days in the future.

Once you understand and approve our conclusions, we prepare a package for presentation to your fiscal intermediary describing the reasons for reopening and listing the additional Medicaid-eligible accounts in the formats they require. Our work, of course, does not end there.

We aggressively work with your fiscal intermediary through the ultimate settlement of the reopening, responding to audit sample requests and answering any questions or concerns. We believe in finishing the job in a timely manner, ensuring a swift completion of the reopening and the earliest possible receipt of the additional reimbursement.

Medicare Bad Debt Reimbursement | Healthcare Provider Tax Refund Analyses