COST REPORTING

Medicare cost report services involve preparing and submitting cost reports to Medicare, which are used to determine the amount of reimbursement a provider will receive.

Reimbursement and Cost Report Services

Cost reports continue to affect facility reimbursement, especially wage-related information. In addition, regulators utilize cost reports for monitoring many reimbursement programs. Therefore, inaccurate cost reports may lead to lower reimbursement and regulatory scrutiny.

Draffin Tucker has extensive third-party reimbursement experience. Since 1967, the first year of the Medicare program, we have filed cost reports for healthcare entities, including hospitals, free-standing and hospital-based nursing homes, home health agencies, and rehabilitation clinics. We currently prepare more Medicare cost reports for submission, with fewer resulting intermediary audits, than any other firm in this service area. We are familiar with many alternatives to maximize reimbursement under the Medicare and Medicaid programs and know the related documentation required by intermediaries.

With a thorough understanding of the relationship and impact of the Medicare and Medicaid programs, we are uniquely qualified to assist your facility. We maintain excellent working relationships with the Medicare Administrative Contractors and State Medicaid departments.

Medicare Bad Debt Reimbursement

Compilation of the Medicare bad-debt lists is a labor-intensive process. As a result, many providers have difficulty capturing all of their Medicare bad debts and ensuring non-allowable portions of Medicare bad debts are not included in their bad debt lists. Through data mining techniques using detailed paid claims data, we routinely assist providers in preparing their Medicare bad debt list. While the assistance routinely identifies additional bad debts to claim on the cost report, a well-organized Medicare bad debt listing also aids in future Medicare audits.

End-Stage Renal Dialysis Bonus Payments

Hospital providers are eligible for add-on payments to their DRG payment for treating a high percentage of end-stage renal dialysis patients. However, the data required for this adjustment is very detailed and can be labor-intensive to compile. Therefore, we routinely assist providers through data mining techniques in compiling the necessary information for submission to the Medicare intermediary.

Additional Services