Disproportionate Share Hospital (DSH) Analyses – Medicare and Medicaid
The Medicare and Medicaid Disproportionate Share Hospital designations provide many hospitals with additional reimbursement for indigent care and other programs. Improperly reported information may lead to loss of funding from these programs. Draffin Tucker assists hospitals related to Disproportionate Share Funding. We work closely with state regulators to remain current with rules and filing procedures. In addition, we help hospitals identify eligible Medicaid days to maximize their ability to participate in such programs, as well as the filing of surveys and plans that regulatory agencies require.
Medicare & Medicaid Reimbursement
Medicare Critical Access Hospital Designation
Medicare Geographic Reclassifications
Reclassification may allow your hospital to obtain increased Medicare funding due to the higher wage index and standardized amounts used in funding determination for inpatient and outpatient payments. Draffin Tucker provides consultation and assistance to providers in reclassifying to another area for the Medicare wage index and standardized amounts.
Medicare Provider-Based Requests
Provider-based facilities often receive greater reimbursement than free-standing facilities. Regulators require proper organization and operation to approve provider-based status. Effective development and organization of provider-based requests are essential for quick approval and avoidance of cash flow delays. Draffin Tucker provides consultation and assistance to providers in substantiating Medicare provider-based status of related entities. Such assistance includes completing provider-based requests, developing and organizing supporting documentation, and liaising with state, federal, and fiscal intermediaries.
Medicare Rural Referral Center Applications
Medicare Sole Community Hospital Applications
Medicare Wage Index Reporting and Reviews
Reporting inaccurate wage index data can be a costly mistake. Errors can substantially impact reimbursement and may even be viewed as compliance deficiencies. Wage data reported on the hospital's Medicare cost report is used to calculate a significant portion of the payment for inpatient, outpatient, inpatient psychiatric, inpatient rehabilitation, skilled nursing facility, hospice, and home health services.
We can help you with every step of the wage index process: from compiling all the relevant data for inclusion on the cost report and occupational mix survey to detailed analysis of the supporting documentation to ensure data is complete and accurate, to reviewing and requesting corrections to the public use files before the data is used to calculate your payments.
Merger & Acquisition Reimbursement Consulting
For many healthcare providers, the ever-changing payment environment has caused organizations to evaluate their position in the marketplace. With lower payments per service unit and more value-added requirements, many healthcare providers are considering either merging with larger providers or acquiring smaller providers to retain economies of scale within their marketplace. These organizational changes result in significant regulatory, compliance, accounting, and reimbursement challenges and opportunities. These challenges and opportunities must be planned and supported with the full knowledge of experienced personnel and consultants.
TRICARE Capital and Direct Medical Education Cost Reimbursement
Hospitals subject to the TRICARE/CHAMPUS DRG-based payment system are eligible for additional reimbursement for allowed capital and direct medical education costs. The professionals at Draffin Tucker can assist you in submitting the required request for reimbursement necessary to obtain the additional funds.
- Accounts Receivable Contractual Allowance Computation and Analysis
- Legislative Reimbursement Analysis
- Medicare & Medicaid Cost-Based Reimbursement
- Medicare Interns and Residents Reimbursements
- Medicare S-10 Analysis & Review
- Medicare SCH & MDH Status
- Volume Decrease Adjustment Requests
- Medicare Transplant Reimbursement
- Medicare Uncompensated Care Analysis & Review
- Reimbursement Consulting
- Service Line Reimbursement Evaluation
- Cost Allocation Methods Analysis