Cost and Governmental Reimbursement
At RSM McGladrey, we offer the following cost and governmental reimbursement services:
Medicare Outpatient Prospective Payment System
We use our proprietary software, strategic impact model (SIM), to help you understand the financial and operational implications of the Medicare Outpatient Prospective Payment System. Using SIM and working with key individuals in your finance, patient accounting, information systems and medical records departments, we help to identify significant outpatient reimbursement.
Medicare cost reporting and appeals
Our approach to Medicare cost reporting is to proactively help you meet this regulatory requirement while realizing any incremental increases in reimbursement you may be eligible for. In addition, we work with critical access hospitals and other exempt services to maximize their cost-based reimbursement.
Disproportionate share recovery
Using proven procedures, we document lost disproportionate share (DSH) reimbursement. Our seasoned professionals evaluate all of the patient population against applicable state eligibility guidelines, while investigating inconsistencies between state eligibility databases and your patient data. We propose services to address revenue cycle process changes that will allow optimum DSH reimbursement.
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