Medicare/Medicaid Cost Report Preparation, Review, Re-Openings, and Appeals
TAG
prepares, reviews and files the annual
Medicare/Medicaid Cost Report with the Medicare
Administrative Contractor (MAC).
We audit the organ acquisition cost centers to determine if all direct and indirect cost are accurately reported in the Medicare/Medicaid Cost Report. We review the documentation that supports these costs to ensure they meet the federal/state guidelines and regulations. Additionally, we audit the number of Medicare/Medicaid patients and Medicare/Medicaid organs in your financial records and the supporting documentation.
In over 25 years of auditing Medicare Cost reports, we have found that due to the complexity of completing a Medicare/Medicaid Cost report, many hospitals understate both the cost of organ acquisitions as well as the number of Medicare/Medicaid organs. Unfortunately, the Medicare/Medicaid Cost report is an extremely complicated report and a full review of major components are always necessary. Our services are focused on increasing reimbursement and ensuring compliance with all the federal/state regulations. We also provide recommendations to improve business processes and procedures.
Medicare/Medicaid Cost
Report Re-Openings and Appeals
TAG reviews the Medicare/Medicaid Cost reports audited by the MAC in order to identify missed and/or underpaid Medicare/Medicaid reimbursement. Re-openings and Appeals with the MAC and the Provider Reimbursement and Review Board (PRRB) following a Medicare/Medicaid Cost report review are often necessary due to underreporting direct and indirect costs as well as a number of vital Medicare/Medicaid components. The Medicare/Medicaid Cost report review (explained above) is an extensive and often multi-year process that provides the necessary information and documentation that will identify additional reimbursement dollars.
On your behalf, TAG will file an amended Medicare Cost report, re-opening, and/or appeal which could result in additional reimbursement. We have been successful in obtaining approximately $200 million from Medicare/Medicaid Cost report re-openings and appeals on behalf of our hospital clients.
Our Services Include:
- Audit of the Medicare/Medicaid Cost Report: The Medicare/Medicaid Cost Report is the summary of all Organ Acquisition and Organ Transplants activities for a full fiscal year period. Additionally, when the Medicare/ Medicaid Cost Report is properly reviewed, organized and documented, it can provide significant amounts of information, which can be used to identify critical factors which will have a major impact on the reimbursement received by the Hospital or OPO.
- Reviewing Medicare/Medicaid reimbursement for organ acquisitions, transplant DRGs and physician and surgeon services.
- Capturing all Medicare/Medicaid allowable expenses of a single and/or multi-organ Medicare approved transplant program(s).