Services Offered Include:

Health Policy Analysis and Development

Analysis of proposed and adopted legislation and regulations impacting hospitals

  • Interpretation/financial analysis of government reimbursement policies
  • Identify government policy implementation issues

Technical and operational support to the District Hospital Leadership Forum

  • Identify and develop innovative payment improvement programs
  • Address financial/reimbursement issues on behalf of District Hospitals

District Hospital Strategic Reimbursement Improvement Program

Provide monitoring and strategic planning related to District hospital supplemental payment programs

  • Advise Clients on impacts of supplemental payment programs
  • Provide guidance and support regarding program requirements
  • Analyze hospital data capturing systems to ensure receipt of adequate payments
  • Assist Client with required data reporting to ensure adequate payments
  • Provide advice on how to develop required programs to obtain supplemental funding

Hospital Financial Assistance Policy/Practices Improvement Program

  • In-depth policy, procedure and practice assessments
  • Establish a documented audit process for identifying eligible patients
  • Capturing and accounting for data used as part of required government reporting
  • Ensure that the data related to the patients qualifying under the charity care policy is properly reported and supported on the Medicare Worksheet S-10 in order to protect Medicare reimbursement levels

OSHPD Accounting and Reporting System Services

  • Report Preparation and Submission
  • OSHPD Accounting and Mapping Analysis
  • OSHPD Data Capturing and Reporting Analysis

Hospital Reimbursement Services

Medi-Cal Disproportionate Share Improvement Program

  • Review and correction of hospital data utilized by the Medi-Cal DSH program
  • Review billing data that is sent to the Medi‐Cal program
  • As applicable apply alternative interpretations of how data is reported

Medicare and Medi-Cal Cost Reporting and Reimbursement Support

  • Prepare and submit Medicare/Medi-Cal cost reports
  • Analyze hospital prepared Medicare/Medi-Cal cost report prior to filing
  • Perform reimbursement analysis and contractual allowance estimations
  • Evaluate cost report audit adjustments for appeal determination

Health Care Litigation Support

Provide technical reimbursement consultation to hospital legal counsel

  • Provide expert witness testimony
  • Identify “group” reimbursement issues and help develop case
  • Provide data support to corroborate the legal case