Creating Useful Resources for Your Hospital:

Financial Issues

Analysis of Acumen Revision of Medicare Wage Index
Final Report:  Part II, March 16, 2010

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Each Year, Hospitals Lose Hundreds of Thousands of Dollars in Medicare Bad Debts Revenue

When beneficiaries are served by a hospital, Medicare does not cover the full cost of their medical care. Co-payments, deductibles and physician fees (if the patient was not enrolled in a Part B coverage plan) are considered to be the financial responsibility of the patient. However in many cases, the patients never pay those fees, which can result in devastating financial losses to the hospitals. Fortunately, under certain circumstances, it is possible for hospitals to receive compensation from Medicare for a portion of that “lost” income.

Now more than ever, it is critical for hospitals to receive every Medicare reimbursement dollar for which they legitimately qualify. Yet each year, hospitals around the country lose hundreds of thousands of dollars by not claiming or under-claiming their Medicare bad debts. Hospitals often ignore this valuable revenue source because they lack the personnel, time or expertise to deal with the fiscal intermediary and/or CMS regarding bad debt issues. Because it can take years to receive the final resolution of a bad debt filing, reimbursement department turnover makes maintaining the bad debt logs especially challenging. That’s why it pays to hire the seasoned professionals at R-C Healthcare Management Services, Inc. (RCHMS) to handle your hospital’s Medicare bad debts filings. We provide efficient, on-site service and consistent follow-up in order to expedite the process and recover the maximum amount of funds—all with no upfront costs or financial risk to the hospital.

Here’s how RCHMS’ Medicare Bad Debt Recovery Service (MBDRS) program works: Our staff of specialized reimbursement professionals works on-site with the hospital’s Patient Accounting Department to research all uncollectible Medicare-related collection and charity care accounts. Utilizing our highly-specialized computerized system, we investigate all payments made on those accounts in order to determine the specific amounts that can be claimed as Medicare bad debts. We then prepare very detailed Medicare bad debts logs and submit them to the hospital’s reimbursement staff to include when filing the cost report for that year. We also prepare back-up documentation for the sample accounts selected by the fiscal intermediary. If any questions arise during the audit, we assist in the resolution of those issues. After the filing has been settled and the hospital has received its reimbursement, the hospital is invoiced and pays RCHMS a small percentage of the recovered funds. All of RCHMS’ travel and other expenses are fully covered by our firm as an inclusive component of our fee and are never the responsibility of the hospital. Therefore, there are no upfront, out-of-pocket fees or financial risk involved for the hospital to participate in RCHMS’ Medicare Bad Debts Recovery Service (MBDRS) program.

Our MBDRS program succeeds because we understand Medicare reimbursement, know how to fully support all claims and have a good working relationship with CMS and fiscal intermediaries throughout the country. Our track record is proven. Best of all, because the hospital pays our fee from the proceeds generated by the bad debts filing only after receiving the funds, the hospital is guaranteed to profit from our Medicare Bad Debts Recovery Service (MBDRS) program.

When experience, efficiency and effectiveness count, you can count on R-C Healthcare Management to be your expert consultants for all issues related to Medicare reimbursement.

Call us at (800) 862-5368 or visit the product-specific area(s) on our web site to learn more about our Medicare Bad Debts Recovery Service (MBDRS) and other programs and how they can help your hospital.