Imagine opening a junk drawer and discovering an uncashed paycheck. It’s money you’ve already earned but haven’t received or been able to use. And while the cash isn’t lost forever, it could have been had you not found it.
This scenario is similar to what many hospitals encounter with Medicare Bad Debt (MBD) reimbursement.
They provide care to Medicare patients, submit annual cost reports for reimbursement, and move on, unaware that they may still have reimbursement revenue waiting to be claimed. These missed opportunities can and do cost healthcare organizations nationwide millions of dollars each year. That’s a lot of money to leave in the drawer.
Fortunately, tentative settlements based on cost report amendments give hospitals a second chance to capture the reimbursement they’re owed, even after initial cost reports have been filed.
Tentative settlements, stemming from cost report amendments, allow providers to receive quick payment from the Centers for Medicare & Medicaid Services (CMS) for Medicare Bad Debt that was mistakenly omitted from previously filed cost reports.
When missed claims are identified, hospitals can file an amended cost report to recoup the reimbursement they’re owed. CMS guidelines state that reimbursement must be delivered within 120 days of submission, a relatively fast turnaround.
Final Settlement: After the tentative settlement, CMS conducts a thorough final review, including potential audits, resulting in the final cost report settlement.
It’s relatively easy for hospitals to overlook eligible bad debt when filing annual cost reports—that’s why tentative settlements for amended cost reports are so critical. Missed claims can add up to significant lost revenue, undercutting a hospital’s ability to invest in staffing, operations, and patient care.
Tentative settlements serve as a financial safety net, giving hospitals a chance to turn missed opportunities into cash flow and bottom-line gains within a quick timeframe from cost report amendment.
Inadequate Technology: Internal teams and even many third-party vendors often lack the sophisticated technology needed to identify every dollar of Medicare Bad Debt, leading to missed claims.
Inexperience: With an industry-wide shortage of experienced RCM employees, internal teams are already stretched thin. It’s difficult to find enough people with the specialized knowledge to find and file for missed MBD reimbursement.
Complex Regulations: The guidelines for what qualifies as reimbursable bad debt are difficult to navigate, increasing the risk for underreporting.
The key to filing a successful amended cost report and receiving a timely tentative settlement is knowing where to look for missed reimbursement. Meduit combines proprietary technology with Medicare Bad Debt expertise to help hospitals identify, submit for, and recover the MBD reimbursement they’re owed. Our balanced approach has helped hospitals and health systems nationwide recover millions, with an average settlement of $2.2 million per client. Here’s how we do it:
Proprietary Technology: Meduit’s advanced data analytics and tools efficiently identify bad debt opportunities that have been missed in the past.
Niche Expertise: With decades of experience, our team of experts knows where to find missed claim opportunities and how to recover them.
Efficient Resolution: As MACs continue to compress timelines for settling open cost report years, our team helps clients move quickly to capture missed reimbursement while staying compliant with evolving standards.
Complementary and Comprehensive: Even if a hospital already has an internal process or third-party vendor in place, Meduit’s MBD “Lookback Service” can serve as an ideal complement. We follow up to make sure all reimbursable value is captured while helping improve processes to secure reimbursement moving forward.
Meduit’s Medicare Bad Debt solution finds value for clients 100% of the time.
What would an extra $2.2 million do for your organization? And wouldn’t it be nice to find out?
In today’s challenging healthcare environment, every dollar made and missed counts. Hospitals that take a proactive approach to Medicare Bad Debt recovery, including utilizing tentative settlements, can significantly improve their revenue cycle performance and financial outlook.
With government-funded programs under intense scrutiny, including Medicare, now is the time to leverage the current rules to recover what you’re owed.
By carefully utilizing cost report amendments and understanding the intricacies of CMS reimbursement policies, providers can ensure they get paid for the care they’ve already delivered.
Whether you have an internal team or work with a specialized partner like Meduit, the key is to be efficient and thorough to capture what’s owed, maximize the financial stability of your organization, and enjoy the peace of mind that comes with knowing you’ve been paid in full for services already rendered.
If you’re concerned that you’re leaving reimbursement revenue on the table, contact Meduit today to learn about cost report amendments, tentative settlements, and our other reimbursement services, including S-10 reporting.
We’re here to help you navigate the complexities of Medicare reimbursement, identify missed Medicare Bad Debt, and turn overlooked opportunities into additional revenue.
Get in touch to learn more about our Medicare Bad Debt services at contactus@meduitrcm.com.