Most hospitals file their annual cost report and move on, thinking all is well.
But usually, it isn’t.
Medicare Bad Debt reimbursement is an area where hospitals and health systems consistently miss out on money they’re owed. Usually, it’s due to a misaligned S-10 field here, a gap created by staff turnover there, or regulations that changed close to the filing deadline.
All are things small enough to miss, but big enough to add up. Industry data pegs hospital underreporting at 6% – 7% every year. That could translate to six or seven figures of reimbursement that a hospital never sees.
MYTH: Most hospitals collect all the MBD reimbursement they’re owed.
REALITY: We’ve found missed revenue 100% of the time we’ve done a lookback.
That 100% figure is real. Every time our Government Reimbursement Team runs a lookback, they find missed value. While recovery figures vary, there’s always one constant: every client we’ve worked with thought they had filed appropriately. Which just goes to show that even the best RCM teams don’t always have the tools or time to double-check everything.
That’s what a lookback is for. There’s no upfront cost. No fee if nothing is found (which has yet to happen). And when the money does come back, it can go where the hospital needs it most, including supporting an overloaded business office to make sure all future reimbursement is accounted for.
The good news for hospitals and health systems is that missed reimbursement isn’t lost for good. The bad news is that it’s just sitting there until someone goes and gets it.