Q. Medicare Bad Debt is a niche area; how did you get into it?
I’ve been in healthcare my entire career, starting in the consulting space. I was at Ernst & Young when I got into Medicare Bad Debt as part of their healthcare advisory group. But I was also interested in the clinical side of healthcare, so I went back and got my nursing degree and did clinical nursing for about 10 years. I have this double lens—on one side is finance and business, and on the other is this clinical understanding—and I think together they’ve given me a unique perspective to lean on throughout my career.
Q. So, what brought you to Meduit?
In 2012, my brother-in-law, who was also a healthcare consultant, started his own firm and asked me to join him. So, I left nursing and went back to consulting. As we found our niche in Medicare Bad Debt, we noticed a glaring lack of technology in the field. So, we built our own tech solution from the ground up.
That propelled our growth until we essentially saturated the Chicago market. At that point, we had best-in-class software and a unique combination of business and clinical expertise, but we were a small team and had no idea how to scale.
And that’s where Meduit came in. They were looking to expand their government reimbursement services at the time, and we were super impressed with their approach and national footprint. They basically added us to their suite of services while letting us keep doing what we were doing. Since joining forces, the business has grown over 20% year over year, and we now have clients from Maine to California.
Q. What does your day-to-day entail as VP of Operations?
Our original management team has remained intact, so our compilation and lookback services are in great hands. That allows me to focus on big-picture items like growing the business. I also spend a significant amount of time working with our technology leads to update our software. We tweak the tool every week.
Q. What are some common issues hospitals face with government reimbursement?
Everyone has a process for doing their Medicare Bad Debt logs. Some do it internally, some use a vendor, and some—although we don’t see it much anymore—buy plug-and-play software. But with healthcare’s complexity and ongoing staffing challenges, there are almost always gaps in reporting. That’s where claims get missed.
What we do—with our technology and our people—is take a 360-degree view of everything. We go back to the original claims and prove out every deductible and co-insurance dollar. We don’t rely on hospital reports or even just our software. We verify every single dollar so there are no gaps. With this approach, we’ve never not found value for one of our clients.
Q. That’s pretty incredible. If there’s always value, why don’t hospitals prioritize Medicare Bad Debt more?
I think it’s an area that most executives don’t think about right away—they’re thinking about days in AR, getting insurance companies to pay them, and cash coming in. That’s where we can educate a little and say, “This is cash you’re due from the government and you’ve already done the work. Let us report it correctly so you can get paid.” And the ROI is quick. A tentative settlement can get you money back within 90 days, which is pretty fast all things considered.
Q. How does S-10 reporting factor in?
S-10 has become another reimbursement area that providers need to make sure they’re doing well. Five or so years ago, Medicare said they were going to start using this uncompensated care worksheet to calculate reimbursement. So, hospitals started trying to figure it out and they struggled. Their vendors struggled, too.
But S-10 and Medicare Bad Debt go hand in hand. If the Medicare Bad Debt isn’t appropriately categorized on the S-10, it might get thrown out. So, we talk to all our clients about aligning those two logs. We even built a module into our software to make sure it’s addressed.
Q. And what does the future of government reimbursement look like at Meduit?
I think we’re getting better at telling the story, and it’s resonating. Basically, we can help you get paid for work you’ve already done. We find value 100% of the time, and if we don’t, you don’t pay us. So, it’s a compelling message, and that’s why I think we’ll continue to grow.
About Tiffani:
Tiffani Frank leads Meduit’s Government Reimbursement team and brings a unique combination of clinical nursing and financial consulting experience to the role. She lives with her husband and four daughters. When she’s not buried in one of the 50 books she aims to read each year, you’ll find her on the pickleball court or enjoying some Illinois sunshine.