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Loss of 15 Months for Additional Reimbursement

September 2010

Hospitals Need to Act Now!

With the responsibility of providing “best practice” resources to our clients, M*D Resources wants to make certain that our hospital clients receive the proper reimbursement for services that have been provided. The Center for Medicaid and Medicare Services (CMS) has noted a number of services in which hospitals have consistently billed incorrectly. CMS has acknowledged these errors in the payment of services and has requested hospitals to resubmit the claims containing these services.

Currently CMS allows the rebilling of outpatient claims from October 1, 2008 to the present. This year, however, CMS changed the timely filing guidelines for retroactive billing. After December 31, 2010, healthcare organizations will no longer be able to collect the lost reimbursement dollars from October 1, 2008 through December 31, 2009. Effectively, fifteen (15) months of additional charge capture reimbursement will be lost after December 31, 2010.

M*D Resources provides a “best practice” solution that will help quickly and efficiently identify additional revenue at no risk to the client organization, thus maximizing the retroactive reimbursement opportunity before the December 31, 2010 deadline. Using proprietary technology and a process which reviews all claims that have the potential for additional Ambulatory Payment Classification (APC) reimbursement, we are able to identify suspect claims, review and provide client organizations with a revised claim for billing. All work is non-intrusive and are done on a contingency fee basis with no risk to the organization.

If you have client organizations and/or colleagues that would be interested in taking advantage of this opportunity, please let us know. We will generate an All Payer Audit—Impact Analysis for each hospital by using the facility’s publicly available data. The impact analysis estimates the potential CASH opportunity that our seasoned team of professionals can assist your client organizations and/or colleagues in pursuing.

Please let us know if you have any questions or would like to receive additional information on this opportunity.

559-447-4488