|HRRG specializes in the identification, analysis, and settlement of Medicare
and third party reimbursement issues for healthcare providers. Through
innovative and unique systems, we identify opportunities for additional
reimbursement to which the provider is entitled. Working closely with our
clients, we resolve their issues and obtain final settlement. We have
developed an exclusive results-oriented review process for third party cost
reports, which encompasses the following qualities:
Our reviews are done in accordance with the Medicare regulations and
supported by proper documentation. As a result, our clients have not had to
refund any of the millions of dollars, which we have recovered for them.
The attached Confidentiality Agreement details the duties and responsibilities
of both parties to ensure the protection of confidential information. In addition,
the attached Fee Agreement specifies that the provider’s approval will be
obtained before any reimbursement item is discussed with the intermediary.
Professional Expertise and Experience
Our staff has an average of 20+ years of Medicare reimbursement experience,
which includes hospital, intermediary, Big Four public accounting, and
independent consulting. We have extensive knowledge of the following:
- Medicare laws and regulations.
- Cost report preparation, reviews, and reopenings.
- Cost report appeals, including resolutions with the intermediary, preparation
of position papers, and representation before the PRRB.
- SNF and excluded-unit requests for exemptions, exceptions, and TEFRA
- Disproportionate Share Hospital (DSH) reimbursement.
- Hospital-based physician reimbursement.
This expertise and experience enables our staff to more readily identify
additional reimbursement, to which the provider is entitled.
Our review process, which identifies “lost” reimbursement, is so effective that
we will perform our professional services on a contingency basis. If our review
does not result in additional reimbursement, your hospital incurs zero costs.
The fee for our reimbursement increases is due only after the final settlement
is paid by the third party payor.
Our review will not be disruptive to your hospital’s operations or staff. We will
need only the provider’s Medicare cost reports, which are subject to reopening
(three years from the date of the NPR), including supporting workpapers, which
were used in their preparation. For those cost reports, which have been
audited and finalized by the intermediary, we will also need to review the
intermediary’s adjustments and supporting workpapers. We can perform the
review at our office or on-site. After our review is complete, we will discuss our
findings with the hospital’s designated staff.
We perform all the services throughout the reopening and appeal processes,
- Research of the regulations.
- Discovery and verification of documentation, including detail-oriented and
time-consuming analyses, Medicare logs, PS&R, contracts, and invoices.
- Preparation of all supporting workpapers and correspondence, including the
reopening request and position paper.
- Representation before the intermediary and PRRB.
- Validation of the final settlement.
Throughout these processes, we discuss our findings and recommendations
with your staff.
As a result of our unique review process, all of our “contingency fee” clients
have received additional reimbursement, with a range from a high of greater
than $11,000,000 to a low of approximately $125,000.
We request the opportunity to determine whether your hospital is entitled to
additional reimbursement. Enclosed are two sets of the Fee Agreement and
Confidentiality Agreement for your consideration. Should the hospital decide
to utilize our services, you can complete, sign, date, and forward the
agreements for our signature. After we sign each agreement, we will return
one original of each document for the hospital’s records. Our address and
phone number is as follows:
17 Coachlight Drive
Millstadt, Illinois 62260-1801
Thank you for your time and consideration. If you have any questions
regarding our reimbursement services or would like to arrange a meeting,
please contact Gene Boron, President, at (618) 476-3715 or firstname.lastname@example.org.