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: Integrity 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. Confidentiality 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 rebasings. - 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. Cost Effectiveness 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. Efficiency 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. Completeness We perform all the services throughout the reopening and appeal processes, to include: - 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. Results-Oriented 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 (618) 476-3715 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 ejb@hrrg.org. |
Contact Us: 618-476-3715 |