Our Medicare DSH review process is a comprehensive approach to ensuring that every eligible Title XIX day has been reported with the proper verification and documentation...
Read MorePRS will provide quarterly, semi-annual or annual verification and documentation of Medicaid eligible days...
Read MorePRS has developed an audit tested process for accumulating actual Medicaid paid and unpaid eligible days that are to be reported on the Medicare cost report...
Read MoreCMS RULINGS - HCFAR 97-2-4
Substantiation of Days Claimed
"As the intermediaries may require, hospitals are responsible for and must furnish appropriate documentation to substantiate the number of patient days claimed."
Continue Reading...CMS RULINGS - HCFAR 97-2-4
hospitals burden of proof
"The hospitals bear the burden of proof and must verify with the State that a patient was eligible for Medicaid (for some covered services) during each day of the patient's inpatient hospital stay."
Continue Reading...Danbury Hospital v. Blue Cross Blue Shield Ass'n
DSH MEDICAID eligible days documentation
"A detailed description of the process that the provider used to identify and accumulate the actual Medicaid paid and unpaid eligible days that were reported and filed on the Medicare cost report at issue."
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