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. Our process has increased Medicare reimbursement to our client hospitals ranging from $200,000 to $2,500,000 per year. Additionally our process has preserved DSH reimbursement for Hospitals who don’t have an internal process to identify Medicaid days to report on the submission of the Medicare Cost report.
Since 2005 PRS has provided to hospital and health systems the solution to the question,
”How can I be sure my Hospital is receiving the appropriate Medicare DSH reimbursement?”
The PRS DSH review process incorporates both electronic and “hands on” components to assure every Medicaid eligible day is identified, verified and documented. Thus the Medicaid days claimed on the Medicare Cost report are appropriately documented as required by CMS.
PRS will provide quarterly, semi-annual or annual verification and documentation of Medicaid eligible days – paid and unpaid.
PRS 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 for hospitals that prefer to do this in house. We will train hospital staff in our proprietary process and provide assistance as needed.