Reimbursement Specialists For:

Medicare & Medicaid Cost Reports

Financial Consultants of Alaska & Washington has highly qualified healthcare reimbursement consultants with extensive experience in preparing Medicaid and Medicare Cost Reports. Our firm has prepared CMS annual cost report for Acute Care, Long Term Care, co-located, Critical Access, facilities as well as Rural Health & Federally Qualified Health Clinics, Home Health Agencies, and Community Mental Health Care Centers. We have prepared more than 300 cost reports. We also prepare the Medicaid cost reports in several states. In conjunction with preparing and filing the cost report are reviews and responses to Medicare on the proposed audit adjustments

FCA&W prepares interim cost reports to assist a facility in making changes during the year.

Our firm can review the cost report filed by you or your consultant to look for improvements in Reimbursement or omissions.

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Critical Access Reimbursement

Our firm has specialized in assisting facilities with obtaining their Critical Access Designation, and obtaining the best billing method from Medicare (option II).

For critical access facilities, the cost report strategy for higher reimbursement largely depends on where statistics, revenue, and cost are recorded. Our firm has assisted hospitals in achieving the highest reimbursement on interim rates and cost reports. Common error counting observation in Emergency or Labor & Delivery. Our vast knowledge of rural and community hospitals has proven beneficial in improving facility’s bottom line. Our firm is willing to review your last cost report and highlight areas that can improve your reimbursement.

CGI Federal, Inc. - Medicaid RAC Audits. Leads off with critical access hospital in the State of Washington.

Critical Access facilities need to place emphasis on the Medicare interim reports. The purpose of the reports is to have Medicare pay your claims throughout the year, a rate that parallels the year end cost report rate. If a facility has a large receivable from Medicare on the cost report, they have lost the use of the money and the interest it would have accrued. On the other hand, if the facility owes a lot of money to Medicare at year end, their reserves may not be adequate to cover payback unless they develop a model that is updated quarterly.

Medicare allows Critical Access facilities to perform mini cost reports step downs to send in with the interim reports. This will give you the assurance that your quarterly rates will closely approximate the cost report payments.

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Financial Feasibility

FCA&W can increase your bottom line with the following:

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Certificate of Need (CON) Projects

Our firm has worked on many CON projects and testified for facilities to assist them in receiving the status or blocking other entities from not being held to CON requirements.

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Indian Health Services

Our study of Medicaid & Medicare claims reimbursement indicates that many IHS facilities are suffering from a high denial rate on total claims submitted. Our preliminary review suggest that many IHS facilities denial rate may be as high as 55%. FCAW can view and analyze your denied, pended and returned claims, and non paid claims. Our firm will assist your facility with resubmission within regulatory time frames. FCAW has successfully completed projects that improved a facility’s bottom line by over $1,000,000 a year. Our firm provides training and reviews for improper claims that could otherwise lead to unnecessary fraud audits and paybacks.

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Rural Health Clinics

Financial Consultants of Alaska & Washington has created financial feasibility models to determine the advantage of changing to freestanding or provider based clinic status.

Swing Bed

Our firm has performed feasibility studies to highlight reimbursement opportunities of swing bed reimbursement versus long term care payments under RUG scoring. Swing bed reimbursement for critical access facilities is cost base and there may be a significant benefit to converting some beds to swing bed status.

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