Turning Transactional Reimbursement into Strategic Value

Today’s transformative environment demands that providers reimagine their traditional reimbursement functions. No longer a tactical process, the reimbursement function has emerged as a strategic advantage for forward-looking organizations of all sizes. To unlock that strategic advantage, leaders must develop lasting processes and strategies to meet not only regulatory compliance requirements, but also play critical roles within the organization's overall strategy and change management.

DHG Healthcare’s Complete solution set is designed to come alongside organizations of any scale with both the expertise to navigate complex technical issues and the capacity to meet regulatory and compliance challenges of any size. This combination is unique to DHG Healthcare, allowing us to be a trusted guide to your organization.

HOW WE SERVE

Our approach to serving our clients with cost reporting and compliance services is to work with each healthcare entity and/or health system as an extension of your organization. In order to provide this level of service, we have assembled a team of professionals whose entire focus is preparing and reviewing cost reports. This level of specialization has provided us with an extensive base of technical knowledge, industry experience and relationships with key stakeholders to leverage throughout the process. We believe the cost report is an important output for every hospital for both meeting regulatory and compliance requirements as well as for enhancing reimbursement.

DHG Healthcare is an industry leader in Medicare/Medicaid DSH reimbursement solutions . We utilize high powered data analytic platforms coupled with a proprietary process to improve DSH reimbursement for our clients across the nation. With over 30 years of DSH reimbursement experience, DHG Healthcare has developed direct working relationships with nationwide key stakeholders at the state and federal levels, which enable us to meet your DSH compliance requirements, improve your DSH reimbursement and support you through any applicable appeal or re-opening process.

DHG Healthcare has a devoted Medicare bad debt team comprised of a core group of professionals responsible for preparing Medicare bad debt logs, monitoring key relevant regulatory developments and provide Medicare audit and appeal-re-opening assistance for clients that range from small independent hospitals to national healthcare corporations. This level of specialization allows our team to focus on providing the highest level of service while utilizing next generation data analytic platforms that incorporate data from multiple sources combined with a proprietary process to complete the logs to help with compliance as well as improve reimbursement.

DHG Healthcare has a devoted Wage Index team comprised of a core group of professionals responsible for monitoring key wage index developments and leading our assessment engagements. Our Wage Index team’s combined experience covers nearly 170+ cities and includes providing services to the largest Core-Based Statistical Areas (CBSAs) in the country, entire state rural CBSAs, as well as individual hospitals. Our approach in these engagements is extensive, focused on obtaining a detailed and complete understanding of the provider’s current and historical organizational and operating structure and systems, which enables a more insightful assessment into the underlying wage data and provides an ability to identify meaningful and value-added corrections for an improved determination of the provider’s average hourly wage, and subsequently the area’s Medicare wage index.

We assist hospitals with feasibility analyses, education and implementation of medical residency programs. We utilize a phased approach, which can be tailored specifically to your needs, that includes but is not limited to, a preliminary assessment and roadmap, creation of financial analyses, identification of necessary business resources and assistance with a broad array of services, including project management to guide your organization through implementation. Our depth of knowledge regarding Medicare/Medicaid reimbursement regulations combined with our specific medical residency experience uniquely positions DHG Healthcare to serve our clients in this niche area of healthcare programming.

DHG Healthcare assists providers in understanding the complex regulatory, reimbursement and operational considerations related to provider-based status for physician practices, hospital outpatient departments and rural health clinics.  Our involvement includes financial assessments, regulatory gap analysis, transition advisory services, assistance with design and structure as well as revenue improvements.  Our highly specialized team also provides accreditation awareness and identifies compliance risks associated with provider-based status.

DHG Healthcare serves organizations throughout the country by utilizing a specialized team. Our deep technical expertise along with our sophisticated, accurate and extensive CMS data modeling capabilities allow us to further assist our clients in the area of Medicare special designations and geographic reclassifications. This team continuously monitors regulatory changes and works closely with legal consultants to monitor the ever-changing legal and regulatory landscape in this area. Utilizing this approach, we creatively identify, design and facilitate implementation of unique scenarios that often result in significant Medicare revenue enhancement for our clients with offerings such as: Medicare geographic reclassification and designations (i.e., Section 401), Medicare special designations (i.e. SCH, MDH, RRC, CAH) and provider consolidation and merger assessments.

We will assess all aspects of the hospital’s kidney, liver and lung transplant programs that affect cost reporting and proper Medicare reimbursement.  We will examine specific components, including direct costs, overhead allocations, organ acquisition costs, counting of organs, Medicare Secondary Payer (MSP) organs, split of pre-transplant versus post-transplant services, cost report reclassifications and adjustments and time studies.

EXPERIENCE

DHG Healthcare Complete solution set is delivered by over 50 professionals focused solely on Medicare and Medicaid regulatory and compliance advisory services. This scale and expertise are the reason we have established long-standing relationships with respected hospitals and health systems throughout the country. We augment this core group with specialists in areas across the reimbursement spectrum. Functioning as a single centralized team, our deep expertise and purposeful engagement management approach powers an impactful engagement experience marked by consistency, collaboration and accountability.

We believe today’s transformative environment demands that providers reimagine their traditional reimbursement functions. No longer a tactical process, the reimbursement function has emerged as a strategic advantage for forward-looking organizations of all sizes. But to unlock that strategic advantage, leaders must develop lasting processes and strategies to meet not only regulatory compliance requirements but also play critical roles within the organization's overall strategy and change management.