Updated: 3/2/2006

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by Healthcare Business Specialists
 
 

                                            

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Consulting Services

 

Cost Report Preparation (Form 222)

HBS will prepare your RHC cost report in compliance with all regulations and maximize reimbursement from Medicare and Medicaid.  Last year we prepared over 100 cost reports for rural health clinics and we have been preparing Medicare cost report for 20 years.  All work is done by Mark Lynn. No junior accountants are assigned to your cost report. 

These reports must be prepared annually to ensure accurate reimbursement for the clinic.  HBS will prepare the Medicare and Medicaid cost reports, Medicare workpapers, and Form 339 Questionnaire as aggressively and accurately as possible under current Medicare regulations.

HBS will also work with intermediaries to resolve any differences concerning the Medicare and Medicaid cost report at no additional cost to the clinic and we will answer any questions that management may have concerning Medicare and Medicaid reimbursement during the year.

We will train your staff on cost reporting and billing by allowing the clinic to send two people to any of our 8-hour seminars.  You get a total of 16 hours training per calendar year.  This service is worth $850.00 (we charge $425.00 for one of our 8 hour seminars) and can not transferred to anyone outside the employment of the clinic.  It is not transferable in any form to a third party.

We will deliver to you all copies of the cost report, 339 Questionnaire, and workpapers ready to file and copies for your records. You simply sign the forms and mail to the intermediary.

Cost Report Contingency Reviews

HBS will review previously filed cost reports to determine if your cost report has been accurately completed.  If we can recoup money from Medicare or Medicaid, we receive a percentage of the money recovered.  If we find nothing; there is no charge and you receive a free benchmarking report comparing your clinic to other clinics in our database. 

        Key Benefits

  • No professional fee unless you benefit
  • Last chance to generate settlement from Medicaid
  • Peace of Mind - knowing you have optimized reimbursement
  • Potential Compliance issues exposed

 

RHC Start-Up Services

HBS will provide consultation which will result in converting a physician practice into a rural health clinic.  Some of the issues covered in our consulting are as follows:

                                    Compliance with Federal, State and Local laws

                                    Physical plant and environment review

                                    Review of organization structure

                                    Review of staffing and staff responsibilities

                                    Provision of appropriate and necessary medical services         

                                    Patient Health records

                                    Utilization review and program assessment

                                    Applicable policies and procedures

Typically, the RHC startup is accomplished with 2 to 3 onsite visits and training sessions including attendance at RHC Update and 101 seminars. HBS completes the 855, State Applications, and produces a policy and procedure manual for it's RHC Startup clients.

Annual Evaluations

The annual evaluation report and process is required to be in compliance with Federal Medicare regulations for Rural Health Clinics. In particular the CFR cites the following regulations which this annual evaluation process fulfills:

  The clinic carries out, or arranges for, an annual evaluation of its total program.

  The evaluation includes review of:
       1. the utilization of services, including at least the number of patients served and the volume of services;
       2. a representative sample of both active and closed clinical records; and
       3.  the clinic's health care policies.

 The purpose of the evaluation is to determine whether:
       1. the utilization of services was appropriate;
       2. the established policies were followed; and
       3. any changes are needed.

The clinic staff considers the findings of the evaluation and takes corrective action if necessary.

Healthcare Business Specialists prepares the annual evaluation by making an onsite visit and obtaining the following information:

1. The latest financial statements for the clinic including the profit and loss statement.
2. The latest Patient visit report including a frequency report which enumerates the CPT codes.
3. The Charge Master for the clinic
4. The last filed cost report.
5. Please have the policy and procedure manual ready to be reviewed onsite.
6. Please have 10 active charts and 5 inactive or closed charts available for review on-site.

The deliverable of the project will be the Annual Evaluation Report which is approximately 20 pages long and includes the following sections:

Introduction
Service Area Defined
Annual Evaluation Committee
Annual Evaluation Procedures
Conclusion
Appendix A - Annual Evaluation Review of Medical Charts
Appendix B - Annual Evaluation of the Job Performance of the Office Manager
Appendix C - Annual Evaluation of the Job Performance of the Nurse Practitioner
Appendix D-Annual Evaluation of Office Policy & Procedures

 

National Health Service Corp Reporting Services

The National Health Service Corp (NHSC) requires a Uniform Data Set (UDS) to be completed 45 days after the end of the year.  This report is rather lengthy and is complicated.  HBS will prepare the report and file the report in a timely manner.

 



















 

 

 

 

 

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