Services

An annual evaluation or program evaluation is one of the eight required conditions of participation that all rural health clinics must meet. Healthcare Business Specialists can assist you in completing this process. This is from the Rural Health Clinic Interpretive Guidelines: "An evaluation of a clinic's total operation including the overall organization, administration, policies and procedures covering personnel, fiscal and patient care areas must be done at least annually. This evaluation may be done by the clinic, the group of professional personnel required under 42 CFR 491.9(b)(2), or through arrangement with other appropriate professionals."

We will come onsite and conduct a mock inspection of the facility, review the policy and procedure manual and supporting documentation that the clinic is following policy, review open and closed medical charts in compliance with the regulations, and issue a comprehensive report regarding the results of the annual evaluation. Additionally, we will review clinic utilization, CPT Code Frequency, Denials, EOBs, and chargemasters to determine if the clinic is charging, billing, and collecting the proper amounts from patients, insurance, Medicare and Medicaid.

The annual evaluation can be accomplished in about a 1/2 day of onsite time and we will present any findings at a meeting at the clinic. This process will eliminate receiving a condition level deficiency when the State inspectors arrive and will help you to evaluate the adequacy of billing process. As a part of the reporting; we will review your expenses to benchmarks of other rural health clinics in our database of rural health clinic cost reports. This report will help you to determine how efficient your clinic is operating in comparison to other rural health clinics. If you would like to see what a sample report would like; follow the link:

2010 Sample Annual Evaluation Report

Electronic Medical Records Stimulus Payment Consulting

If you’re like most rural health clinic administrators the $64,000 question is “How do I get my share of the Electronic Medical Records Stimulus funds?” That question is going to lead to “Do I take the Medicare stimulus monies or the Medicaid funding?” which is going to lead to “Do I even qualify for the payments and what does “meaningful use” mean and how do I demonstrate that we are meaningful users and get my hands on the electronic medical records stimulus funds. It is easy to see why it can be confusing and how much is riding on the correct information.

Healthcare Business Specialists has experience in grant writing and grant administration, Uniform Data Set reporting requirements of the National Health Services, implementation of Quality Improvement plans, and preparation of rural health clinic cost reports. All these skills help us to be prepared to help you navigate the minefields related to the Electronic Medical Records stimulus payments.

Cost Report Preparation (Form 222)

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

We provide a 150-page cost reporting book (a $100 value) that has all the forms and organizes the cost report information so that it can be easily filed.

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.

If your rural health clinic is not above the Medicare reimbursement maximum of $77.76 for 2010; then, you should consider having us prepare your cost report. Last year 100% of our clients were at or above the reimbursement cap and the cost reports were filed conservatively as we did not have a single cost adjustment in our cost reports. Our recent refilings and contingency work has indicated that a number of clinics are not getting the maximum reimbursement rates and it is not due to low costs. It is due to incorrectly prepared cost reports. We have been working with Medicare and Medicaid cost reports since 1981 or 29 years of experience. That experience has proven results. HBS has recovered over $500,000 in lost Medicare and Medicaid reimbursement by re-filing Medicare and Medicaid cost reports. We can look at the previous year's cost reports on a contingency basis and if we will only be paid if we find something. The fee is 25% of the Medicare increased reimbursement when it is credited to your account. If you are below the cap it just makes sense to have your cost report reviewed. Even if we do not find increased reimbursement; we will send you a free benchmarking report comparing how your clinic compares to other clinics in physician compensation, charges per Medicare visit, reimbursement per Medicare visit, physician visits, NP visits, PA visits, Flu shot reimbursement, pneumococcal reimbursement, and other key operating variables of a rural health clinic.

Professional Staff

One of the benefits of working with Healthcare Business Specialists is that all cost report work will be performed by Mark R. Lynn. He has worked for almost thirty years as a health care consultant and Certified Public Accountant (CPA) for rural health clinics, physicians, and hospitals.

Cost Report Contingency Reviews

If your rural health clinic is not above the Medicare reimbursement maximum of $77.76 for 2010; then, you should consider having us prepare your cost report. Last year 100% of our clients were at or above the reimbursement cap and the cost reports were filed conservatively as we did not have a single cost adjustment in our cost reports. Our recent refilings and contingency work has indicated that a number of clinics are not getting the maximum reimbursement rates and it is not due to low costs. It is due to incorrectly prepared cost reports.

We have been working with Medicare and Medicaid cost reports since 1981 or 29 years of experience. That experience has proven results. HBS has recovered over $500,000 in lost Medicare and Medicaid reimbursement by re-filing Medicare and Medicaid cost reports. We can look at the previous year's cost reports on a contingency basis and if we will only be paid if we find something. The fee is 25% of the Medicare increased reimbursement when it is credited to your account. If you are below the cap it just makes sense to have your cost report reviewed.

Even if we do not find increased reimbursement; we will send you a free benchmarking report comparing how your clinic compares to other clinics in physician compensation, charges per Medicare visit, reimbursement per Medicare visit, physician visits, NP visits, PA visits, Flu shot reimbursement, pneumococcal reimbursement, and other key operating variables of a rural health clinic.