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Today’s
healthcare providers are faced with complex business challenges. As the
urgency to increase cash flow mounts and the pressure to improve the bottom
line grows, the challenge is greater than ever before. As you are aware,
your reimbursement can be impacted in a number of different ways. The
Rybar Group has designed services to assist you in navigating the complicated
maze of payment regulations.
Click a topic to go to that section:
Cost
Report Reimbursement Review (top
of page)
The Rybar Group consultants are dedicated to assisting you in the preparation
and filing of your current year cost report. They will spend time onsite
at your facility, reviewing your supporting documentation, and making
recommendations where opportunities are revealed. In addition, our consultants
are available to review your prior year Medicare, Medicaid, and Blue Cross
cost reports, and can assist in the preparation of workpapers and negotiation
with third-party payors. Through the use of our cost report review, you
will be assured that the latest changes in Hospital operations will be reflected
in filed cost reports, a list of all potential reimbursement methodology
changes will be compiled, and optimized reimbursement amounts will be
achieved, all at a savings of time and effort by your staff.
Appeal services are available, including analysis and preparation of cost report appeals, TEFRA Exception Requests, Renal Exception Requests, MGCRB Reclassification Requests and Sole Community Low Volume Adjustment Requests.
Blue
Cross Payment Negotiation (top
of page)
The complexities of the BCBS payment negotiation process creates the need
for a high level of expertise to help obtain appropriate payment levels.
Our many years of experience and successful negotiation skills are utilized
to assist our clients in working through the process. Specific services
include the analysis of Blue Cross audit adjustments, development of documentation
and workpapers to support Hospital positions, assistance in or direct
negotiation with BCBS staff and management, and guidance on potential
opportunities based upon the negotiation.
Disproportionate
Share Review
(top
of page)
Verifying DSH eligibility can be a time-consuming and tedious task. The
Rybar Group recognizes the work involved in such an assignment, and has
developed programs to assist Hospitals in this area. Ensuring that your
facility is properly reimbursed for the services that you provide, and
for the criteria DSH that you meet, are some of the various services that
we specialize in. We have assisted several urban and rural Hospitals in
obtaining payment as a result of meeting the eligibility threshold for
DSH payments. The Rybar Group has the resources to provide your Hospital
with the same support. Click here for more information...
Sole
Community Hospital and Medicare Dependent Hospital Status
(top
of page)
The Rybar Group can prepare an application for Sole Community Hospital
status consistent with the applicable Medicare regulations for your facility.
Before beginning the application process, our consultants will analyze
the financial impact of your facility becoming a Sole Community Hospital,
providing you with a summary of this impact. Any negotiation with relevant
United Government Services (UGS) and Medicare management over the application
will be handled by consultants experienced in this area. We will follow
through with the PRRB appeal process where applicable. Upon successful
completion of the application, your Hospital can realize increased reimbursement
amounts for Medicare purposes.
Financial
Analysis and Assistance (top
of page)
Another “pair of hands” is available to perform those analyses
that healthcare providers may not have time or expertise to prepare. These
include:
- Development of feasibility analyses on proposed projects.
- Contract Analsys
- Preparation of budgets, forecasts, and projections.
- Reimbursement and payment analysis assistance with preparation of cost reports, third-party audits, and negotiation over reimbursement issues.
Tricare/CHAMPUS
Reimbursement
(top
of page)
Our team of professionals will review indirect medical education and capital
payments to determine if reimbursement amounts from CHAMPUS are accurate.
Strategic
Pricing Analysis
(top
of page)
Positive bottom line impact can be achieved from appropriate pricing of
Hospital procedures and analysis of departmental revenues. Our computerized
revenue system permits us to enhance Hospital net income by using provider-specific
payor and procedure mix in the rate setting process. The result is a summary
of the procedure/pricing recommendations that can enhance your net revenue
by as much as 1% to 2%.
Square
Footage Allocation
(top
of page)
New construction, additional leasing, reallocation of space. These are
continuous processes for healthcare organizations as they grow and change.
Compliance with Medicare reporting requirements necessitates annual reviews
of square footage allocations.
Home
• Clinical Coding • Cost
Reporting • Physician Services •
Patient Financial Services
Data Assessment Services •
Compliance • Rural
& Critical Access Hospitals • Management
DSH Review • Low
Volume Adjustment • Career Opportunities
• Education
• Contact
Us
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