REIMBURSEMENT SERVICES | FINANCIAL REPORTING | OTHER SERVICES
The Business Professionals Choice for Strategic Healthcare Decisions
Hospital Management Services (HMS) is a financial consulting firm, based in Southern California Since 1969, HMS has provided services to over 175 acute and skilled nursing hospitals, ranging in size from 13 beds to 2000 beds, as well as Home Health Agencies.
HMS has provided its clients with a wide variety of financial and reimbursement expertise in such areas as:
- Preparation of the facilities required Medicare and Medi-Cal (Medicaid) cost reports,
- In California, preparation of the facilities required Office of Statewide Health Planning and Development (OSHPD) annual disclosure report,
- Evaluate and recommend changes, where appropriate, to the facilities chart of accounts for functionality and (in the case of California) compliance with OSHPD requirements,
- Provide recommendations in the regular gathering of pertinent data to best evaluate the over or under payments on a monthly basis under the government programs,
- Provide guidance as to the financial and statistical information to be gathered on a monthly basis in conformity with government requirements for reporting purposes,
- Evaluating insurance carrier payments to cost incurred in aiding hospitals in contract negotiations,
- Provide the logging of bad debts for reimbursement under the Medicare program,
- Provide scrutiny and scrubbing of hospital generated Medicare bad debt logs in an effort to secure the greatest possible reimbursement,
- Assist hospitals in obtaining and evaluating from the State a listing of patients who represent a disproportionate share (DSH) of indigent patients under the Medicare program in obtaining additional reimbursement,
- In the area of wage index requirements to the Medicare program, we either provide evaluation of the information provided us by the facility or in the logging of that information on a monthly basis for reporting to Medicare,
- Cost to charge ratio analysis is helpful to our clients in their evaluation of pricing as well as cost report analysis,
- Upon completion of cost report preparation and after the intermediary has completed its tentative settlement of the cost report, we scan all of our work papers into a digital format and place a copy onto a CD and provide that to our client for their future use.
- When we learn of a Medicare or Medi-Cal audit starting, we provide that auditor with a CD copy of the cost report work papers thus aiding in an effort to minimize questions to the client staff.
- We assist hospitals in both qualifying for and in the maximizing of their potential reimbursement within the program of Medi-Cal DSH.
- For those hospital clients who are not contracting with the State of California we evaluate and provide financial guidance to the Medi-Cal Peer Group Inpatient Reimbursement Limitation (PIRL) calculation.
- Where there is a disagreement in the intermediary’s interpretation of a government regulation we assist, and where necessary, file on behalf of our client an appeal to the appropriate government body.