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:
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.
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.
