Provider Reimbursement Enterprise Services
Our professionals help deliver reimbursement solutions that impact the overall strategy and operations of your healthcare organization.
Provider Reimbursement Enterprise Services
Optimizing your organization’s reimbursement requires a deep understanding of the cost report and coordination across people, systems, and processes.
As you navigate Medicare and Medicaid’s ever-changing landscape, our professionals can deliver reimbursement solutions that support the overall strategy and operations of your healthcare organization—whether you’re looking for full enterprise outsourcing solutions, or help in a specific area.
Spotlight
What to know about Medicare bad debt
Learn what you need to know about Medicare bad debt and how you can help your hospital navigate reporting challenges.
CMS Transmittal 18: Medicare DSH, Worksheet S-10, and bad debt reporting
The Centers for Medicare & Medicaid Services (CMS) issued Transmittal 18 requiring more data, and not preparing could hurt reimbursement.
How to choose a qualified Medicare reimbursement partner
Explore key attributes hospital providers should consider to select the right partner for Medicare reimbursement and consolidate activities with one firm.
Our full enterprise support includes:
- 340B Program-related services
- Medicaid eligibility matching, including identifying patients eligible for medical assistance under state-approved plans under Title XIX for inclusion in the as-filed Medicare cost report
- Medical education programs
- Medicare and Medicaid cost reimbursement
- Medicare bad debt logs
- Medicare cost report and DSH appeals
- Medicare Disproportionate Share Hospital (DSH) reimbursement analysis for initial cost report filings and retrospective reviews
- Medicare Organ Acquisition & Transplant Programs
- Outsourcing & Staff Augmentation
- Provider-based licensure and certification
- Rural reimbursement support
- SSI ratio recalculations
- Volume Decrease Adjustment reimbursements
- Wage index reviews
- Worksheet S-10, including bad debt and charity care reporting for uncompensated care
In addition to staying alert to the latest regulations, our professionals have a deep understanding of how the operations of your organization, whether revenue cycle operations or billing practices, impact reimbursement.
We deliver insight on areas including:
- Revenue cycle processes such as payer mix management, charge master, and billing
- Regulatory interpretation of federal and state provider-based and outpatient service line assessments
- Clinical pathway reviews for inpatient and outpatient service lines
- Application of overhead rates including indirect cost for federal grant funding, managed care plans, and the correlation to FFS calculations
Featured case studies
Navigating changes to Medicare skilled nursing facility reimbursement rates
Explore key updates in the FY 2026 SNF Proposed and Final Rule and how Baker Tilly helps providers navigate Medicare skilled nursing facility reimbursement rates.
Urban hospital reclassifies as a Rural Referral Center to secure additional $2 million in drug expense savings
This case study highlights how Baker Tilly helped an urban hospital reclassify as a Rural Referral Center to secure additional Medicare reimbursements from the 340B Drug Pricing Program.
Hospital combination yields additional $3 million in Medicare DSH and reimbursements
This case study highlights how Baker Tilly helped two hospitals combine to secure an opportunity to receive an additional $3 million in Medicare DSH and uncompensated care reimbursements.
Rural hospital draws $1.8 million in annual Medicare reimbursements through status change
This case study highlights how Baker Tilly helped a rural hospital lock in an additional $1.8 million in annual Medicare reimbursement payments.
Health system optimizes Medicare reimbursement rate by reclassifying hospitals
This case study highlights how Baker Tilly helped a health system reclassify select hospitals to maximize their Medicare reimbursement rates.
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