Strategic reorganization and redesign of the operations reimbursement and cost reporting divisions for organizations including of three of the nations largest healthcare providers.
Develop and implement standard policy, procedures and effective third party government compliance programs. Pre/Post file reviews, audits, standardized work papers, standardized effective requests for information, yearly event planning.
Strategic/Defensible pricing and outlier analysis. OIG/DOJ investigation assistance and shadow audits. Corporate Integrity Agreements/IIndependent Review Organization.
Medicare/Medi-Cal and OSHPD cost report preparation and review, appeals, rate setting. Disproportionate Share Reimbursement, IME/GME, Wage Index, Geographic Reclassifications, Volume Decline Studies, Bad debt assistance, organ acquisition and all other aspects of reimbursement from both the Federal and State Governments.