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WHAT OUR CLIENTS SAY

“HFS served as my reimbursement department and also performed some other projects including Medicaid and Medicare, cost reports. HFS improved the quality of the product.

We had less than a week to turn around a situation that had to do with a filing date with Medicare and if we missed that date we’d miss an opportunity to recover funds. HFS turned it around and did it right away and recouped the money. They were available right when I needed them.”
– Southern California
Hospital CFO
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John Pfeiffer
John Pfeiffer

Partner
Reimbursement and Government Programs

John Pfeiffer has worked in health care reimbursement and finance since 1985, with specific expertise in Medicare and Medicaid, operations, and budgeting and forecasting.

Optimize Returns

Reimbursement Services and Government Programs


We provide a comprehensive portfolio of Medicare/Medicaid reimbursement services from individual products to complete outsourcing of the government programs function.


Services

Our team is made up of seasoned professionals with some of the best credentials in the industry. We focus on customer service while demonstrating a robust and comprehensive compliance program. We provide:

  • Medicare/Medi-Cal preparation, review, appeals and rate setting
  • OSHPD cost report preparation, review, appeals and rate setting
  • Appeals; rate setting;
  • Disproportionate Share Reimbursement (DSH)
  • IME/GME
  • Wage Index
  • Geographic Reclassifications
  • Volume Decline Studies
  • Bad Debt Assistance
  • Organ Acquisition and
  • All additional aspects of reimbursement from both the federal and state governments

Wipfli/HFS prepares annual Medicare, Medicaid and OSHPD cost reports to claim the full reimbursement due to the hospital and other health care providers. These reports have an impact on the reimbursement levels and compliance positions of providers.

Working closely with clients, we offer a clear understanding of the reimbursement issues they are facing. Throughout the year we maintain contact and are able to:

  • Review payments
  • Advise on cost report settlements
  • Respond to data requests from government auditors and work with them on proposed adjustments
  • Advise on circumstances affecting reimbursement and compliance
  • Defend against adverse or improper audit adjustments
  • Provide representation to Medicare and other authorities through the audit and appeals process, or through legal means

Cost Report Preparation

We have been preparing cost reports since 1991 when we opened our doors for business. Our cost report preparation process is efficient, effective and high quality. We minimize client involvement in collecting data as much as possible, and remain in frequent communication during the cost report preparation process.

Medicare Wage Index

The Medicare Wage Index review determines the level of Medicare reimbursement. Inaccuracies in wage and benefit data can be extremely costly to hospitals and health care organizations.  Since 2008, our Medicare Wage Index findings have increased revenue to our clients by over $135 million, generating an average return on investment of 30 to 1.

We offer our clients an interactive tool that delivers real-time benefit updates and offers education and best practices for wage index reporting. This secure wage index client portal  (LINK to Wage Index Portal) provides a state-of-the-art method for our team to interact with clients, provide updates on changing regulations and present detailed instructions and tips for reporting wage index information on the Medicare cost report.

Medicare Disproportionate Share Hospital Payments

Our goal is for our clients to obtain their entitled Medicare disproportionate share hospital (DSH) payments, and also to maximize additional Medicare DSH reimbursement. We stay current on the continually changing hospital payment systems and compliance issues related to Medicare DSH payments. Our consulting services include the necessary research and investigation to pursue the Provider Reimbursement Review Board hearing process when necessary on behalf of hospitals of various sizes. 

Graduate Medical Education

With the anticipation of a nationwide physician shortage, hospitals are becoming more involved in graduate medical education (GME) and are working to create or expand their programs for residents. One of the challenges they face is the limitation in federal reimbursement. Wipfli/HFS has extensive experience in GME and works with clients to provide a comprehensive analysis of operating and reimbursement areas. We work with academic medical centers and large teaching hospitals to:

  • Maximize reimbursement
  • Improve compliance and documentation processes
  • Facilitate planning for future expansion

We have managed projects involving the planning and budgeting for new GME programs, documentation process assessments, educating finance and clinical leaders, development of Medicare affiliated group agreements, , and assistance with the development of a rural track program.

Experience

Our team has been preparing reports since 1991 when HFS Consultants was founded. We have comprehensive knowledge of reimbursement principles and systems as well as keen insight into Medicare and Medicaid rules and guidelines.

We are the only firm that has the expertise to assist your entire portfolio of providers, from large academic medical centers to small Critical Access Hospitals, RHCs and post acute providers.  

Engagements

  • Complete outsourcing of the reimbursement department at Hollywood Presbyterian Medical Center
  • Successful review of California’s Rural Floor, providing wage index, resulting in over $60M in increased inpatient Part A reimbursement to California Rural Floor recipients
  • Expert witness testimony on behalf of an FQHC relating to Medi-Cal program reimbursements
  • Strategic redesign of the reimbursement functions for one of the nation’s largest health care systems
  • Individual hospital cost reports, DSH, wage index and other core reimbursement services for over 100 hospitals, large and small, annually

 

 

RESULTS
Case Study Alt Attribute

Large hospital system that needed to create consistent, accurate government programs reporting across all of its locations...

RESULTS
Case Study Alt Attribute

The results are impressive--improved reimbursement to clients by over $300 million, generating an average return on investment of 30 to 1 ...