Medicare rules and state-specific regulations are complex and continually change. Many hospitals lack the internal resources and technology needed to accurately determine eligible Medicare reimbursement.
By leveraging our best-in-class technology and deep domain expertise in complex and data-intensive cost report issues, you’ll be able to streamline and automate key areas of the cost report preparation process to bolster your bottom line.
Maximize reimbursement for unpaid Medicare coinsurance and deductibles. Medicare Bad Debt (MBD) represents a significant revenue source for hospitals — 65% of the eligible amount of MBD they incur. However, complex rules regulating Medicare bad debt processes and reporting make it hard to recover these payments.
TransUnion Healthcare’s Medicare Bad Debt solution addresses these challenges by automating the MBD review process. By leveraging the unique processing and data integration capabilities of our STINGRAY™ platform — the industry’s only Software-as-a-Service (SaaS) solution for MBD — hospitals can accurately and efficiently identify reimbursable bad debts by:
This solution can be delivered as a fully-outsourced consulting service or as a SaaS solution.
Maximize reimbursements for unpaid Medicare coinsurance and deductibles incurred by Medicare Advantage (MA) members. With more than 30% of all Medicare beneficiaries enrolled in a MA plan, Medicare Bad Debt – Medicare Advantage (MBD-MA) represents a significant revenue opportunity. MBD-MA is complex as it deals with multiple plans that don’t administer it consistently. This makes it even harder to obtain reimbursements without a robust, automated system in place.
Our automated MBD-MA solution utilizes the STINGRAY™ platform to identify reimbursable bad debts by:
Identify all patient days eligible for DSH reimbursement to increase payments. Medicare DSH payments are a vital funding source for hospitals that serve low-income populations, but aggregating and integrating the patient data needed to qualify for these payments is challenging.
Our Medicare DSH solution — backed by the unique SaaS platform STINGRAY™ — helps identify DSH eligible patients and patient days by:
The solution is available as a fully-outsourced consulting service or as a SaaS solution.
Ensure Worksheet S-10s are complete and accurate to streamline uncompensated care payments.
TransUnion Healthcare’s Uncompensated Care Analytics solution was one of the first products offered in the industry to help hospitals complete Worksheet S-10. The solution provides:
Determine eligibility to qualify for VDA reimbursements. This Medicare payment adjustment — for Sole Community Hospitals or Medicare-dependent hospitals that experience an annual decline in discharges greater than 5% due to external factors — can impact overall yield.
We offer the experience and analytics required to help hospitals become qualified for VDA by:
“We are a 21-bed hospital and every dollar of reimbursement is important to help us deliver excellent patient care. TransUnion Healthcare’s work recovered over $300,000 for us, exceeding our expectations. We couldn’t be more thrilled with the results.”
— Controller, Southern hospital
1 HFMA staff and volunteers determined that these products met specific criteria developed under the HFMA Peer Review process. HFMA does not endorse or guaranty the use of these products.
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