MEDICARE DSH
DSHRIP | Medicare Disproportionate Share (DSH) Revenue Improvement Program
MEDICARE ID & SHADOW BILLING
Medicare Part A and Medicare Advantage Identification Service (MAIDs)
Failing to capture all Medicare Part A and Part C accounts is quite common given the complexities of the Medicare billing system and usually results in substantial loss in Medicare Reimbursements to teaching hospitals and non-teaching hospitals alike. Properly identifying Medicare fee-for-service and Medicare Advantage inpatient days for which traditional claims or Shadow Bills have not been submitted is crucial for maximizing:
- Medicare EHR incentive (HITECH) payments.
- Medicare education payments for Direct Graduate Medical Education ("DGME").
- Medicare education payments through claims for Indirect Medical Education ("IME").
Our exclusive MAIDs data mining solution taps into all appropriate sources to identify even the most difficult to find lost opportunities, generating maximum results that are returned in a user –friendly batch report prior to timely filing allowing you adequate time for submitting claims and shadow bills as directed.
GDS can effectively help you maximize revenue based on Medicare Part A and Part C days by:
- Accurately identifying and reporting Medicare Part A and Part C days for which your hospital has not yet submitted a clean, timely claim.
- Providing complete documentation, instructions, and full support for billing the missing claims.
- Continuously tracking claims through adjudication to ensure acceptance for audit and accurate reimbursement.
- Providing billing support for resolving claims in RTP status.
