Ontash

Meditools

Software tools to assist hospitals in preparing Disproportionate Share (DSH) and Crossover Bad Debt for Medicare Cost Reports.

Overview

Hospitals receiving revenue from Medicare need to prepare several worksheets to file their annual Medicare Cost Report. Meditools is used to accurately prepare Medicare Crossover Bad Debt Listings, and Disproportionate Share (DSH) patient listings which contribute to significant Medicare reimbursements.

Hospitals can quickly prepare these reports prior to filing the cost report without using a consultant - and still achieve an accuracy of 95% of a home grown bespoke process.

  • Disproportionate Share (DSH)
  • DSH is a mechanism, by which U.S. hospitals that serve disadvantaged populations, may receive payments from Medicare to help offset unpaid medical charges. In order to receive DSH payments, the hospital must provide verified documentation relative to (1) SSI patient days; (2) Medicare days; (3) Medicaid days; and (4) total patient days. The key to improving DSH payments lies in identifying all verifiable Medicaid patient days. This process involves matching databases from the hospital, state Medicaid and Medicaid contractors - to document every patient who was eligible for Medicaid (but not paid by Medicaid) over the course of the hospital’s fiscal year. Meditools is HIPAA compliant and automates the process, so that the hospital may submit a complete report at the time of cost report filing. Hospitals will then receive complete DSH payments with their Notice of Program Reimbursement (NPR) as opposed to waiting an additional year to two years for payment if a vendor compiles the report.

  • Crossover Bad Debt
  • Crossover Bad Debt is a government program, by which hospitals may be reimbursed for unpaid deductible and copay charges for patients who have both Medicare and Medicaid health insurance. Meditools software imports 835/837 EDI transaction data, the Master Patient Index from the patient accounting system and identifies all Medicare/Medicaid “dual eligible” patients who were discharged within the hospital’s fiscal year. It then matches this database with state contractor databases to automatically calculate all Medicaid charges that were billed, but not paid by the state’s Medicaid agency. Meditools Bad Debt software is HIPAA compliant, and the report may be run just before the hospital files its cost report. So CMS payment will be issued upon issuance of the NPR (approximately 1 to 2 years earlier than if a vendor performed the service).