Transfer Recovery System
Medicare underpayments occur when a patient is discharged as a “transfer,” but there is no post-acute care (PAC) billing. This often happens when a patient decides to forego the recommended PAC after discharge. Accurate transfer coding at the time of discharge is difficult, if not impossible, as it requires that the discharge staff know what the patient will do in the future–not merely what the patient is advised – or intends to do. Unless a specific underpayment audit process is conducted for these cases, the revenue loss will persist and continue to grow.
Our solution automates all of the Medicare inpatient transfer rules, while remaining highly responsive to the dynamic changes in Medicare claim correction procedures. We help expedite the fastest cash recovery of Medicare underpayments.
Understand Transfer DRG Reviews in 5 Minutes
Although all providers can benefit financially from Transfer DRG reviews, it’s common for most to forgo it; and often, those who do decide to perform a first-time, secondary, or even tertiary review may blame themselves for the underpayments. Relax. It’s not your fault. Your staff could not have prevented this from happening.
Provider Advantage Solutions
Archstone Management has collaborated with Medidal, Inc. to provide world-class payer search services to hospitals in need of revenue sourcing. Our insurance and eligibility discovery service finds previously unidentified commercial insurance, Medicare, and Medicaid claims eligibility on accounts that have been written off. We manage the process end-to-end, including status claims, denial management, and the facilitation of DSH reports.
We review 100% of uncompensated accounts and have a hit rate of 5-12% in newly identified eligibility. We manage status claims and denial management services, and we help facilitate DSH reports. This could mean significant additional revenue for your organization, with the convenience of a single service revenue management team to streamline processes and timelines to payment.
Services provided to uninsured or self-pay patients often result in unbillable and uncollectable fees. With no third-party payer identified at time of service, or subsequently through an eligibility vendor software program, the services provided are unbillable. They are often assigned to the Self Pay, Charity, Limit of Liability or Bad Debt buckets – increasing the outstanding A/R.