BC Advantage - 2009 Issue 8
Challenges, Pitfalls, and Opportunities When Dealing With Medicare Transfer DRG Cases
In this issue of IMA Insights, we would like to discuss an issue that has impacted hospital reimbursement increasingly since the inception of the post acute transfer rule in Federal Fiscal Year (FFY) 1998. Based on our experience, we have identified a window of opportunity for hospitals to recover Medicare reimbursement ranging, on average, from $150,000 to $4 million. The question arises as to what a hospital can do to recover this revenue while at the same time keeping in mind the compliance implications inherent in the recovery process. Background As initially enacted by Congress...
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