Medicare Transfer Account Review
Under current CMS reimbursement guidelines, hospitals receive less reimbursement when a patient is discharged to another facility for additional ‘skilled-care’ versus discharging the patient to their home. The lesser payment is dictated by the discharge status. Occasionally, the transfer patient does not receive the Medicare-approved follow-up care. When this event occurs, the hospital is underpaid because they should have received the full Medicare DRG payment.
If the hospital can identify these accounts and provide all of the supporting documentation, they can submit an adjusted claim for the ‘underpaid’ amount.
Comprehensive, Prompt Reviews
PMMC provides a Medicare Transfer Account Review that quickly identifies the claims appropriate for resubmission. Once PMMC receives the client’s data, most reviews are completed in a few weeks. This is accomplished through a balanced approach that leverages automation and a dedicated team that specializes in this area.
Nominal Efforts Required
With experience in various patient accounting systems, claims processing, common working files, and data extraction methodologies, PMMC’s review has a minimum impact on the Hospital’s staff.
Data Integrity and Security
PMMC maintains strict security measures to keep client data safe. Following HIPAA guidelines, PMMC security measures include data encryption systems, secure file transfer protocols, passwords and background checks on employees.