报销咨询
20多年来，LBMC一直是医疗保健咨询领域公认的公司. Our dedicated team provides a wide range of services, including cost report preparation and review, and reimbursement consulting services for both cost-based and PPS providers. We provide payor negotiations, 承包服务, Chargemaster审查和战略性定价调整，以满足当今对医疗保健定价更透明的需求.
我们独特的合作方式使医疗保健提供者能够通过全年主动监测业务变化来预测报销率的潜在变化, eliminating rate setting surprises. 在LBMC, 我们了解成本报告和报销对医疗保健实体的重要性，并提供各种服务来帮助您实现目标.
警告:CMS 2552-10第40章传输18供应商成本报告表格和说明
2023年11月更新
CMS于2022年12月29日发布了医院成本报告表格2552-10的传输文件18. Several changes were made in this transmittal, 但影响几乎所有医院提供者的是更新的医疗保险坏账(表2a)和S-10(表3b和3c)，这些是本传输文件中要求的. 在2023年9月30日或之后结束的成本报告期间需要这些附件.
- 表现出2 -从2022年10月1日开始及之后的成本报告期间的医疗保险坏账日志
- 展览3 b – S-10 log for charity care charges
- 展览3 c – S-10 log for total facility bad debts
More detail of Transmittal 18: http://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/Transmittals/r18p240i
LBMC准备协助所有受此传输监管的供应商，并协助准备这些展品.
2023年1月发布
影响几乎所有医院提供者的是以下更新的展品，这是本传输中要求的. 这种传输影响到从2022年10月1日或之后开始的成本报告期间的供应商.
- 展示1 – Allocation of Physician Compensation
- 附表2 – Medicare bad debt log for cost report periods beginning prior to Oct 1, 2022.
- 表现出2 -从2022年10月1日开始及之后的成本报告期间的医疗保险坏账日志
- 展览3 – Medicaid eligible days for a DSH eligible hospital
- 展览3 b – S-10 log for charity care charges
- 展览3 c – S-10 log for total facility bad debts
ALERT: FY23 Appropriations Bill Update
2023年拨款法案规定了几个农村卫生项目的资金水平. It was signed by President Biden December 29, 2022.
该法案指定500万美元在疾病控制和预防中心设立农村卫生办公室。. 疾控中心的农村卫生办公室将加强实施疾控中心的农村卫生组合, 协调疾控中心各项目的工作，制定农村卫生战略计划.
该法案还支持 乡村医院 and core rural health care programs, as listed below:
农村医院项目
- $3.450亿美元 Rural Community Facilities Program 还有200万美元 Rural Hospital Technical Assistance Program 通过美国农业部农村发展(RD)项目.
- $64.300万美元 Medicare Rural Hospital Flexibility Grants Program (an increase of more than $2 million over FY 2022 funding levels). 64美元的.300万美元中包括2100万美元用于小型农村医院改善赠款方案，500万美元用于继续资助农村急诊医院(REH)技术援助方案.
Continuation of Core Rural Health Care Programs
- $12.5 million for 状态 Offices of Rural Health (level funding)
- 1.45亿美元用于农村社区阿片类药物应对计划(增加1000万美元)
- $12.5 million for the Rural Residency Development Program ($2 million increase)
- $125 million for the National Health Service Corps ($3 million increase)
- 800万美元用于HRSA的农村妇产管理战略项目(RMOMS)(增加200万美元)
Statutory Pay-As-You-Go Act (PAYGO) of 2010
2010年的法定现收现付法案(PAYGO)要求一项强制性的支出和收入立法，以避免增加联邦预算赤字. 随着《明升体育app下载》的通过，现收现付的自动减支在22年12月31日之前被放弃. 现收现付的自动减支现在被推迟到2025年1月，这避免了4%的医疗保险报销削减.
远程医疗
远程医疗 flexibilities will now continue until December 31, 2024. 在2022财年的综合拨款法案中，远程医疗的灵活性延长了151天. The bill extends these critical PHE provisions, including audio-only flexibilities through December 31, 2024.
医疗保险支付
- Low-Volume Hospital (LVH) and Medicare-Dependent Hospital (MDH) designation both extended through September 30, 2024.
- Ground Ambulance add-on payments extended for two years through December 31, 2024.
- 医生附加付款 for services furnished in calendar year 2023, the add-on payment will be 2.医生占5%. For services furnished in calendar year 2024, the add-on payment will be 1.25%.
- Home health rural add-on payment at one percent through the end of 2023.
精神健康条文
- 医疗保险下的婚姻和家庭治疗师(MFT)和心理健康顾问(MHC)的覆盖范围.
- 新增200个精神病学或精神病学专科住院医师名额. 2026财年, the Secretary shall begin distribution of these slots, with a minimum of 10 percent going toward hospitals located in rural areas.
- Inclusion of the Restoring Hope for Mental Health and Well-Being Act
这是美国医院协会关于这1美元通知的链接.7万亿美元的综合法案. http://www.aha.org/news/headline/2022-12-30-biden-signs-17-trillion-omnibus-appropriations-bill
报销咨询 服务
成本报告服务
- Preparation and/or review of Medicare and/or Medicaid Cost Reports.
- Review and assistance with tentative settlements, 成本报告审计, appeals and other correspondence with CMS and MACs.
- 审核以前提交的成本报告，以确定潜在的风险和报销机会.
- 汇编或独立审查各种医疗补助和其他国家计划报告，如住院治疗中心.
Payor Contracting and Negotiations
- Chargemaster评论
- Review all current contracts for compliance, performance and renegotiate with payors, 适当的, to obtain more favorable contract conditions and/or rates.
- Review all new contract proposals and recommend acceptance or denial, based on potential performance and fit with the group’s strategy and goals.
- Review payor market shares in your area and new contract recommendations.
- 就付款人合同相关问题向员工提供电话和电子邮件支持.
- Provide ongoing monitoring of contracts for payor compliance.
- Project environments: Hospitals, ASC, 康复中心, Psych (inpatient and outpatient), Physicians (hospital and non-hospital based) and Ancillary services.
咨询服务
- 确定并协助医疗/外科和康复医院的不成比例份额(DSH)和低收入(LIP)报销机会, 分别.
- 协助编制和/或审查传统的医疗保险坏账和医疗补助“交叉”坏账.
- Square Footage Analysis for proper cost allocations.
其他发还款项服务
- 协助工资指数审核和审查潜在的地理重新分类.
- Consultations for various Provider based issues.
- Assistance with completion and filing of occupational mix surveys.
- 尽职调查，协助处理收购/合并活动中的机会和责任.
服务的客户类型
- 急症护理医院
- Behavioral health hospitals (BHH)
- Critical access hospitals (CAH)
- 透析中心
- Federally qualified health centers (FQHCs)
- 家庭保健
- 家庭办公室
- 临终关怀设施
- Long-term acute care hospitals (LTACH)
- 养老院
- 医生实践
- 农村保健诊所(RHCs)
- Skilled nursing facilities (SNFs)
