Reimbursement

Maintaining billing privileges and retaining patient receivables are two key ingredients for achieving a healthy bottom line in any healthcare organization. But these tasks are proving to be more and more difficult for healthcare providers as federal and state governments continue to ramp up efforts to reduce fraud, waste and abuse in the Medicare and Medicaid programs. CMS and its contractors are rigorously enforcing program participation rules like never before, and many healthcare providers are now faced with reimbursement denials, civil monetary penalties, or even worse – termination from participation in the Medicare, Medicaid and/or TRICARE programs.

HDJN’s Reimbursement Group actively counsels healthcare providers on how to structure their operations in compliance with ever-changing payment systems. We also provide day-to-day advice on Medicare, Medicaid, TRICARE and private payor billing and coverage requirements. The HDJN Reimbursement Group represents providers in every level of reimbursement appeals, and has significant experience in working with administrative agencies, courts and commercial insurance companies.

Reimbursement Services:

  • Reimbursement Appeals and Claims Denial Management
  • Medicare/Medicaid Enrollment and Certification
  • Regulatory Compliance/Billing Audits & Investigations
  • Self-Reporting of Overpayments
  • Survey Management
  • Responding to Government Investigations
  • Graduate Medical Education Reimbursement Issues
  • Routine Billing Questions
  • Navigation of the 60-Day Repayment Rule

We understand the complexities and frustrations providers encounter on the reimbursement front and HDJN is here to help every step of the way.

Contact:

Mary C. Malone
Mary C. Malone