What You Can Learn About Medicare Bad Debt Reimbursement from Tax Season 

March 29, 2024

Medicare bad debt reimbursement and tax season have much more in common than you might think. Whether you expect a refund or simply seek to maximize what you can collect through accurate deductions, navigating how to get reimbursed can be quite a headache. You need to find find what deductions you can claim, which forms you need to apply for the current year and many other nuanced tasks.

For hospitals and health systems, navigating Medicare bad debt reimbursement is similar. Many health systems don’t realize the amount of money they’re leaving on the table due to manual processes, unspecialized partners and consistently changing guidelines and rules. 

For health systems leaving Medicare bad debt dollars behind, the excuses are similar to those of taxpayers who don’t leverage available deductions and expertise to get the highest return. Some of those reasons include: 

  1. “It’s too time consuming. I don’t have time to find every possible deduction and figure out how to claim it.”

    Much like finding all of the allowable deductions on your personal taxes, finding and recovering Medicare bad debt takes time – something hospitals and health systems often don’t have. Labor shortages and high turnover rates continue to wreak havoc on health systems and jeopardize patient care, meaning time is precious to the skilled resources you do have.

    Luckily, recovering more Medicare bad debt no longer needs to rely on spreadsheets and databases that require a heavy lift from internal staff. Instead, hospitals and health systems can rely on proprietary rules and algorithms that put an end to missed allowable claims and help ensure compliance with changing regulatory and MAC requirements. Plus, partnering with the right expert means health systems like yours have access to practionerys with relevenat expertise who are solely committed to adhering to MAC standards and changing guidelines.  

  2. “We already have an audit vendor. They may not be specialized but they’re good enough at getting us some money back.”

    A templated online tax worksheet won’t get you the same return as working with a certified expert who has both the hospital and CMS/MAC-level expertise needed to navigate the requirements and expedite your settlement. Similarly, finding and resolving Medicare bad debt reimbursement isn’t a one-size-fits-all process. Instead, choose a partner that can work with you to focus on key interest areas and data trends specific to your hospital or health system. It’s important to choose a partner that won’t put you into a templated box that won’t maximize your return.

  3. “Our budget is tight right now; I can’t afford to get outside help. I need to justify the cost.”

    When looking at a business cost, it’s important to look at what the end result could be. Due to our contingency-based offering, R1 assumes all the financial risk; thus, any additional reimbursement recovered increases your financial position. For example, one health system uncovered $7 million in Medicare bad debt reimbursement dent by investing in audit support and analyzing their past data.  

R1, named 2024 Best in KLAS for Government Reimbursement Services, has an experienced team of former MAC auditors and experts who know exactly where to look to uncover potential Medicare reimbursement opportunities. Our clients have experienced success rates of 100% of claims reviewed, a nearly 100% MAC audit pass rate and more than 2% additional Medicare bad debts claimed as allowable. 

If you’re ready to take your Medicare reimbursement to the next level, reach out to start with a free assessment to identify current gaps. 

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