Proven Medicare reimbursement results at scale
2-4%
Increase in DSH/MBD allowable
$73M
Medicare/Medicaid recoveries in 2025
~100%
MAC audit pass rate
R1 helps hospitals and health systems improve reimbursement accuracy, uncover missed revenue and support compliance across key Medicare programs
Medicare Bad Debt (MBD)
Identify, validate and support eligible MBD claims with lifecycle management and audit-ready documentation.
Worksheet S-10 Uncompensated Care
Improve uncompensated care reporting with data validation, documentation support and compliance review.
Disproportionate Share Hospital (DSH)
Strengthen DSH reimbursements with defensible data, eligibility review and support through MAC scrutiny.
SSI Redetermination
Find underreported SSI reimbursement opportunities with expert analysis and documentation support.
R1’s approach to Medicare reimbursement aligns policy expertise, RCM data and audit-ready documentation to identify, file and defend Medicare reimbursement opportunities
Medicare reimbursement success stories
How R1’s Medicare experts recovered $13 million in Medicare bad debt reimbursement
R1 helped recover $13 million in lost revenue for several Midwestern and Northeastern clients reporting to the same Medicare Administrative Contractor (MAC).
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Worksheet S-10 identifies missing uncompensated care by $4M
With R1’s help, the Southeastern medical center was able to increase the identification of uncompensated care by nearly $4 million.
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Disproportionate share hospital recovers $13.6M in Medicare reimbursement
R1 identified DSH reimbursement of $13.6 million for all 19 hospital fiscal years and achieved a 99.8% acceptance rate on findings.
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R1 uncovers $7M in reimbursement
Reviewing six years of data identified an additional MBD reimbursement of $7 million.
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Autonomous follow up for Medicare reimbursement
Part of Phare Flow
Phare Flow doesn’t just follow up — it follows through. From claim submission until payment, intelligent agents work alongside humans to manage claim status checks, denials, escalations, credits and adjustments at scale. By combining payer connectivity, automation and human expertise, R1 supports greater continuity across back-end revenue cycle workflows and helps drive open AR down to zero.
Differentiators
Tech-enabled R1 expertise across reimbursement and revenue cycle with defensible support from analysis to audit
Audit-ready support
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Recognized category leader
Minimal staff lift
R1 is ranked #1 by KLAS® in Government Reimbursement Services
We’re proud to be recognized for outstanding performance and customer satisfaction excellence in the Government Reimbursement Services category.
Meet our experts
Download the Medicare Reimbursement solution overview
Solution overview
Get a concise overview of how R1 blends specialized expertise, cutting edge technology and scaled support to strengthen reimbursement outcomes and audit defensibility.
Latest trends and expert analysis
Explore R1’s Medicare Reimbursement solution
