Medicare Bad Debt

Optimize Medicare bad debt reimbursement and compliance

Maximize Medicare bad debt value with a meticulous end-to-end service that combines highly skilled experts with review of 100% of claims over the entire lifecycle using proprietary leading-edge technology.


Discover R1’s award-winning Revenue Intelligence® solution.

Optimize reimbursement and compliance with our elite team of former Medicare Administrative Contractor (MAC) auditors, providers and consultants — giving you an informed perspective from all sides.

Proprietary rules and algorithms far surpass spreadsheets and databases, putting an end to missed allowable claims and ensuring compliance with changing regulatory and MAC requirements.

Uncover more revenue

Tap into this significant revenue stream and never miss an allowable claim with R1’s proprietary rules and algorithms that process 100% of Medicare bad debt claims.

Gain compliance confidence

Be assured the results delivered by our team of former MAC auditors, providers and consultants are fully compliant with the latest regulations.

Achieve unmatched audit success

Rely on R1’s solid relationships and experience with MACs and Centers for Medicare and Medicaid Services (CMS) for a nearly 100% MAC audit pass rate.

Leverage our expertise for better results

Partner with R1 to optimize Medicare bad debt and stay ahead of changing regulatory and MAC requirements for no-stress compliance and accuracy. Here’s a look at how we work together.

You provide patient and claim level data from your patient financial services (PFS) system and remote, read-only access to your PFS system so that we can answer any questions on our own. This takes a significant burden off your staff.

We perform a retrospective and/or prospective review by running the data through our proprietary rules and algorithms, quickly uncovering qualifying patient claims. Our Medicare bad debt experts thoroughly review 100% of claims to assure Medicare compliance and accurate documentation.

We provide a detailed patient listing with allowable uncompensated care claims and associated dollar amounts to help you recover all the revenue you are entitled to. We ensure clean and accurate file submission directly to individual State Medicaid eligibility databases and work directly with the MAC on any follow-up issues or questions.

Experienced and professional auditors provide comprehensive support until the Medicare cost report is finalized and a Notice of Program Reimbursement is issued. We share our deep expertise with best-practice policies and procedures for ongoing improvement.

Get in touch to optimize Medicare bad debt reimbursement.