SSI Redetermination

Optimize underreported SSI reimbursement

Be confident you’re capturing the reimbursements you’re due with our SSI redetermination services that identify redetermination opportunities that lead to higher overall reimbursements.

Secure additional disproportionate share reimbursement through our SSI redetermination services. Industry-recognized expertise precisely and accurately identifies redetermination opportunities.


SSI Redetermination overview

Our powerful AI platform accurately captures all regulatory changes from 1988 forward for precise SSI recalculation and determination of disproportionate share benefit. R1’s SSI Redetermination is used by finance and reimbursement leaders to optimize government benefits revenue.

Leverage our unmatched Medicare experience

You can count on R1’s solid relationships and experience with MACs and CMS to optimize your results.

Benefit from a full-service solution

From SSI recalculation until the Notice of Program Reimbursement (NPR) is issued, we’re with you every step of the way with specialized knowledge and MAC audit support.

Zero IT and minimal staff involvement

Minimize disruption and overwork. We achieve results utilizing our own CMS portal and publicly available databases.

Better results with an optimized process

Be assured that partnering with R1 means best practice processes and accurate results. There’s zero risk with our 100% contingency fee-based model. Here’s a look at how we work together:

We take on 100% of the work, analyzing SSI patient information through our secure CMS portal.

We use the CMS data and publicly available Medicare cost report (MCR) information to perform calculations. The first calculation checks the original result from CMS for comparison to the audited MCR. The second calculation shifts the discharges from the federal fiscal year to the hospital fiscal year.

We compare the results, and if there is a positive benefit to request a recalculation, we prepare the re-opening packages for you. We provide full MAC audit support until the cost report is finalized and an NPR is issued.

We share our deep expertise with best practice policies and procedures for ongoing improvement.

Looking to learn more about us? It all starts here.