Athens-Limestone Hospital, a non-profit hospital located in Athens, Alabama, has selected BESLER Consulting, a provider of comprehensive revenue integrity services to healthcare organisations, to assist in the identification of Medicare Transfer DRG underpayments.
Under the Medicare reimbursement regulations, a discharging hospital is paid at a reduced rate when certain patients are transferred to other providers to continue treatment. In some cases this reduced payment is not justified by the actual post-discharge care.
Beyond the transferring hospital’s control, some patients are not treated as planned after being transferred. This results in a reduction in the transferring hospital’s Medicare reimbursement.
According to BESLER, properly reviewing the post-transfer care that patients receive and identifying underpayment situations can provide hospitals with a significant revenue boost.
Athens-Limestone Hospital selected BESLER to efficiently work through the identification and follow-up tasks required to validate the accuracy of post-acute care transfer billing and to ensure compliance.
Athens-Limestone Hospital compliance officer Traci Collins said that the hospital’s processes are good but after discharge things can happen that are beyond its control.
"We’re confident that BESLER Consulting will be able to help us to recover Transfer DRG underpayments in a thorough and compliant manner," Collins added.
BESLER also offers the BVerified suite of web-based solutions, which allows providers to bring the work of identifying, prioritising and recovering Medicare underpayments in-house.
BESLER president and CEO Jonathan Besler said the company’s proprietary Transfer DRG technology allows it to review every transfer claim to ensure its clients receive all of the revenue they’ve earned.
"We’re looking forward to working with Athens-Limestone Hospital," Besler added.
The services offered at the hospital include the Baby Place, diagnostic services, education classes, emergency services, a sleep disorders clinic, surgical services, therapy services, wellness facilities, and a long-term acute care facility coming in 2014.