Ministry Health Care, an integrated healthcare delivery network headquartered in Wisconsin, 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.
Ministry Health Care 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.
BESLER also offers the BVerified suite of web-based solutions, which allows providers to identify, prioritise and recover Medicare underpayments in-house.
After undergoing a rigorous review, BESLER’s Transfer DRG Revenue Recovery Service was awarded the "Peer Reviewed by HFMA" designation by the Healthcare Financial Management Association.
BESLER president and CEO Jonathan Besler said the company is pleased to be working with Ministry Health Care on the recovery of Transfer DRG underpayments.
"Our proprietary technology and our focus on compliance allow us to effectively identity additional, legitimate revenue for our clients, facilitating their ability to carry out their mission in healthcare," Besler added.
Ministry generates nearly $2.2bn in annual operating revenue with 15 hospitals, 46 clinics, and more than 12,000 associates including 650 physicians and advanced practice clinicians.
Ministry Health Care recently joined Ascension Health as the second healthcare ministry in Wisconsin. Ascension is the largest Catholic and not-for-profit healthcare system in the US.
Ministry’s Network Health has received 4½ star recognition by the Centers for Medicare and Medicaid Services (CMS) for its Medicare Advantage plans.