Home   |   News   |   Contact Us

Medicare Fee-for-Service Underpayment Recoveries

MCare Solutions, Inc. reviews and analyzes all discharges with a status code other than 01 to determine if the status has been correctly assigned.   Our proprietary system quickly identifies those accounts that have potential reimbursement opportunities, both positively and negatively (an important feature in keeping hospitals compliant). Following the identification of these opportunities, MCare personnel then analyze each account to see what actually occurred after the patient was discharged from the acute care facility, and follows up with both payers and post-acute care providers as necessary for determination.

Once determined that the original status is incorrect, we submit an adjustment claim to the intermediary via the DDE system.  Given our then familiarity with each account, as well as our knowledge of Transfer DRG rules and regulations and more than 15 FIs across the country, we perform all rebilling.

Payments made to the hospital resulting from our recovery efforts are monitored by MCare through the DDE system.  As most or all of the payments for specific time frames are received by your facility, MCare will submit an invoice for services corresponding to those time frames and payments.

"));