MCare Solutions, Inc. Announces New 3-Day Payment Window Reimbursement Service

December 1, 2009 – Houston, Texas

MCare Solutions, Inc. (MCare), the nation’s first provider of Transfer DRG reimbursement recovery services, announces an additional service for the provision of revenue recovery associated with underpayments resulting from bundled outpatient / inpatient services and same-day ER / inpatient admits.

“The 3-Day Payment Window policy is a longstanding Medicare policy, but one with which most hospitals still struggle, and unfortunately most are being under-reimbursed as a result. Many hospitals believe that they are operating within the Medicare regulations and receiving due reimbursement if they simply bundle any outpatient service provided to a patient within three days of admission to inpatient care. It’s not nearly that simple, however,” says David Jupp, President and Founder of MCare Solutions, Inc.

According to Jupp, “There are specific regulations allowing for varying reimbursement related to the provision of diagnostic and non-diagnostic services, specific revenue and CPT codes that distinguish the two, and special circumstances surrounding same-day inpatient admits from the ER. MedPar data and our client hospitals are proving that many current industry practices are not only resulting in significant underpayment, but are actually outside compliance with the 3-Day regulations. Our proprietary systems allow hospitals to separate charges that can be unbundled and submit those to Part B. For an average hospital with 3400 IP admissions, the resulting increase in revenue is estimated at $975,000 annually.”

“MCare is always exploring niche opportunities to increase due reimbursement to our client hospitals, and we are excited to see this new service emerge in the healthcare industry,” continues Jupp.

About MCare Solutions, Inc.

MCare was founded in 2005 as the first provider of Transfer DRG reimbursement recovery services for acute care providers. To date, MCare has reviewed and analyzed millions of Transfer DRG discharges and is responsible for more than $75 million in reimbursements to client hospitals. The initial focus of Medicare fee for service accounts has since expanded to include acute care discharges related to Medicare Advantage payers, IME/GME and 3-Day Payment Window reimbursement. MCare now represents more than 300 for-profit and not-for-profit hospitals from Alaska to Florida, including individual community hospitals that range in size from <100 to 1,000-plus beds and regional and national healthcare systems.

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