
ATLANTA, GA—March 1, 2007
HSI Financial Services, Inc. announces today an agreement to provide Transfer DRG Reimbursement Recovery Services and to jointly market existing HSI clients and prospects in concert with MCare Solutions, Inc., Houston, TX.
“Transfer DRGs are a growing reimbursement issue for hospitals, and proper highly specialized handling of these accounts can represent significant, additional reimbursements for all hospitals”, notes Jeff Korn, President of HSI. “In keeping with our desire to bring additional value to our clients, members and the marketplace we are delighted to be offering this service in partnership with MCare Solutions.”
Mr. Korn added: “WellStar Health System, a five hospital system in metropolitan Atlanta, Floyd Medical Center in Rome, Southern Regional Medical Center, and Gwinnett Medical Center in Lawrenceville have contracted to be the first Georgia-based hospitals to utilize our newest recovery services.”
Transfer DRGs and associated payment edits were initially established by CMS to help curb payment inaccuracies for patients who receive post acute care treatment via home health agencies, skilled nursing facilities, and other defined settings. While Medicare edits identified overpayments to hospitals, no similar checks and balances were built into. payer systems for detecting and correcting underpayments. With the number of DRGs growing from initially 10 in 1999, 29 in 2005, and currently 188 individual diagnoses, the potential underpayments to hospitals has grown several fold.
Dave Jupp, founder and President of MCare Solutions, says, “We have been on the leading edge of this developing reimbursement issue since 2005. Since then, we’ve developed a proprietary software solution to identify and analyze potential additional reimbursements associated with transfer DRG’s, as well as a follow-up process that has provided significant returns to over 60 client hospitals nationwide. Obviously, we’re excited to expand our marketing channels through HSI Financial Services, and look forward to this new relationship.”
MCare Solutions has found, among its clients to date, that approximately thirty per cent of Medicare inpatient discharges have qualifying transfer DRG’s. Of that amount, notes Jupp, “About eight per cent have coding errors representing potential underpayments. The challenge lies in identifying the potential in the first place, and the intensive specialized monitoring to receive adjusted and corrected payments. We’ve found a unique and beneficial approach to doing that.”
About HSI Financial Services, LLC
HSI Financial Services, LLC (a wholly owned subsidiary of Phoenix Health Care
Management Services, Inc.) was founded in 1983 by healthcare provider executives who
were in search of professional revenue cycle services for their respective organizations.
This same group of non-profit providers subsequently formed VHA GA. HSI programs
are designed to facilitate improved Revenue Management exclusively for healthcare
providers. HSI’s Mission and Values statement imparts in our culture a sense that we are,
in fact, healthcare workers. For these reasons HSI has become the choice for many
prestigious healthcare systems. HSI has requisite compliance programs in place to assure
adherence to FDCPA, OIG, CMS and HIPAA regulations. HSI puts a high value on
education, training and supports certification by the National Healthcare Collectors
Association within the first year of employment and through HFMA’s Certified Patient
Account Representative (CPAR). Participation in these programs is encouraged and
rewarded for all employees.
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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Media Contact:
Jeff Korn
President
1000 Circle 75 Parkway, Suite 400
Atlanta, GA 30339
Phone: 404-308-5344
jkorn@hsifin.com
www.healthcarestrategiesinc.com