PROFESSIONAL REFERENCES
University of Nebraska Medical Center-Nebraska Health System
Contact: Mr. Bill Barnes Title: Systems Coordinator
Phone Number: (402) 559-2995
Summary of Results:
Quality Reimbursement Services (QRS) recovered over seven million dollars in additional Medicare Disproportionate Share reimbursement over a five-year period. The additional Medicare Disproportionate Share required the identification of Medicaid eligible patients serviced by the hospital in several states.
QRS recovered over four hundred thousand dollars in additional DSH reimbursement as a result of the increase in the SSI proxy.
Empire Health Services
Contact: Mr. Ronald Biondi Title: Director - Audit and Compliance Officer
Phone Number: (509) 473-4000
Summary of Results:
Empire Health Services is a 400 bed multi-hospital system that has a teaching program.
QRS recovered over eight million dollars in additional Medicare disproportionate share payments over a period of eight years.
QRS recovered over one million dollars in additional DSH reimbursement as a result of the increase in the SSI proxy.
University Medical Center
City/State/Zip: Lubbock, TX 79415
Contact: Mr. William Kelly Jones Title: Director of Reimbursement
Phone Number: (806) 743-3426
Summary of Results:
QRS identified over one and one-half million dollars in additional Medicare disproportionate share payments over a three-year period.
QRS personnel worked with MediFax who had access to Medicaid eligibility data obtained from the Texas Department of Health and Human Services. This required automated computer verification and a reconciliation of the data received from the State with the hospital’s internal records. This was achieved with a minimal involvement of hospital’s personnel. The pertinent patient information was obtained from the provider’s MIS department including the years where the data was archived due to system changes.
University of Kansas Medical Center
City/State/Zip: Kansas City, KS 66160
Contact: Mr. William H. Marting Title: Asst Vice-President & Chief Compliance Officer
Phone Number: (913) 588-5801
Summary of Results:
QRS identified over one-half million dollars in additional Medicare disproportionate share payments for one year. The vendor used to identify Medicaid eligible days to enhance Medicare Disproportionate Share payments was Blue Cross of Kansas.
QRS personnel worked with Blue Cross of Kansas who had access to Medicaid eligibility data obtained from the State of Kansas. This required automated computer verification and a reconciliation of the data received from the State with the hospital’s internal records. This was achieved with a minimal involvement of hospital’s personnel. The pertinent patient information was obtained from the provider’s MIS department including the years where the data was archived due to system changes.
Lester E Cox Medical Center
City/State/Zip: Springfield, MO 65807
Contact: Mr. Larry D. Pennel Title: Chief Financial Officer
Phone Number: (417) 269-8811
Summary of Results:
QRS recovered over five million dollars in additional Medicare Disproportionate Share payments over a period of seven years. The process of identifying Medicaid days will be similar to the work required by your hospital.
QRS personnel worked with Verizon to verify Medicaid eligibility for patients who had Medicaid as secondary payer. This required automated computer verification and a reconciliation of the data received from the State with the hospital’s internal records. This was achieved with a minimal involvement of hospital’s personnel. The pertinent patient information was obtained from the provider’s MIS department.