Medicaid eligible days are one of the two
components that make up the
Disproportionate Share Hospital (DSH) reimbursement.
After HCFA (presently CMS) ruling of 97-2
clarified what constitutes an allowable Medicaid
day, it opened a great opportunity for Hospitals
to maximize their DSH payments by identifying
eligible Medicaid days (example: paid and unpaid
Medicaid Eligible Days).
However, based on Hall Consulting Services’ (HCS)
reviews, we have found that a considerable
amount of Medicaid eligible days are not
captured through traditional methods used to
capture Medicaid days. We also identify
databases which were not fully analyzed or
available during the original filing of the
Medicare Cost Report.
At HCS, we
use an integrated method of client patient data,
state information, and detail analysis to
capture the appropriate Medicaid days.
Our methods have yielded considerable
reimbursement to our clients, and, in some
instances, helped clients to qualify for DSH
reimbursement.
