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Reimbursement Services

The primary focus of our practice is assisting clients with issues related to Medicare and Medicaid reimbursement. The services provided to our clients include:

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Medicare and Medicaid Cost Reports

E&A provides Medicare and Medicaid cost report preparation and review with a focus on accuracy, reimbursement optimization and regulatory compliance. We provide support through the audit process and will assist in cost report appeals and reopenings when appropriate.

Disproportionate Share Eligibility and Uncompensated Care Projects

We assist clients in compiling total Medicaid paid and eligible patient days to be included in the Medicare disproportionate share calculation and provide assistance in compiling and maximizing Uncompensated Care data. We also prepare and submit SSI realignment requests.

Graduate Medical Education and Allied Health Projects

We help our clients navigate the complex medical education regulations and provide prudent strategies to ensure maximum reimbursement, in addition to analyzing existing programs and closing programs. We also provide consultation on optimal reimbursement strategies for implementing new graduate medical education and allied health programs.

Transplant Projects

We assist clients in reviewing their transplant accounting and tracking practices to maximize available Medicare and commercial payer reimbursement.

340B Consulting and Compliance Services

E&A provides 340B consulting and compliance services to all types of covered entities. We are able to help maximize the benefits of a 340B drug program by providing compliance and audit checks, implementation, operation assessments, and education. Our 340B consulting will help you achieve a meaningful impact for patients, pharmacy, and your health system.

Financial Projections

We assist clients with a variety of financial projections and related services including projected financial statements, analysis of new services, outpatient freestanding versus hospital-based departmental financial feasibility analysis and joint venture arrangements between hospitals and physicians. E&A also provides review of third-party accounts and net revenue budgeting preparation and review.

Medicare Bad Debts

E&A assists in compiling and reviewing Medicare bad debt logs and providing audit assistance.

Square Footage Studies

We assist clients in completing detailed facility square footage studies to properly assign square feet for third party reimbursement and cost accounting reporting purposes.

Medicare Wage Index

E&A compiles and reviews Medicare wage index data to ensure accurate reporting and to optimize wage index results. We also review Medicare cost report adjustments made by the Medicare Administrative Contractor at the time of wage index audit.

Volume Decrease Adjustment

We prepare Volume Decrease Adjustment reimbursement requests for Sole Community and Medicare Dependent Hospitals that have experienced a greater than 5% decrease in total discharges as compared to the preceding cost reporting period.

Expert Testimony

E&A has provided expert testimony in cases involving Medicare and Medicaid reimbursement when determining reasonable medical compensation in medical malpractice cases. Additionally, the firm has provided expert assistance pertaining to matters of Medicare medical education reimbursement and has testified before the Provider Reimbursement Review Board on various issues.

Other Services

We formulate feasibility and impact analyses pertaining to combining multiple existing hospitals and the capital reimbursement impact for building a new hospital. In addition, we determine Sole Community Hospital and Medicare Dependent Hospital eligibility and advise on reimbursement issues pertaining to these designations.


At EMRHEIN & ASSOCIATES we are committed to responsiveness and accuracy. We treat all our clients with respect and work diligently to develop long-term relationships. We take pride in always responding to inquiries within 24 hours and recognize that consistent communication is of the utmost importance in an ever-changing regulatory environment.


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