Payment Reimbursement and Managed Care

Ask the Experts Answer: Medicare Crossovers to Medicaid Bad Debt

If Medicaid contractualizes all or some of the amount deemed as coinsurance by Medicare, can the contractual amount be claimed as part of the bad debt on the cost report? Or, are we only able to claim the amount that Medicaid notes as being the copay or deductible on the cost report?

HFMA October 25, 2012

Ask the Expert: PMPM Payments for Case Management

PMPM payments for case management.

HFMA October 25, 2012

Ask the Expert: Achieving Transparency

Q Are there any best practices that you can recommend for transparency? 

HFMA October 25, 2012

Ask the Expert: Medicare Payment for Home Health

Medicare does not distinguish payment by hospital-based or stand-alone home health agencies.

HFMA October 25, 2012

Ask the Expert: Small Claims Court Proceedings

In developing a policy for small claims court proceedings, there are a few homework and research items you will need to complete before proceeding.

HFMA October 25, 2012

Ask the Expert: Adjusting and Automating Self-Pay Accounts

Adjusting and automoating self-pay accounts.

HFMA October 25, 2012

Ask the Expert: When Physicians Terminate Medicare Part B Contracts

When physicians terminate Medicare Part B contracts.

HFMA October 25, 2012

Ask the Expert: Calculating Weighted Averages in Favored Nation Clauses

Calculating weighted averages in favored nation clauses.

HFMA October 25, 2012

Ask the Expert: How Far Can Plans Make Patients Travel?

Can a health plan make a patient travel outside a particular service area (say 40 miles away) to receive care from an exclusively contracted provider?

HFMA October 25, 2012

Ask the Expert: Managed Care Payment Trends

Do you know of any studies that may support managed care payer payment trends to hospitals for 2011, 2012, etc?

HFMA October 25, 2012
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