Government Reimbursement Solutions
Frictionless results from complex and regulated reimbursement efforts
Government Reimbursement Solutions
Frictionless results from complex and regulated reimbursement efforts
Are you making the most of your government reimbursements?
Despite some growth in 2023, most hospitals are operating with negative margins compared to where they were in 2020. These financial losses are significantly affected by the complexities of managing Medicare and Medicaid reimbursements. These programs, accounting for 32% of hospital revenues, present critical challenges in program design and frequent underpayments.
How To Guide
How to Maximize Medicare and Medicaid Reimbursements
Get strategies to navigate reimbursement complexities, enhance understanding and optimize financial outcomes.
Boost government reimbursements accurately the first time
The regulated environment among government-sponsored healthcare often leaves hospitals struggling to manage complex reimbursement processes. Even for an experienced reimbursement team, the process alone is 100% manual and can take months to finish.
Trusted by thousands of US hospitals, FinThrive partners with hospitals to accurately maximize Medicare reimbursements and underpayments. Rely on our team of over 170 industry experts and proprietary technology platform to take on this for you.
Our Government Reimbursement Team
Specializes in software and services to maximize revenue from complicated Medicare and Medicaid claims
Leverages technology that’s built to handle the data analysis necessary to identify errors and underpayments, adhere to reporting requirements, adjust and resubmit claim, and maximize reimbursement
“We were surprised that the assessment showed significant additional reimbursement opportunity for transfer patients since we had a strong internal reimbursement team but elected to move forward with a detailed review. The solution was able to recover an additional $1.2 million.”
“The firm is very thorough and effective, and they always deliver on time; that is the most important piece. Every time we engage with FinThrive’s staff on an issue, they are very well researched and topical, and they always suggest the answer we end up using. The firm certainly has the expertise for more strategic aspects, though we don’t leverage them for that.”
“Overall, things are very good with FinThrive. They do a good job, and they provide me with exactly what I need. They are the only company that I know of that has a data mining tool, so we make sure that we are capturing all their data, and that makes the firm very valuable. All the other firms want to do the whole thing themselves, and that costs twice as much, so we are not interested in that. FinThrive is the only one that meets our needs.”
"The firm’s strength is their ability to analyze a mass amount of data and put it into a consolidated, summarized format to identify opportunities. They take the lead in the conversations with the auditor and do not rely on us to reach out to them for assistance. Instead, the firm only reaches out to us for documentation support or additional explanations that they may not have related to internal decisions and processes. Other firms wait for us, or they want us to do all the communication with the auditor and reach out to them for questions. We are looking to our firms for their expertise. They should have more information than someone who has to look at the whole product instead of just one piece of the process."
"FinThrive does a very thorough job of identifying Medicare bad debts. The firm has a strong compliance tilt, and it is always comforting to know that they are not going to be pushing the edges. FinThrive is very well organized. They conduct their business according to an agenda, and there are progress points. If we don't hit those points, we get a phone call. The firm keeps us moving and improves our own desire to keep things moving."
Master your cost report
FinThrive Cost Reports Manager saves time and money by automating portions of a complicated reporting process and maximizes reimbursement for unpaid Medicare co-insurance and deductibles.
Cost Reports Manager Modules:
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Medicare Bad Debt
Our Medicare Bad Debt module provides a fully transparent view of a hospital’s Medicare bad debt reimbursement opportunity by performing a full reconciliation of multiple years of patient encounter data, including coinsurance and deductible amounts.
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Medicare Disproportionate Share (DSH)
Our Medicare Disproportionate Share (DSH) module maximizes hospital reimbursement by identifying all patient days eligible for DSH reimbursement.
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Worksheet S-10
Our Worksheet S-10 module solves complex and data-intensive cost report issues by providing hospitals with core data points, detailed audit documentation, impact analysis and peer benchmarking.
Maximize your revenue
FinThrive Revenue Opportunity Manager helps hospitals address complex transfer DRG and shadow billing workflows by automating and detecting underpayments.
Revenue Opportunity Manager Modules:
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Transfer DRG (TDRG)
Our Transfer DRG (TDRG) module identifies reimbursement opportunities available under Medicare’s Post-Acute Care regulations.
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Medicare IME/GME (Shadow billing)
Our Medicare IME/GME (Shadow billing) module identifies Medicare Advantage claims that need to be shadow billed to meet CMS requirements and maximize IME/GME reimbursement.
FinThrive Government Reimbursement Solutions
$2,100,000
We helped one midwestern health system recover $2.1 million in Medicare underpayments over a five-year period
98%
Our HFMA Peer Reviewed Revenue Opportunity Manager solutions deliver a 98% audit success rate, historically
$1,900,000
We helped one 200-bed community hospital recover $1.9 million in Medicare Bad Debt reimbursement
We’ll meet you where you need us
FinThrive offers multiple delivery models for our Government Reimbursement solutions
Turn Key Consulting Service
Outsource reimbursement recovery with the FinThrive team to complete the work on your behalf
Leverage our Government Reimbursement solutions technology, plus FinThrive’s expertise to increase recoveries while reducing costs and effort
Technology SaaS
Implement our Government Reimbursement solution technology to give your internal teams access to our data automations tools
Gain control over your reimbursement process, eliminating additional consulting fees, increasing recoveries and improving analytics based on full visibility into your hospital data
Accreditations
Imagine revenue cycle management without the friction
See how it’s possible with FinThrive
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