Transplant Analytics specializes in reviews of filed Medicare cost reports. Our reviews are extensive and thorough, focusing on the capture of direct costs reported on Worksheet A, time studies, expense reclassifications and adjustments, overhead statistics, pre-transplant charge capture, organs excised/donated at the facility, revenue offsets, and the Medicare usable organ percentage. When looking at the Medicare usable organ percentage, we validate both the Medicare usable and Total usable organ counts reported on Worksheet D-6. We also look at Medicare secondary issues to determine if there is remainder liability on organs after Primary insurance payments, if managed care contracts have paid in full contract language, and if Medicare was billed as the secondary payer. We can also be available to consult with your Fiscal Intermediary's staff when they conduct their audits. Our goal is to help you receive your proper Medicare settlement.
Transplant Analytics can prepare your organ acquisition cost reports. We are experienced in completing all Medicare worksheets and transplant data elements that determine your Medicare settlements for organ acquisition. Once we have completed the cost report, we will provide you with a comparative analysis with the prior two filed cost reports and with an explanation of any material variances.
Transplant Analytics can educate both your clinical and financial staffs on the Medicare Organ Acquisition cost report worksheets and settlement process. This education can be especially useful if you have a staff that is not experienced with organ transplant reporting and settlement. Reimbursement for organ acquisition is unique in the Medicare "world" in that it continues to be a cost-based program with many reporting concepts that are not clearly defined in CMS regulations and manuals.
We are experienced at preparing and filing Medicare cost report appeals and re-openings. We can assist your financial staff in drafting CMS appeals and cost report re-opening packages, when you disagree with how your Medicare auditors settled your cost report. Our knowledge of the Medicare organ acquisition cost reporting rules and regulations help you identify, evaluate, and articulate appeal items on your audited cost reports. We can also be available to defend your appeal positions during the appeal's process. For re-openings, we can assist in drafting re-opening letters and with accumulating supporting documentation. As with appeals, we can offer our support and participation in Fiscal Intermediary re-opening discussions.
Transplant Analytics will prepare a Profit & Loss and/or Contribution Margin Analysis for your transplant product line. This analysis is useful for senior management to help determine how to allocate scarce system resources and to help Transplant Administrators evaluate the financial performance of their departments. It can also provide pertinent information to your financial staff for negotiating managed care contracts.
Our consultants can assist your transplant center in the event you find yourself working "under" a System Improvement Agreement (SIA) with CMS. We can provide a group of qualified medical professionals to act in the capacity of an Independent Peer Review Group. We can also provide the services of an Independent Consultant as defined by CMS in their SIA agreements.
Review of regulatory compliance is an essential responsibility of all transplant centers. Transplant Analytics is prepared to provide review and/or audit of your centers' compliance with CMS Conditions of Participation, UNOS Policy, and QA/QI program assessment.
Transplant Analytics can provide an analysis of your center's clinical operations. The analysis can be tailored to address the patient evaluation process, patient throughput, patient scheduling, clinical documentation and staffing.