DSH – Medicaid Fraction (Medicaid Days)
McKay seeks to identify DSH Medicaid eligible days by performing procedures on every patient stay. We suggest the performance of multiple verification matches over time to allow the states’ Medicaid data bases to mature. Our procedures allow us to mine hospital data, and data from other Medicaid data bases in order to locate heretofore missing verification data elements, thereby enhancing verification results.
McKay Consulting is a national leader in providing strategic consulting services related to Medicare DSH reimbursement.
Our DSH Medicaid eligible days services are delivered on either a prospective or retrospective basis. Regulations have been crafted that require providers to look closely at their DSH determinations including their compilations of specific lists of Medicaid days that support each cost report filing, whether an initial filing or a subsequent amendment. As part of our retrospective DSH services, we consult and work with hospitals to ensure that the most appropriate avenues to update or correct previously filed Medicaid days are pursued – whether it be delivering updated lists at the commencement of the MAC audit, or filing a cost report reopening request with the MAC, or filing an appeal with the Provider Review Reimbursement Board (PRRB). McKay’s work product supports the appropriate number of Medicaid eligible days for cost report filings, amendments, reopening requests, and/or appeals.
Our goal is, and has always been, to provide our clients with the best finance and reimbursement consulting services in compliance with all applicable laws and regulations, while positioning providers for optimal reimbursement.