Premier Partners with RevFinders to Boost Hospital Reimbursement

Premier, a healthcare industry leader based in Charlotte, North Carolina, has entered into a contract with RevFinders, a consultant specializing in helping hospitals maximize their revenue. The partnership aims to identify patients eligible for Medicaid reimbursement whom claims were not submitted, enabling Premier members to increase their payments under the Medicare Disproportionate Share program. According to RevFinders, many U.S. hospitals are entitled to additional DSH reimbursement due to the current process used by fiscal intermediaries to identify Medicaid-eligible patients. By accurately identifying and documenting these additional eligible days, hospitals can significantly increase the monies owed through state and federal DSH programs.

Key Takeaways:

• Premier has contracted with RevFinders to help its members increase revenue by identifying patients eligible for Medicaid reimbursement.
• RevFinders uses hospital price databases to analyze claim procedures, reimbursement rates, and historical payment experiences to recommend adjustments.
• The partnership focuses on two packages: Market Focused Pricing and Medicare Disproportionate Share.
• RevFinders claims to have won hospitals up to $30 million in additional reimbursement through its services.
• Many U.S. hospitals are entitled to additional DSH reimbursement due to the current process used by fiscal intermediaries, which fails to capture a large number of patient days eligible for reimbursement.
• Premier's senior vice president and general manager, Stephanie Alexander, believes that the partnership has the potential to return hundreds of millions of dollars in value to its members.

Statistics:

• RevFinders claims to have won hospitals up to $30 million in additional reimbursement.
• Many U.S. hospitals are entitled to additional DSH reimbursement.
• The partnership focuses on two packages: Market Focused Pricing and Medicare Disproportionate Share.

Sources:

• "RevFinders helps Premier boost revenue for members through Medicaid reimbursement optimization" [No source provided in the text]

References:

None