Article
Unlocking healthcare back-office value: Medicare and Medicaid cost reporting
April 4, 2025
Medicare and Medicaid cost reporting is a critical aspect of financial management for healthcare providers. While often viewed as a routine and compliance driven task, cost reporting holds significant potential for uncovering valuable insights that can drive strategic decisions and improve financial performance. Effective cost reporting doesn’t come without its hurdles. Providers commonly face:
- Complexity: Medicare and Medicaid requirements are intricate and ever-evolving.
- Accuracy: Ensuring precise documentation to avoid discrepancies and potential audit findings.
- Missed reimbursements: Failure to capture all qualifying costs can lead to missed reimbursement opportunities.
- Timeliness: Delays in submission can result in delayed or forfeited payments.
Is your current cost reporting approach effective?
Beyond compliance, cost reports offer valuable financial and operational insights to help make informed business decisions. Here are three key areas to focus on, with self-reflection questions to help you assess the effectiveness of your current cost reporting strategy:
1. Bad debt reimbursement: Are you capturing what you’re owed?
Accurately identifying and reporting Medicare Part A bad debts can significantly boost reimbursements. To avoid leaving funds unclaimed, consider:
- Are we being reimbursed for any bad debts on our Medicare cost report?
- Are there Medicare gap insurance plans at play, or are we missing follow-ups on claims?
- Is our bad debt log thorough and accurate?
- Are we following our billing policies to allow for proper write-offs of bad debts?
