Guides to getting paid, rule by rule
Short, practical guides for spotting unclaimed money, avoiding the findings auditors look for, and going into a Medicare Administrative Contractor (MAC) review prepared. Every point cites the rule behind it.
Volume Decrease Adjustment (VDA) Case Studies
Key staff left. Discharges fell more than 5%. The qualifying hospitals got paid. A rural health system that lost key physicians, and one hospital with two bad years and two different causes.
Read the VDA case studies →Missed Medicare bad debt from prior years: how the three-year reopening window works
Bad debt left off a settled cost report can be added back through a reopening. Your hospital has three years from the Notice of Program Reimbursement (NPR) to ask, and the MAC decides whether to reopen.
Read: Missed Medicare bad debt from prior years: how the three-year reopening window works →VDA eligibility checklist for Sole Community and Medicare-Dependent Hospitals
Ten questions to answer before you file a VDA request. The request is due within 180 days of the date on the MAC’s NPR. A missed deadline means the payment is lost.
Read: VDA eligibility checklist for Sole Community and Medicare-Dependent Hospitals →The Medicare bad debt listing and Exhibit 2A: a practical walkthrough
What the listing must contain, and the rules behind the columns auditors test.
Read: The Medicare bad debt listing and Exhibit 2A: a practical walkthrough →Lessons from Office of Inspector General (OIG) Medicare bad debt audits
What the OIG disallowed at other hospitals, and how to keep it off your listing.
Read: Lessons from OIG Medicare bad debt audits →Every guide cites primary sources: the Electronic Code of Federal Regulations (eCFR), the Centers for Medicare & Medicaid Services (CMS), and the Department of Health and Human Services Office of Inspector General (HHS-OIG). Information is general and not advice for a specific hospital. If you would rather have the work done for you, see RRP’s Medicare bad debt recovery and VDA services, or request a no-cost review.
Find out what Medicare may owe your hospital
RRP’s team will review it at no cost and tell you plainly whether it’s worth pursuing. If your hospital receives nothing, RRP is owed nothing.
Send us your hospital’s Medicare provider number. We’ll review your most recent public cost report for Medicare reimbursement opportunities and reply within one business day. We don’t need any patient data.
Request a no-cost review