Fees and how RRP works

Questions finance leaders ask

Why pay a contingency fee at all?

RRP is paid based on what your hospital is paid. Nothing is due up front, and if your hospital receives nothing, RRP is owed nothing.

We can’t send patient data to an outside firm.

Nothing is sent until a BAA is signed, and no patient data goes through this website. RRP asks only for the data the work requires. David Kennedy, who is responsible for keeping client data secure, implemented encryption and audit processes supporting HIPAA compliance at Healthcare Reimbursement Solutions (HRS). RRP carries professional liability, cyber liability, general liability and umbrella insurance.

Our reimbursement staff is already stretched.

Your team’s part is pulling the reports RRP lists and answering the team’s questions: Medicare PS&R reports, 835 remittance files, patient accounting detail for deductible and coinsurance write-offs, collection agency placement and return reports, Medicaid remittances, and your collection and indigence policies. RRP works from what your records show. For a past cost reporting period, an account counts only if it came back from the agency and was written off as bad debt in that period, so the team documents what happened then rather than try to change it now. RRP’s experts map the codes, reconcile the data, build the listing, and answer the MAC. For a VDA request, after the first interview your team’s part is usually a few hours to a day of gathering data and sending it to RRP. The work starts as soon as the cost report is filed, while the staff, their memory of what happened, and the documents are still at hand. RRP does most of the gathering itself: the cost reports, research and archival material. Your team supplies items it already has, such as board minutes and internal discharge data. You approve, a hospital official signs, and you keep one senior contact from start to finish. Files come to RRP through your hospital’s private folder in RRP’s secure ShareFile portal, never through this website.

Our cost report consultant already does this.

A cost report listing usually starts from what your system reports as bad debt, and that is the right place to start. RRP starts one step earlier: every deductible and coinsurance dollar on the PS&R, reconciled to its final disposition, including accounts in other write-off codes, agency accounts returned and written off during the year but left off the listing, missed Medicaid remittances across in-state and out-of-state Medicaid, fee-for-service and managed, unbilled crossovers, and Medicaid misclassified to the wrong write-off code. The team also looks at prior years that can still be reopened. The first review costs nothing, so checking costs you nothing.

Your consultant keeps the cost report. RRP rarely needs to involve them, because the team can prepare an amended cost report or a reopening request on its own. When RRP does work with your consultant, the team gives them bad debt listings that meet Centers for Medicare & Medicaid Services (CMS) requirements split by inpatient, outpatient, subprovider, charity, self-pay and crossover, along with the recoveries CMS requires to be netted against claimed bad debt, which are usually recoveries of bad debt from prior periods.

Will claiming more bad debt bring more MAC scrutiny?

It can. Any listing can be sampled, and a larger listing, or a reopening that adds accounts, can lead the MAC to look harder at the whole year. That’s why RRP builds each account to the standard the MAC tests, and answers sample requests, questions and data requests quickly and thoroughly through final settlement, even years after filing. Over decades of work on Medicare bad debt, disproportionate share hospital (DSH) payments, transfer DRGs, IME/GME and VDA, RRP’s team has worked with every MAC. Before a prior-year reopening, the team goes over with you what it involves; RRP’s guide to reopening prior years for missed bad debt sets out the rules.

Who does the work?

RRP’s own team. It does the reconciliations, internal quality-control testing and mock audits, supports your review and acceptance of the work, and supports it through MAC audit. RRP is service-first: the team does the work, rather than handing your hospital a software platform to run and defend on its own.

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