Working with a Critical Access Hospital from ground zero in the development of their Point of Service Collection process, The Rybar Group provided the hospital with the tools and skills necessary for the conversion, yielding positive results customer relations wise and assisting the hospital in recognizing over $219,000 in additional revenue over the course of one year.
- Our clients have received over $61M in additional reimbursement amounts related to the Volume Decrease Payment regulation, with over a quarter of our appeals averaging $2.9M. Our expertise includes successful outcomes at the Provider Reimbursement Review Board (PRRB), resulting in payments made to the appealing hospital.
- The Rybar Group assisted a Sole Community Hospital in increasing its projected reimbursement amount by nearly 2,200% (from approximately $38,000 to approximately $873,000). By working with the facility and offering recommendations for changes in cost report allocations, our consultants achieved a nearly $850,000 increase in Medicare reimbursement for the hospital.
- Through the work of our consultant team, we achieved a Volume Decline Payment of approximately $6M for one fiscal year for one of our clients.
- Through the assistance of our consultants, a large corporate health system was able to achieve optimal Volume Decrease Payment results, increasing reimbursement for two of their hospitals by over $300,000.
- A hospital of a large corporate health system was able to increase its Volume Decrease Payment opportunity 21% ($400,000) with a cost report review by our consultants. This also positively impacted the Rural Hospital Medicare Demonstration Project cost per discharge payment.
Data Integrity and Compliance Consulting
Working to aid in the criminal defense of a clinician related to a claim of inappropriate billing practices and a high volume of medically unnecessary services, The Rybar Group performed an extensive review of the government’s data and evidence, identifying inaccuracies in numbers and building a case for lack of supporting data to substantiate the claim. Our activities validated the provider’s active pursuit of compliant and correct billing practices and lead to an unprecedented move, less than a month from the scheduled trial date, of the judge dismissing the case. The clinician, who was facing upwards of 6 years in prison, was able to get his life back and continue practicing medicine.
Data Analysis/Provider Compensation
A regionally integrated health care delivery system client was paying some employed healthcare providers based upon data that was generated from its patient billing system on a monthly basis. An erratic pattern developed from the data which caused the payments to its staff to be very inconsistent with the work produced and caused dissatisfaction to the team. Through an analysis of the data and the ongoing process for accumulating the data, The Rybar group identified several opportunities for improvement which increased the accuracy of the employee payments and their overall satisfaction with the client.
Hospital Financial Performance
A 150-bed hospital client, with over twenty satellite offices, was experiencing operational losses. In addition, the hospital lost both its CEO and CFO to attrition. One of our team members went to work as the Interim CFO of the organization for a period of two years, stabilized the operational losses and increased cash on hand from approximately 110 days to 165 days in that period.
- The Rybar Group successfully assisted a Critical Access Hospital in changing the structure of its cost report, netting the hospital over $50,000 in additional reimbursement on a go-forward basis.
- By changing the methodology for a cost center and the structure in the cost report, The Rybar Group assisted a Critical Access hospital in netting $100,000 in reimbursement on a yearly basis and an increased cash flow to the hospital by over $400,000 per year.
The Rybar Group has assisted a number of hospitals in successfully appealing Medicaid settlements and in the successful recovery of outpatient Upper Payment Limit differentials. This includes the recovery of over $300,000 for one acute-care hospital.
Contact us today to see how your facility can become one of our success stories…