We are the experts in Medicare Bad Debt Reimbursement providing “Full Reconciliation” of hospital deductible and coinsurance along with the fully-tested listings. We also provide concierge-level audit support through the NPR.
The CDI Advantage
Agency Pullback Expertise
Extensive expertise developing and implementing policies to return all accounts from final agency. Our policy and data efforts have helped hospitals return and realize millions in MBD reimbursement.
Detailed reconciliation of all accounts NOT eligible for MBD reimbursement. Quantification of lost MBD reimbursement and guidance on how to potentially realize that lost MBD in current and future periods.
Over 94% allowance rate at audit, with more than half a billion dollars submitted for additional MBD reimbursement.
Who We Are
Specialized Expertise in MBD Reimbursement
At CDI, we pride ourselves on doing one thing better than anyone else: Medicare Bad Debt (MBD) reimbursement. Our unique edge comes from our in-house proprietary MBD system, crafted to handle your critical settlement items with precision. Coupled with detailed analysis and interpretation of IPPS rulings, we are able to maximize your reimbursement, all while adhering to the nuanced regulations of MBD.
Proprietary Systems and PFS Trained Team
Our services are delivered through a robust in-house proprietary MBD system and a team of Patient Financial Service (PFS) trained professionals, who bring specialized knowledge to two core project types. The first is current year filing, where we manage the annual listings with unparalleled accuracy. The second, a retrospective look back, enables us to scrutinize prior year filed listings to find additional reimbursement opportunities.
Laser Focus Provides Maximum Results
We are distinguished by our dedication to MBD reimbursement, our cutting-edge proprietary system, and our team of PFS trained professionals who masterfully navigate its complexities. Our meticulous attention to detail, specialized expertise, and steadfast commitment to our clients' success make us the preferred partner for hospitals aiming to optimize their MBD processes.
What We Do
Retrospective Look Back
Our Retrospective Look Back involves a comprehensive review of a healthcare provider's previously written-off Medicare bad debts. The purpose of this project is to identify and reclaim any amounts that may have been improperly categorized or inadequately pursued, ensuring compliance with Medicare regulations.
Current Year Filing
During a Current Year Filing project our team undergoes a systematic process of identifying, documenting, and submitting eligible bad debts to the Centers for Medicare & Medicaid Services (CMS) for reimbursement within the current fiscal year.
Concierge Audit Support
We don't walk away once the initial filing is done. Instead, we are right there with you through the first Notice of Program Reimbursement (NPR), providing concierge audit support tailored to your needs. Our expert team helps you navigate the complex NPR, ensuring that the reimbursement due to you for Medicare services is accurate and compliant with all relevant regulations.
How We Work
The MBD Model
Our proprietary SQLServer-based model has been developed and continuously improved over the past 15 years and has been real-world tested on over 440 hospitals across 2000 cost reporting years.
Streamlined Data Request
We have a scaled down data request that asks for only minimally-necessary fields. We can complete our engagement with as few as 25 raw data fields. All calculations are done on our end.
In-process data never leaves the CDI network. All work takes place in a secured virtual environment, located at the CDI data center. Final listings are protected in-transit using our CMS-approved encryption application.
Our PFS trained and experienced analysts perform significant testing of individual accounts to ensure that the output from our MBD model will withstand the scrutiny of Medicare audit testing.
Our automated MBD model produces accurate results for up to 80% of the data. Our experienced analysts then fine tune and test the remaining data, achieving an average 94% allowance rate at audit, in as little as 8 weeks.