Do you know what a reimbursement accountant is?

excel screen shot, old excel, financial statementsWell I didn’t either so keep reading and you will find out.   Lately I have been thinking a lot about where I would like this blog to go in the future.  I have drawn out plans as to how I see it in the future.  While not working on the site in the past few days I have been deep in thought.  I conducted an interview for a newspaper and I have been busy at work.  This time of the year is especially busy in hospital finance. 

Each year as the financial audits are coming to a close, the reimbursement staff in hospitals are beginning to get their gears going.  They are driving through every statistic that makes up the hospital that they work at.  They are figuring out which dollars are for salaries, which are for benefits and which are just capital costs.  The reason you ask is why, why go through such great lengths to determine what a salary dollar for a nurse is or what a discharge in the ICU is. 

The way that capital costs and salary dollars are allocated to the specific departments can have an impact on how that particular operating unit is paid.  Understanding the payment systems of Medicaid and Medicare is no easy feat to grasp; I have been working here for 3.5 years and still at times have difficulty. 

The financial and statistical data is submitted to Medicare and Medicaid to analyze and put into the hospital rates in the future.  This report is filed annually for all the hospitals across the country that participates in the program.  This is a time consuming and arduous process that takes more than a month to complete, in fact I start working on it after the start of the New Year and do not finish until the end of May for Medicare and the end of June for Medicaid.  When completed each of the reports is close to 200 pages long.

What do you think; did you think there was much data compiled by Medicare and Medicaid?  This is in addition to all the government tax forms like the 990 and payroll stuff.  If you are bored Google CMS 2552-10 to find out about some of the forms that are necessary to be completed.  So with that said, I have revised my posting schedule for the time being to Monday, Wednesday and Friday. 

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 PHOTO BY: MicrosoftSweden
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Comments

  1. I didn’t know there were that many forms but I knew it was pretty complicated. I’ve also heard that Medicare really doesn’t pay the hospital anything near what they’re billed. If the bill is $1k for instance, they may pay $200-300.
    Jason recently posted..Broke, Desperate, and Being an IdiotMy Profile

    • @ Jason – What we bill and what we are paid are no where near each other. You can essentially bill whatever you would like, but doing these cost reports Medicaid and Medicare can determine our costs per unit of service. This is how they come up with a rate when they aggregate all the hospitals across the country. It is unfortunately the person that doesn’t have insurance that gets stuck with the full bill!

  2. Sounds like a freaking headache, dude, sorry you have to handle some of that!
    TB at BlueCollarWorkman recently posted..Road Rage With a Gun… for realMy Profile

    • @ TB – I enjoy plowing through the numbers because the numbers can paint a picture of exactly what the hospital does. It does desensitize you though, you see high dollar cases and you just see revenue, but you forget that there are people close to death in some of these cases.

  3. Sounds like a lot of work to process all of that financial data. At a decent sized hospital there must be a massive number of individual expenses to go through. Good idea to cut back on your posting schedule a bit while dealing with that stuff. You don’t want to wear yourself out.
    Modest Money recently posted..Are Finance Bloggers Perfect Identity Theft TargetsMy Profile

    • @ Jeremy – It takes months to process all of the financial data!!! We are a small hospital too, and between Medicare and Medicaid it keeps 2 full time staff more than busy!

  4. Is there ever a time that someone says…. “Oh, that’s too much to charge for that service. Let’s look at it again to see how we can reduce the costs to our customes.”

    • I have been here close to 4 years and it has not happened yet. We typically may change the charge structure around to shift money from inpatient to out patient by the way we structure our contracts. I have not seen any prices lower and they typically go up every year. If you ask for a discount on services we certainly offer those if you are willing to pay up. This can be up to 30% of your bill, so if you are a paying customer there are options.

  5. This is why some schools in canada have implemented an online system where you can check whether a candidate graduated easily.
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