Medicare Cost Report Appeals and Reopenings—Commonly Appealed Issues–A Deep Dive Webinar [PODCAST]

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Highlights of this episode include:

• What is this webinar about?
• Who will be joining Kristin on the webinar
• Key takeaways
• What this series about
• Who can benefit from this webinar

Kelly Wisness: Hi, this is Kelly Wisness. We’re pleased to welcome back Kristin DeGroat, Besler Holdings’ Chief Legal Officer. In this episode, Kristin will provide us with a glimpse into Besler Holdings’ next webinar in its Medicare Cost Report Appeals & Reopenings Series, Medicare Cost Report Appeals and Reopenings: Commonly Appealed Issues: A Deep Dive, live on Wednesday, June 17, at 1 PM Eastern Time. Welcome back and thank you for joining us, Kristin.

Kristin DeGroat: Thank you for having me again. I appreciate it.

Kelly: All right. Well, let’s go ahead and jump in. So would you please tell us a little bit about this webinar?

Kristin: Well, as you mentioned, it is the second webinar in the series on cost report appeals and reopenings. And we’re really going to focus on the appeals side and the commonly appealed issues before the Provider Reimbursement Review Board. So hopefully, we kind of gave a little bit of a glimpse into what we were going to talk about in the other webinar. So hopefully, everyone coming will be ready to take that deep dive.

Kelly: Awesome. Yeah. Sounds like it’s going to be a great webinar. And you have some guests joining you on this webinar. Can you tell us a little bit about the people that will be joining you?

Kristin: I do. I have Leslie Goldsmith and Page Smith from Bass, Berry & Sims joining me. And we have done some webinars in the past together. We complement each other really well. Both Page and Leslie have an extensive background in appeals, both at the Provider Reimbursement Review Board level, the administrative level, and the court level. So, they are ready to help me kind of dive into the issues. And where they have more expertise in the area, they’ll be able to lend you their thoughts as to the status of those issues and kind of where we approach it from a legal standpoint and more of a cost reporting standpoint. So, I think together, it’s going to be a great webinar.

Kelly: I agree. I’m really looking forward to hearing you all kind of come together and complementing one another. Please share what you think some of the key takeaways will be from this webinar.

Kristin: Greatest thing will be not only an insight into what exactly the issue is that’s been appealed and determining, “Well, is this something that would apply to me, to my hospital? Are there others out there with the same issue?” and then also where it is today. Where is the issue? Are we still waiting on a decision at the Provider Reimbursement Review Board, or are we waiting on a hearing decision? And where we are in court, are these issues there? Are we expanding the ideas behind these appeals? All those insights that a provider who may not have an outside consultant or an outside lawyer that’s privy to the ongoings– I think it’s going to be a great webinar to dive into that.

Kelly: Right. I totally agree. Can you tell us a little bit more about this webinar series? The first one that we had, last month. We’re going to have another one in July. Can you just tell us a little bit about why the series came about?

Kristin: The series is really focusing on the cost report and more an appeals focus, although a lot of the issues that we appeal can also be reopening issues. And kind of the goal is once we appeal it, if we get a favorable decision, it tends to lead to the issue being more of a reopening issue and getting providers that reimbursement a little bit quicker than the appeals process tends to take. But we’re looking at it high level. We started with, “Well, what is the board? And why do we appeal? And what are the processes behind filing those appeals? And how they differ from reopenings.” But then we’re now going to move into really the meat: not only the why, but here’s what we appeal. And the status of that leading to providers having a better understanding of what might be available to them out there that are– maybe there’s other groups, they’re not comfortable doing it on their own and they want to join a group. Well, then they can see, “Okay, well, where do I fall in that? Is there opportunities for me to join that?” I think that’s really the biggest thing. And then we’re going to end kind of on a best practices from all parts and parcels, not only from the board itself, but maybe how to file the issue. Maybe there’s ways to tailor it a little bit better. So, the best practices, I think, is a great way to end the webinar. And I’m hoping that all of them together, that the people attending will be able to avail themselves of all three together, because I just think it’s a great series to help figure out, again, what do I appeal and where am I at in this process?

Kelly: Right. No, I think it’s going to be a great webinar series. Looking forward to this one and the next one. And you mentioned the people who are going to be watching this. What is the target audience for this webinar series?

Kristin: So, it really is what I call on the front lines. Those people preparing the cost reports, attending the audits, and whether it be a desk review, and then there’s a final review, final review meeting, that’s probably the front line. But we also have to have those who make the decisions, who decide, “Okay, my reimbursement manager has told me, this is an issue I need to tackle, something I need to handle. Why?” So those decision makers, the CFOs, maybe even the corporate reimbursement directors, maybe even up to the CEO, whoever’s making those decisions and really needing to understand why we have the process. And then, of course, the what. So, I think at all aspects. And then maybe if there’s documentation required – which, quite frankly, there is – maybe getting the patient financial or accounting, or whoever does the data, who would handle the data requests and the data needed to pursue these appeals. So, I think it really spreads across the organization. And so, I think those people attending really would have the best full, complete picture of the process.

Kelly: Right. No, that makes a lot of sense. Well, thank you so much for joining us, Kristin, and for giving us this glimpse into Besler Holdings’ free webinar, Medicare Cost Report Appeals and Reopenings: Commonly Appealed Issues–A Deep Dive. Join us live on Wednesday, June 17, at 1 PM Eastern Time. And as a bonus, you can also earn CPE. Thanks again, Kristin.

Kristin: Thank you.

Kelly: And thank you all for joining us for this episode of The Hospital Finance Podcast. Until next time…

[music] This concludes today’s episode of The Hospital Finance Podcast. For show notes and additional resources to help you protect and enhance revenue at your hospital, visit besler.holdings/podcasts. The Hospital Finance Podcast is a production of Besler Holdings.

If you have a topic that you’d like us to discuss on The Hospital Finance Podcast or if you’d like to be a guest, drop us a line at update@besler.com.

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