Medicare Bad Debt Recovery

Bad debt recovery is critical to the financial health of the hospital, regardless of payer. Once the hospital’s bad debt accounts are returned from the collection agency, Medicare has a specified process for recovery in place. However, this can be tedious, requiring more time and resources to complete than what the hospital has available. Added to this, in recent years MACs have become more stringent in the audit process, denying a larger percentage of submitted accounts.

Webdale Healthcare has developed the Medicare Bad Debt Recovery Service to aid hospitals in reclaiming these unpaid co-pays and deductibles of Medicare beneficiaries. We take on the task of compiling the logs for submission. We also work closely with hospitals during the audit process if defense is necessary.

The Medicare Bad Debt Recovery Service is not a computer program, but a line-by-line review of each account. All necessary adjustments are made and logs compiled accordingly. This attention to detail has yielded an acceptance rate of over 97%.

Originally provided for traditional Medicare, Webdale Healthcare expanded the offering to Medicare Advantage as well. With increasing number of Medicare beneficiaries opting for Advantage, recovery of these bad debts has grown in importance. Webdale Healthcare offers both Medicare Bad Debt Recovery Service (MBDRS) for traditional Medicare and Medicare Advantage Bad Debt Recovery Service (MABDRS) for Advantage. These programs are offered together or separately.

Traditional Medicare Bad Debt Recovery

Using the MBDRS program, we follow the criteria set forth in CFR 413.89 to prepare claims on the hospital’s behalf.  This hands-on service has our experts perform all the necessary work for filling claims including:

  • Research all uncollectable, Medicare-related collection, charity care and crossover accounts
  • Review the collection policies and procedures of the hospital and their outside agencies
  • Analyze all payments to determine which amounts can be claimed as bad debt
  • Prepare detailed debt logs
  • Compile documentation to support the bad debt claims for the sample accounts selected by the MAC
  • Assist the hospital in defending its bad debt claims during the MAC desk review
  • Evaluate the impact of ongoing CMS policy changes and advise the hospital in how to establish policies and procedures that will help ensure recovery of future claims

The MBDRS program has helped hospitals throughout the United States recover millions of dollars in lost revenue.  The MBDRS does not require significant dedication of time and resources on the part of the hospital as we can do manage the project remotely.

Medicare Advantage Bad Debt Recovery

As the Advantage option has grown in popularity with beneficiaries, so too has the bad debt associated with these plans.  Webdale Healthcare developed the Medicare Advantage Bad Debt Recovery Service (MABDRS) to aid hospitals in reclaiming the unpaid co-pays and deductibles of Medicare Advantage beneficiaries.  Hospitals know of their ability to collect on traditional Medicare bad debt, but may not be aware that Medicare Advantage bad debt can be recovered as well. Our specialists follow the same criteria as for the collection of traditional Medicare bad debt, as well as taking steps particular to Medicare Advantage carriers.  In the MABDRS program, Webdale Healthcare:

  • Review Advantage contracts for language addressing bad debt
  • Research all uncollectable, Medicare-related collection, charity care and crossover accounts
  • Review the collection policies and procedures of the hospital and their outside agencies
  • Analyze all payments to determine which amounts can be claimed as bad debt
  • Prepare detailed debt logs
  • Compile documentation to support the bad debt claims for the sample accounts selected by the carrier
  • Assist the hospital in defending its bad debt claims during the carrier audit

The MABDRS program has helped hospitals throughout the United States recover hundreds of thousands of dollars in lost revenue.  The MABDRS does not require significant dedication of time and resources on the part of the hospital as we can do manage the project remotely.