Purpose:
20/20 RMP will identify additional Medicaid eligible days to have hospital providers exceed the minimum requirement for 340B DSH qualification and reimbursement.
340B Disproportionate Share Hospital (DSH) - Result of Additional IP Days Discovered
Case Study Challenge:
A Georgia hospital failed to meet the requirement to qualify for 340B Disproportionate Share Hospital (dsh) reimbursement for one Fiscal Year – short nearly 225 days. To avoid duplication of efforts, 20/20 received a complete listing of IP visits and days for the applicable Fiscal Year, which was already calculated and processed by another firm.
Solution:
After all efforts by the original firm were exhausted to identify additional appropriate days to meet the threshold to qualify for 340B DSH reimbursement, 20/20 was hired and proved successful at successfully finding the additional days needed.
Upon receiving the complete list of already identified days, 20/20’s process identified an additional 320 IP days. This resulted in the hospital’s qualification for 340B DSH reimbursement for the applicable Fiscal Year.
Results:
20/20 did not expect to receive any fees unless the provider qualified to receive DSH reimbursement for applicable Fiscal Year based on 20/20’s efforts identifying additional DSH days.
After the appeal efforts that added the additional 320 IP days 20/20 discovered, the hospital recovered nearly $1.8 million dollars.