Hospitals and other institutional providers receive payment from traditional Medicare through claims and cost reports. While appeal of claims is a more common form of payment dispute, appeal of cost reports often involves a higher monetary stake.

Cost report items and other related payments are appealed through a unique process involving the Provider Reimbursement Review Board (PRRB) and the federal courts. High ticket items such as yearly payments from Medicare for Medicare disproportionate share hospital adjustments, direct medical education costs, indirect medical education costs, nursing and allied health costs, the annual payment update related to quality reporting compliance, wage index and Medicare bad debt are just some of the items that are the subject of these appeals.

If you are a hospital, you likely have been part of either an individual or group appeal before the PRRB.

Access a recording of our recent discussion of these appeals. Bass, Berry & Sims healthcare attorneys Leslie Demaree Goldsmith and Page Smith provide an overview of PRRB appeals — who can appeal, how to appeal, what can be appealed and the process for such an appeal.

Who Should Attend?

  • Reimbursement and revenue cycle personnel
  • Finance department leaders and managers
  • In-house legal counsel responsible for reimbursement
  • C-level executives, consultants, and principals

Accreditation

The webinar has been approved for one hour of General Tennessee CLE credit. Certificate of completion and other necessary application forms will be provided for use in other jurisdictions.

Questions?

Submit questions for presenters during registration. For more information, please email healthcare@bassberry.com.