The primary objective of TPR’s due diligence work plan is to assess the risk of any exposure with Medicare or Medicaid cost report related settlement issues in addition to the evaluation of the adequacy of the 3rd party balance sheet reserve accounts for hospital acquisitions.
TPR can analyze audited Medicare cost reports that are within the three year reopening window including supporting documentation as follows: Medicare cost report supporting work papers, intermediary audit adjustment supporting work papers, intermediary audit adjustment summaries, and NPR letters. We will evaluate the Medicare cost reports and supporting documentation for revenue recovery opportunities.
TPR can analyze or prepare the current year estimate for those cost reports that have not been filed and compare settlement estimate data and key input factors to supporting documentation.
TPR can analyze the most recent NPR intermediary adjustments and evaluate if the adjustments have been considered in future cost reports and compute the potential reimbursement exposure.
Evaluate key reimbursement data for all unaudited filed cost reports, including but not limited to:
DSH / Uncompensated Care
IME and GME
Nursing and Allied Health
Medicaid OP Settlements
Cost Finding Methodologies; and,
Others as deemed necessary
TPR can analyze or prepare schedules of unrecorded differences.