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Medicare Bad Debt Auditing: Are You Losing Money?

We have not previously discussed Medicare bad debts here. The importance of Medicare Bad Debt is simple: you can receive up to 70% for allowable Medicare bad debts. These payments are usually made biweekly (every 2 weeks) and can provide additional revenue that you otherwise would not have. What is the criteria for allowable Medicare bad debts? You can find the relevant citation here. The relevant subsection is (e). It provides the following 4 requirements:

  1. The debt must relate to covered services and be derived from deductible/co-insurance amounts.
  2. Reasonable collection efforts must be made
  3. The debt was uncollectible when claimed as worthless
  4. Sound business judgment established there was no likelihood of recovery in the future

What can you offer?

We offer the ability to review your electronic systems to ensure that you are capturing all the appropriate Medicare bad debts. Regardless of what system you use (McKesson, Excel, etc.) to track your bad debts, there is some chance that you have missed or are continuing to miss allowable bad debts. For example, are you ensuring that you are appropriately recalling accounts sent to collections?

  • Are you certain that your Medicare bad debts controls are adequate?
  • Do you know the risks of inadequate Medicare bad debt controls?
  • Did you know that old Medicare bad debts can generally be reported in current cost report periods?
  • Are you looking to obtain results using a no-risk approach?
  • Are you unwilling to pay high costs before results?

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