Federal Claiming

Relieving the revenue-recovery burden

UMass Medical School’s Center for Health Care Financing relieves pressure on overburdened public-sector managers whose myriad work responsibilities include struggling with evolving rules and regulations in complex and ever-changing Medicaid programs. In that common workload conundrum, the Center for Health Care Financing's revenue efficiency and recovery resources can be of service.

The Center’s consultants identify new ways to claim revenue, with a thoughtful and studied approach based on the application and transfer of knowledge in a university environment. In Massachusetts, the Center evaluated reimbursement systems for state-owned hospitals to ensure compliance with upper payment limits while balancing Medicaid costs with Medicaid payments. Additionally, the Center’s team collaborated with the state’s Medicaid federal reporting unit to automate its reporting function through the creation of a web-based system that produces superior information and results.

Center staff members bring their experience, insight, and objectivity to the following areas:

• Family Planning
  The Center's staff understands federal claiming and knows how to identify these services and claims. They help clients pursue the 90 percent federal matching rate available for the delivery of family planning services to the Medicaid population and also provide consulting services related to Medicaid and the Children’s Health Insurance Program.
• Children's Health Insurance Program
  The Center has expertise in key areas of the program as it relates to identifying services and claims. They have been successful in pursuing additional federal funding for states.

Other claiming activities include:

• Public Provider Reimbursement
  We provide Massachusetts with revenue management services to maximize the collection of federal and state dollars for health care and related services provided by public hospitals, mental health clinics, psychiatric hospitals, skilled nursing facilities and community-based programs.