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Medicaid eligible days are one of the two components that make up the Disproportionate Share Hospital (DSH) reimbursement.  After HCFA (presently CMS) ruling of 97-2 clarified what constitutes an allowable Medicaid day, it opened a great opportunity for Hospitals to maximize their DSH payments by identifying eligible Medicaid days (example: paid and unpaid Medicaid Eligible Days).


However, based on Hall Consulting Services’ (HCS) reviews, we have found that a considerable amount of Medicaid eligible days are not captured through traditional methods used to capture Medicaid days.  We also identify databases which were not fully analyzed or available during the original filing of the Medicare Cost Report.


At HCS, we use an integrated method of client patient data, state information, and detail analysis to capture the appropriate Medicaid days.


Our methods have yielded considerable reimbursement to our clients, and, in some instances, helped clients to qualify for DSH reimbursement.




Back to Medicare Disproportionate Share Hospital Analysis