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Our Services
01.OPPS Imaging Cost Architecture & APC Optimization
Helping Hospitals Capture the Reimbursement They’ve Already Earned Medicare’s Hospital Outpatient Prospective Payment System (HOPPS) is built on complicated rules that determine how imaging services are paid. For large hospital systems, especially academic medical centers, even small structural issues in cost centers, APC assignments, or charge capture can quietly drain millions in reimbursement every year. This isn’t about working harder - it’s about structuring things correctly.
02.CAH Cost Report Reconstruction & Cost Recovery
Cost‑Based Reimbursement Only Works When Costs Are Reported Correctly. Critical Access Hospitals operate under a completely different Medicare model. Unlike OPPS hospitals, CAHs aren’t paid based on APCs or charges - they’re paid based on cost. That means one thing: If costs are under‑reported, reimbursement is under‑paid. CAHs work hard to serve their communities, but the complexity of Medicare cost reporting often leads to missing or misallocated imaging costs. We help fix that.