Disproportionate Share Reimbursement

Disproportionate Share Services


HealthQuest Consulting, Inc. Offers superior services in connection with Medicare disproportionate share reimbursement (DSH). Our DSH services include:

    · Medicaid eligibility verification
    · SSI Enhancement including SSI realignment and SSI appeals 

Medicaid Eligibility Verification and log preparation

Our proprietary software program EverX ensures the greatest possible number of Medicaid eligible days and corresponding DSH reimbursement. Features of our software program include:

· Match eligible newborns to eligible birth mothers and assign birth mother's SSN to newborn's account for eligibility verification and inclusion

· Identify erroneous SSNs for exclusion and further investigation

· Incorporate Medicaid paid claim files to extract Medicaid ID#S


· Identify and exclude non-PPS days

· Generate automatic State export file for ease of eligibility verification

· Import State Match results and group days based upon State match results

· Separate restricted aid code days based upon diagnosis code ensuring separate sampling of highly scrutinized day categories

· Generate an Excel log for Intermediary review and sampling

SSI Enhancement

HealthQuest Consulting, Inc. is one of the leading consulting firms in the area of SSI enhancement for Medicare DSH. 

We've analyzed the SSI Medpar data files for hundreds of hospital cost reporting periods.

If you would like more information on the SSI data analysis and how HealthQuest Consulting, Inc. can help your hospital, call us now at 714-832-2895.