Medicaid Contract Compliance and Consulting Services
In the constantly changing landscape of the health care system, staying abreast of current regulations can be challenging. Since the mid-1960s, PHBV Partners has worked on behalf of federal and state government agencies to help ensure that Medicare and Medicaid providers receive only what they are entitled to under federal and state laws and regulations. Our staff of Medicaid and Medicare audit and consulting professionals is one of the largest and most experienced in the United States. The health care services that we have provided for government agencies include:
- Cost report audits
- Program integrity and claims audits
- Disproportionate Share Hospital (DSH) audits
- Managed Care Organizations' financial and performance audits
- MMIS Audits
- Eligibility Payment Error Rate Measurement (PERM) activities
- CMS 64 – Quarterly expense report reviews
- Establishment of provider reimbursement rates
- Reimbursement methodology design and implementation
- Medicaid policy consulting
- Medicaid Agency operations consulting
- State Plan Amendment assistance
- Medicaid funding consulting including provider assessment plans
- State Auditor assistance
- Assistance with CMS and OIG audit findings
- School Based Health Services
