Recover the Medicare bad debt and VDA payments your hospital is missing.
Allowable Medicare bad debt goes unclaimed when write-off codes hide it, and Volume Decrease Adjustment (VDA) payments go unrequested when the 180-day deadline passes unnoticed. We review your records, find what’s missing, and document each claim to hold up when your Medicare Administrative Contractor (MAC) reviews it.
A senior reimbursement expert leads your case from first review to final settlement, and you have a direct line to the Partner on it. Our team handles the reconciliation and paperwork; your staff supplies the files and approves the filings.
No recovery, no fee. We’re paid only from what we recover.
- No-cost reviewRemittances, collection history and cost report data
- Reconciliation and analysisAllowable bad debt and VDA eligibility
- Filing with your authorizationSupport built to the rule your MAC tests
- Audit defense and settlementWe stay with it through the final Notice of Program Reimbursement (NPR)
Specialists in Medicare bad debt and Volume Decrease Adjustment
We know both programs in depth: the regulations, the Centers for Medicare & Medicaid Services (CMS) manual sections, and what MAC auditors test. Payment goes to the hospital whose documentation holds up, and building that documentation is our daily work.
Medicare Bad Debt Recovery
Allowable bad debt is often missed because write-off codes don’t capture it. We trace every deductible and coinsurance dollar through your Provider Statistical and Reimbursement (PS&R) report and 835 electronic remittance data, then build a CMS Exhibit 2A listing, the patient-level bad debt listing CMS requires, designed to hold up when the MAC samples it, for this year’s cost report and for prior years that can still be reopened.
How bad debt recovery works →Volume Decrease Adjustment (VDA)
If your Sole Community Hospital or Medicare-Dependent Hospital (SCH/MDH) lost more than 5% of its discharges because of circumstances beyond its control, such as a flood or an inability to recruit essential physician staff, your hospital may qualify for a lump-sum payment for the fixed costs it still carried. We confirm you qualify, build the request, and handle the MAC.
The request is due within 180 days of the original NPR. Miss it, and the payment is lost. Received an NPR recently? Call (425) 930-9874 with the date on it and we’ll confirm your deadline and discuss your eligibility at no cost.
How VDA requests work →Why hospital finance leaders work with us
A senior expert on your case
The person who reviews your numbers on day one signs everything we file and answers the MAC, and you reach that person directly.
Built to hold up at audit
Every account we claim and every VDA figure we calculate is documented to the rule the MAC tests, so the support is ready before the auditor asks.
With you through settlement
Filing is not the finish line. We stay through MAC review, sampling, and the final NPR.
Paid only when you are
Our fee comes out of what we recover, after your hospital is paid. Nothing is due up front.
We carry the workload. You keep one senior contact.
Our reimbursement team takes on the data work and the paperwork, so your staff stays on its own priorities and you always know who to call.
Our approach- No-cost reviewYou learn what’s likely there and whether it’s worth pursuing before you commit to anything.No cost, no obligation.
- Reconciliation and analysisEvery account is reconciled, so your claim includes the allowable accounts your records support, and every dollar in it is documented.Your lead reviews every finding.
- Filing with your authorizationNothing goes to your MAC without your approval, and your lead signs every filing.
- Audit defense and settlementWe answer the MAC until you’re paid, so your team isn’t left to handle audit requests alone.Same person, start to finish.
Free guides for your team
VDA eligibility checklist
Ten questions that tell you whether you qualify, and what the MAC will want to see.
The bad debt listing and Exhibit 2A
Get the listing right the first time, so your cost report isn’t rejected.
Lessons from OIG bad debt audits
What the Office of Inspector General (OIG) disallowed at other hospitals, and how to keep it off your listing.
Reopening prior years for missed bad debt
Which settled years are still open, what the request contains, and what the MAC will test.
Salim Nice’s career in hospital reimbursement
These figures cover Salim’s full career in hospital reimbursement, most of it before RRP.
Senior experience on every case
Our leadership built and ran reimbursement firms, including Healthcare Payment Specialists and Healthcare Reimbursement Solutions. Salim Nice or Laura Kortokrax leads every engagement, so that experience works on your hospital’s numbers directly.
Meet the leadership team →
What hospital finance leaders say
“The final recovery was almost exactly what they said it would be. They found reimbursement opportunities in both Medicare bad debt and VDA, walked us through every step, and kept us informed on both engagements. Knowledgeable and efficient. I’d recommend them.”
“We’ve been very happy with the outcome. We engaged the team for a Medicare Volume Decrease Adjustment (VDA) payment, and the result was strong enough that we extended for another year. They handled every question from our Medicare Administrative Contractor (MAC). At a time when every bit of revenue matters, the $1.6 million in VDA payments we received has made a real difference.”
“Our ongoing partnership with the RRP team has saved us a great deal of time. They prepared the Medicare bad debt listing for our cost report and are still working on recovering prior years. They found pockets of bad debt we were missing and helped us fix broken processes. It helps to have an experienced group we know and trust as our partners on this.”
“This has proven to be a valuable partnership for us. The team is knowledgeable and takes care of every detail, which makes the process easy on our side. They’ve helped us recover over $7 million so far, and counting. I recommend them.”
“I was just saying this morning how simple and painless the process was for me. Data collection was minimal, and the review with Laura was quick.”
Client comments are shared with permission and without names, to protect client confidentiality.
Find out what Medicare may owe your hospital
We’ll review it at no cost and tell you plainly whether it’s worth pursuing. If we don’t recover anything, you don’t pay anything.
Request a no-cost review