Recover the Medicare bad debt and VDA payments your hospital is owed.
Allowable Medicare bad debt goes unclaimed when write-off codes hide it, and VDA payments are lost when the 180-day deadline passes.
RRP’s experts review every account, apply every Centers for Medicare & Medicaid Services (CMS) rule, and support their work with your Medicare Administrative Contractor (MAC) through final settlement. Fees come only from reimbursement RRP recovers, never from anything your hospital collects on its own, and only after your hospital is paid. No Recovery, No Fee. It’s That Simple.
Send us your hospital’s Medicare provider number. We’ll review your most recent public cost report for Medicare reimbursement opportunities and reply within one business day. We don’t need any patient data.
Specialists in Medicare bad debt and Volume Decrease Adjustment (VDA)
RRP knows both programs in depth: the regulations, the CMS manual sections, and what MAC auditors test. Payment goes to the hospital whose documentation holds up, and hospitals across the country rely on RRP to build it.
Medicare Bad Debt Recovery
Allowable Medicare bad debt is easy to miss when accounts sit in other write-off codes, stay at a collection agency, or are missed Medicaid crossovers. RRP’s experts reconcile it, document it, and stay with it through settlement.
- Recover allowable bad debt your cost report missed
- Recover prior years that can still be reopened
- Listings built to hold up when the MAC checks them
Already claiming bad debt? Prior years that can still be reopened are reviewed at no cost. See how a second look works →
Volume Decrease Adjustment
If your Sole Community Hospital (SCH) or Medicare-Dependent Hospital (MDH) had a decline of more than 5% in total discharges from the prior cost reporting period, due to circumstances beyond its control, Medicare may owe it a lump-sum payment.
- Find out quickly whether your hospital qualifies
- File before the 180-day deadline. A missed deadline means the payment is lost.
- RRP handles the MAC’s questions through final settlement
Case studies: key staff left, discharges fell more than 5%, and the qualifying hospitals got paid. Read the VDA case studies →
What hospital finance leaders say
“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.”
“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.”
Client comments are shared with permission and without names, to protect client confidentiality. References are available to prospective clients on request.
Senior experience on every case
RRP’s leadership built and ran reimbursement firms, including Healthcare Payment Specialists (HPS) and Healthcare Reimbursement Solutions (HRS). Salim Nice or Laura Kortokrax leads every engagement, so that experience works on your hospital’s numbers directly.
Meet the leadership team →
Salim Nice’s career in hospital reimbursement
These figures cover Salim’s full career in hospital reimbursement, most of it before RRP.
Laura Kortokrax’s Medicare audit experience
These figures cover Laura’s full career, including prior firms.
Why hospital finance leaders work with RRP
A senior expert on your case
The same expert reviews your cost reports, account data and records, prepares everything submitted to the MAC, and answers questions. You reach that person directly.
Built to hold up at audit
Every account on the listing and every VDA figure 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. RRP supports the filings through MAC review, sampling, and the final Notice of Program Reimbursement (NPR).
Paid only when you are
RRP is paid based on what your hospital is paid. Nothing is due up front, and if your hospital receives nothing, RRP is owed nothing.
Already claiming bad debt? Most hospitals are.
- 2835 remittance filesSorted intoMedicaid payers identified: in-state and out-of-state, fee-for-service and managed
- 3Write-off codesSorted intoCharity care and self-pay accounts
- 4Other payments toward deductible and coinsuranceRemovedPaid by the patient, other insurance or the state
- 5Non-allowable write-offsRemovedSmall-balance write-offs
- 6Medicare fee-schedule rulesRemovedNon-allowable fee-schedule coinsurance
- 7Match to your listingRemovedAlready on your listing
Most hospital bad debt listings start from write-off code reports for accounts correctly written off to bad debt, and that’s the right place to start. RRP’s review starts one level deeper, with every deductible and coinsurance dollar on the detailed Medicare Provider Statistical and Reimbursement (PS&R) report, which is the full bad debt universe. The team reconciles every dollar to its final disposition. That includes known and unknown write-off codes, accounts returned from collection agencies, full and partial charity care write-offs, missed Medicaid crossovers (in-state fee-for-service, in-state managed, out-of-state fee-for-service and out-of-state managed Medicaid), unbilled crossovers and retroactive Medicaid eligibility, Medicaid misclassified to the wrong write-off code, and even coinsurance on fee-schedule services that Medicare doesn’t allow as bad debt. This view of the bad debt universe does more than pick up additional allowable bad debt. It also shows your staff and systems where dollars are leaking, so future losses stop. The team also reviews prior years that can still be reopened or amended.
“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.”
RRP carries the workload. You keep one senior contact.
The team handles the data work. Your staff provides the files and approves each filing, and you always know who to call.
Fees and how RRP works- 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 bad debt listing 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. Your hospital official signs every filing, and RRP supports the submission once you authorize it to act for you.
- Audit defense and settlementThe team answers the MAC through final settlement, so your team isn’t left to handle audit requests alone.Same person, start to finish.
Before any data moves: a Business Associate Agreement (BAA) is signed first, no patient data goes through this website, and each client hospital gets its own private ShareFile folder. How RRP protects your data
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 Office of Inspector General (OIG) bad debt audits
What the 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.
Find out what Medicare may owe your hospital
RRP’s team will review it at no cost and tell you plainly whether it’s worth pursuing. If your hospital receives nothing, RRP is owed nothing.
Send us your hospital’s Medicare provider number. We’ll review your most recent public cost report for Medicare reimbursement opportunities and reply within one business day. We don’t need any patient data.
Request a no-cost review