Specifications include, but are not limited to: The University seeks a qualified firm to analyze inpatient discharges during the hospital’s Cost Report year to determine if the days associated with each discharge do or do not qualify for Disproportionate Share Hospital (DSH) days, as well as Social Security Income (SSI) evaluation. The successful Supplier will work in partnership with the University and will be expected to fulfill the following scope of services, including but not limited to: 1. Analyzing each discharge for both Medicaid and Medicare eligibility 2. Incorporating state paid claims files 3. Matching all newborns to their mother 4. Performing a labor and delivery analysis 5. Analyze all SSI info and support the University in associated activities related to Medicare Cost Report filings, updates, and/or audits; The successful Supplier will also be required to: 1. Assess claims for eligibility into the Medicaid Waiver programs in place in Iowa. In addition to the detailed analysis, the qualified firm will provide all supporting schedules and documents for the Operating and Capital DSH payment related to reporting Medicare Cost Report Worksheets S-2, lines 24-25 & S-3, Part I, Column 7 (or replacements/expansions thereof). 2. Generate detailed DSH listings and gather required documentation to support the Cost Report schedules required to comply with the Fiscal Intermediary Cost Report audits. 3. Support the University in responding to audit questions from the Fiscal Intermediary regarding the DSH listings. 4. Provide an analysis of protest amounts for any issues arising related to DSH payment calculations, including but not limited to, Medicaid fraction days, Social Security Income (SSI) days and dual eligible days. 5. Assist the University as a partner, or finding a partner, to file any protests with the appropriate government agencies for review and compensation recovery. 6. Additional related services may also be requested throughout the scope of work.
