Decision tool · included
Which hospitals report less bad debt than peers?
Medicare reimburses part of the bad debt a hospital cannot collect from patients' deductibles and coinsurance. See which hospitals report less of it than similar hospitals, then review a hospital's accounts on your own computer, with patient files that never leave it.
| Hospital | Its ratio | Peer median | Position |
|---|---|---|---|
| Hospital A · TX | 2.8% | 10.4% | Below peers |
| Hospital B · OH | 9.9% | 11.2% | Within peers |
| Hospital C · CA | 16.8% | 14.6% | Above peers |
How it works
From a list of hospitals to a reviewed account.
01
Screen the list
Filter more than 6,000 hospitals by position among their peers, state, type and size. Hospitals that report less Medicare bad debt than similar hospitals come first.
02
Hospital page
Allowable bad debt as a share of the deductibles and coinsurance billed to Medicare, pooled over the latest five cost reports of about a year each, beside the peers it is compared with. Every figure shows the report status and the worksheet lines it came from.
03
Dual-eligible bad debt
How much of the bad debt comes from patients who are also on Medicaid, read against what the hospital's state Medicaid program pays toward Medicare cost sharing. Unusually little is flagged.
04
Report & watchlist
A printable report for a client conversation, and a watchlist that shows what changed when a hospital files a new cost report.
05
Review accounts on your computer
Add remittance and claim files in your browser. They are read in that window and never sent. Each account is checked against the Medicare bad debt rules, with the rule behind every decision, and the tool prepares a draft CMS Exhibit 2A, Excel workpapers and evidence packets that you save to your own folder.
06
Share a summary, if you choose
Only a de-identified summary can leave your computer: no names, numbers, dates finer than a year or free text. You see the exact package before anything is sent, and the result appears on that hospital's page, visible to your account only.
Patient data stays with you
Protected health information never leaves your computer.
Protecting patient information is the first design rule of the Offline Review Tool, not an add-on. It was built so that you can review accounts without the patient files, or the PHI in them, ever reaching us or anyone else.
Your files are read on your computer
Remittance and claim files are opened and read in your own browser window. They are never uploaded, and we never receive them.
Nothing leaves without your explicit consent
The tool sends nothing unless you confirm it, and even then only a de-identified summary can leave, never the files. Its page is served with a security policy that stops it opening network connections of its own, so there is no background channel.
Nothing is kept in the browser
Files and results are held in memory only. Close the window and they are gone, so save your Exhibit 2A, workpapers and evidence packets to your own folder first.
The summary is de-identified, and you see it first
No names, numbers, dates finer than a year or free text. The package is checked against a fixed list of allowed fields, and you see exactly what it contains before you decide whether to send it.
We test for leaks, not just for features
Our tests feed the tool fake patient records and fail if any of them appears in a network request, saved data, a log or an error report.
Where the numbers come from
Filed values, traced to the line.
A position below peers is a question to look into, not a finding. The screen and the Offline Review Tool do not file bad debts, give legal advice or certify compliance; the Exhibit 2A they prepare is a draft for your own review.
- Cost reports
- HCRIS Worksheet E, with Worksheet E-3 for critical access hospitals. Each report is scored on its own, so a hospital that changed its fiscal year never has two reports blended into one.
- Peers
- Hospital type first, then state, then size and rural or urban where the group is large enough. The group used is shown on every hospital.
- State Medicaid policy
- How each state pays Medicare cost sharing for patients on both programs, classified from state rules, state plans and payer manuals, with the source on file.
- Rules
- 42 CFR 413.89 and the Provider Reimbursement Manual, held as data so a rule change is a data change. Every account decision cites the rule behind it.
- Checks
- The report's status sits beside every ratio. Reports that look like filing errors are flagged, and Maryland and the territories are shown but not scored.
Included
Part of the portal subscription.
No separate price. If the question is bigger than the model, our analysts can work it with you.