Overview
Focused and specialized.
Our team of audit professionals can assist your healthcare organization with specialized services to assist your compliance efforts. Our services include Disproportionate Share Hospital (DSH) audits, audits of cost reports for Federally Qualified Health Centers, and HealthChoices examinations. With highly experienced team leaders who have a detailed understanding of Medicare/Medicaid financial reporting requirements and federal funding programs supporting healthcare, you are in good hands.
Disproportionate Share Hospital Audits
A Disproportionate Share Hospital (DSH) is a hospital that treats a significant number of patients who are classified as low-income, including those who are Medicaid-eligible or uninsured. Maher Duessel performs independent audits of DSH hospitals where we verify that the hospital qualifies for payment, payments are not in excess of allowable costs, and that hospitals have correctly reported their payments, spending and utilization.
Audits of Cost Reports for Federally Qualified Health Centers
Federally Qualified Health Centers (FQHC's) are clinics that serve medically underserved areas and populations. These centers offer primary care services to all patients, regardless of their ability to pay, with fees adjusted on a sliding scale according to their financial capacity. Maher Duessel's FQHC clients include those that provide preventative health services, dental care, mental health and substance abuse treatment, transportation services, and hospital and specialty care.
HealthChoices Examinations
Maher Duessel's clients that participate in the Pennsylvania HealthChoices program provide integrated behavioral health initiatives that offer access to quality, cost-efficient services, and supports. We consistently stay informed regarding changes in PA Department of Human Services regulations impacting HealthChoices examinations. For mental health and drug and alcohol services, our clients contract with a Managed Care Organization (MCO). Our team has lengthy experience working with MCO's and subcontractors. With technical proficiency combined with attentive service from professionals who regularly perform HealthChoices examinations, our clients have the confidence to rely on us year after year.
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Experience Highlights
- Since 2015, we have performed DSH audit services for a State Department of Human Services, an agency serving more than 2.3 million residents, with DSH payments exceeding $700 million. We were the first accounting firm contracted to complete this agency's DSH audit.
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We work with the same state agency to perform audits of cost reports of FQHC's. The value-added services we have provided to our clients include suggestions for enhancing the current FQHC handbook and recommendations to FQHCs to help them improve their financial reporting processes, ultimately benefiting the agency.
- Maher Duessel has been involved in HealthChoices examinations in Pennsylvania since the inception of the HealthChoices Program in 1997. We have conducted HealthChoices examinations for 43 Pennsylvania counties over the years.
- We use a secure client portal to streamline the process of uploading information requests between hospitals. This portal enables hospitals to quickly see what information is required, what has been uploaded, and the corresponding due dates.
Service Contact
Through the specialized services we offer to our health care clients, we handle large and complex data systems and have extensive knowledge in the proper procedures for Health Insurance Portability and Accountability Act (HIPPA) compliance. Contact us to learn more about how Maher Duessel can help you.