“Our window to appeal the Medicare cost report for HFY2008 was closing when we engaged NAVEOS. They built an amended DSH log in just 10 days for HFY2008 and found sufficient additional Medicaid Title XIX eligible days to re-qualify the hospital for over $2.5 million in DSH reimbursement, which had previously been lost in audit.”
“NAVEOS worked with the Medicare Administrative Contractor (MAC) throughout the extensive reopening process in a highly professional fashion and succeeded where previous attempts had failed.”
- Timothy Reilly, AVP Financial Planning & Reimbursement, Winthrop University Hospital
“NAVEOS has helped the Hospital tremendously. The increase in DSH eligible days has been significant since we engaged NAVEOS® in 2008 and they have prevented us from falling below the threshold required for 340B Program participation. Our most recent annual savings for the 340B program was $2,705,257 - this is for both the Cancer Center and the Outpatient population. We are looking forward to continuing our partnership with NAVEOS and engaging them to optimize our DSH and Uncompensated Care Payments under the Affordable Care Act, manage our eligibility in the 340B Program and on a pro-active basis, focus on the management of the eligibility of our Medicaid and Medicare Part A/C patient population (the groups that are the major drivers for the 340B threshold calculation).”
- Chief Financial Officer, 240+ bed Hospital in Tennessee
“I tell our hospital members that the best analogy for the services you provide is to compare the role of a primary care physician to a sub-specialist; your sub-specialty expertise enables you to take a primary diagnosis and refine it to point where you can focus on the specific issues affecting our members.”
- Chief Operating Officer, Hospital Association
"We brought NAVEOS as a third opinion vendor and were quite skeptical that they could produce anything near what their conservative projections were; four years and $9 million in supplemental Federal DSH reimbursement later, they are our primary and only vendor and handle the full spectrum of DSH/340B management for us."
- Corporate Director of Reimbursement, University Teaching Facility, Virginia
"We engaged NAVEOS to handle multiple prior years that had been done previously by the State that were over-stated and could have resulted in substantial reserve increases for Federal DSH; subsequently, he expanded the engagement to cover State DSH for a program we were notified in July 2009 that we no longer were qualified for that would have a cost to us of $5.7 Million/year. NAVEOS® prepared a comprehensive appeal package and four iterative versions that convinced the State their internal calculations were flawed,which resulted in our continued participation in this State DSH fund."
- Vice President of Finance for 5 Hospital System with 800 bed flagship Hospital serving as a tertiary regional referral center in NJ
"In 2005, we were notified by the Fiscal Intermediary that they had made an audit adjustment to our DSH Log from our prior vendor that would have resulted in the loss of our entire DSH payment. Within 60 days, NAVEOS intervened, identified and documented over 700 additional days, of which 100% were accepted by the FI including patient types they had never previously encountered. Since that time, NAVEOS has made our facility over $7 million in Federal DSH funds with zero audit adjustment."
- Senior Vice President of Finance, 400+ urban facility in Virginia
"By November of 2010, we knew that we had fallen under the 340B threshold and that it was only a matter of time before we would be notified that OPA had removed us from the participating facility list; that would increase our OP Pharmacy cost by $2 million per year. We had already heard of and engaged NAVEOS to re-qualify us for this critical program as our existing CPA vendor had failed to keep us in. Within 75 days, NAVEOS reviewed the prior vendors’ work papers, removed inappropriate accounts, add over $500K of additional DSH value for 1 year and re-qualified us for the 340B program."
- Director of Pharmacy Affairs, 600+ teaching facility in Georgia
Our facility, prior to 2008 had never qualified for Federal DSH reimbursement. In the summer of 2009, we were notified that the Fiscal Intermediary was going to start its audit within 30 days. We had already engaged NAVEOS to review 2007 and 2008; upon our request, they shifted gears smoothly to 2008 from 2007 and in 30 days reviewed our submitted DSH Log and removed 2,500 days that did not meet the criteria for inclusion in the Medicaid fraction; however, they also found 3,500 additional days that were not included in the DSH Log and have completed the review with Auditor that will result in our first ever Federal DSH payment of $3 Million once the 2007 SSI values are released.
- VP of Finance, 700+ bed Hospital in Pennsylvania