Health Care

Reimbursement and Provider Compliance

Discover a full range of Medicare and Medicaid reimbursement services for all types of providers.

Clear understanding of reimbursement issues is paramount when evaluating reimbursement services. Our team stays current with pending legislation and Medicare and Medicaid rule changes that may impact your organization. 

Our team of reimbursement experts respond to data requests from government auditors, advise on circumstances affecting reimbursement and compliance, defend against adverse or improper audit adjustments, and advise on cost report settlements. We do this while focusing on your specific reimbursement needs and developing plans that address your concerns.

Seasoned experts help obtain full payment while staying within the boundaries of compliance so that the bottom line thrives.

We offer the following reimbursement services:

  • 340B Drug Pricing Program
  • Annual Medicare/Medicaid cost report preparation
  • Coding and compliance
  • Disproportionate share
  • Expert witness and litigation support
  • HRSA grant assistance for FQHCs
  • Licensing and Medicare/Medicaid certification/enrollment
  • Medicare bad debts
  • Medicare/Medicaid appeals
  • Nursing home accounts receivable outsource billing
  • Onsite reimbursement staffing
  • Payment projections for regulatory changes
  • Payor contract audits and compliance
  • Provider-based applications
  • Reimbursement consulting services
  • Rural health clinic/FQHC claims reconciliations
  • Rural health clinic/FQHC rate-setting and change-in-scope rate change reports

Are you current with new regulations and how your cost report is impacted? Have you conducted an in-depth analysis to find additional Medicaid-eligible days? These are not easy questions to answer but we can help. Contact us today to start a conversation.


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Featured Expertise

John E. Pfeiffer

John Pfeiffer is a partner in the firm’s health care consulting practice.  He specializes in health care reimbursement, accounting, and finance and has saved clients millions of dollars through outstanding cost report preparation and defense. John works with hospitals as well as specialty providers and nursing facilities, federally qualified clinics, and rural providers. In addition to client work, he is an accomplished presenter and speaks at various industry events.

Midwest Medical Center
Tracy Bauer, President and CEO

“We were very fortunate to have Wipfli’s help with the implementation of our electronic health record. They were able to provide the expertise we needed to be successful. A critical access hospital (like ours) doesn’t have the ability to hire various IT and management positions, and our current employees already wear multiple hats, so to bring in the expertise Wipfli had to offer was very effective.”