Long Term Care

Myers and Stauffer's experience with long term care facilities (nursing facilities, intermediate care facilities for the mentally retarded and developmental disability waiver services) includes the following activities:

• Cost report audits and desk reviews
• Retrospective cost settlements and prospective rate setting
• Minimum Data Set (MDS) data management, analysis, reporting and consulting
• State plan consulting (developing justifications and findings)
• Consulting on the design, development and implementation of long term care reimbursement systems (specializing in case mix payment)
• Litigation support

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Hospitals

Myers and Stauffer's experience with hospitals includes the following services:

• Cost report audits and desk reviews
• Cost settlements and prospective rate setting
• Diagnosis Related Group (DRG) rate setting and consulting
• Ambulatory Patient Classifications (APC) and Ambulatory Patient Group (APG) consulting
• Graduate Medical Education (GME)/Indirect Medical Education (IME) consulting and payment analysis
• State plan consulting (developing justifications and findings)
• Disproportionate Share Hospital (DSH) payment calculations and consulting
• Fiscal analyses and studies
• Utilization monitoring of prospective payment systems
• Providing technical assistance to support hospital payment methodologies
• Performing analysis of proposed legislation or other legislative initiatives.
• Consulting in the design, development and implementation of hospital reimbursement systems
• Maintaining claims databases, grouper software and other computer resources to support our hospital services
• Litigation support

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Home Health Agencies

Myers and Stauffer's experience with home health agencies includes the following services:

• Cost report audits and desk reviews
• Cost settlements and prospective rate setting
• OASIS data management, analysis, reporting and consulting
• State plan consulting
• Consulting on the design, development and implementation of HHA reimbursement systems
• Litigation support

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Federally Qualified Health Centers and Rural Health Centers

Myers and Stauffer's experience with federally qualified health centers includes the following services:

• Cost report audits and desk reviews
• Performing cost settlements
• Cost report training and other support activities
• Maintenance of cost report guidelines
• Maintaining accounts receivable and payable of cost settlements
• Performing analysis of proposed legislation or other legislative initiatives
• Consulting on the design, development and implementation of FQHC and RHC reimbursement systems
• Litigation support

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Physicians and Practitioners

Myers and Stauffer's experience with physicians and practitioners includes the following services:

• Physician/practitioner profiling
• RVU/Coding analysis and consulting
• Anesthesia reimbursement rate setting and analysis
• Physician and practitioner utilization monitoring and fiscal analysis
• Advanced practice nursing policy consulting
• State plan consulting
• Telemedicine reimbursement consulting
• Other technical assistance with rate setting and reimbursement policies
• Consulting on the design, development and implementation of physician and practitioner reimbursement systems
• Litigation support

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Pharmacy

Myers and Stauffer's experience with pharmacies includes the following services:

• Dispensing fee studies and consulting
• Drug acquisition cost studies and consulting
• State plan consulting (developing justifications and findings)
• Consulting on the design, development and implementation of pharmacy reimbursement systems based on established agency policies
• Litigation support

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Managed Care Delivery Systems

Myers and Stauffer's experience with managed care delivery systems includes the following services:

• Financial monitoring of managed care systems
• Operational reviews of state contracted managed care organizations
• Clinical assessments of medical coding
• Focused pattern of care studies
• EPSDT screening studies
• DRG validation
• Shadow claims validation
• Fraud/abuse detection
• Payment error prevention studies
• Quality indicator studies/clinical reviews (Tailored to specific state program objectives)
• Case review
• Consulting on the design, development and implementation of managed care reimbursement systems based on established agency policies

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Dental

Myers and Stauffer's experience with dental programs includes the following services:

• Dental fee schedule studies and rate setting
• Utilization monitoring
• State plan consulting
• Member access and provider participation studies
• Consulting on the design, development and implementation of dental reimbursement systems
• Litigation support

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Other Ambulatory Provider Services

Myers and Stauffer's experience with transportation, durable medical equipment, Medicaid waiver, care coordination and other ambulatory services include:

• Utilization monitoring
• Rate setting and analysis
• State plan consulting Member access and provider participation studies
• Consulting on the design, development and implementation of other ambulatory provider services reimbursement systems
• Litigation support

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