Provider Reimbursement Enterprise Services

Optimizing your organization’s reimbursement requires a deep understanding of the cost report and coordination across people, systems, and processes.

As you navigate Medicare and Medicaid’s ever-changing landscape, our professionals can deliver reimbursement solutions that support the overall strategy and operations of your health care organization—whether you’re looking for full enterprise outsourcing solutions, or help in a specific area.

Our full enterprise support includes:

In addition to staying alert to the latest regulations, our professionals have a deep understanding of how the operations of your organization, whether revenue cycle operations or billing practices, impact reimbursement.

We deliver insight on areas including:

  • Revenue cycle processes such as payer mix management, charge master, and billing
  • Regulatory interpretation of federal and state provider-based and outpatient service line assessments
  • Clinical pathway reviews for inpatient and outpatient service lines
  • Application of overhead rates including indirect cost for federal grant funding, managed care plans, and the correlation to FFS calculations

We’ve Combined with Southwest Consulting Associates

We’ve Combined with Southwest Consulting Associates

Moss Adams has combined with SCA, a national leader in reimbursement services for hospitals and health-system organizations. The combination substantially expands our Health Care Consulting Practice and the scope of our service offerings.


Join us for an on-demand webcast exploring how to complete an accurate Worksheet S-10 and remain compliant with MAC audit requirements.

The Medicare Shared Sharings Program (MSSP) is one of the largest alternative payment models in the nation and has received bipartisan support for its success in reducing Medicare spending and improving the quality of patient care. Recently overhauled in 2019, the MSSP’s new Pathways to Success program can be an ideal stepping-stone for organizations that are new to value-based care and payer risk, and it can easily align to the suite of services provided by organizations that are already experienced with managed care. Join us for an on-demand webcast to learn how to get involved with the program, requirements and timelines, and how to seize the substantial benefits it has to offer.

With increased pressure from the Centers for Medicare and Medicaid Services (CMS) to move from fee-for-service to value-based care reimbursement, more health care organizations are starting to consider alternative payment models and risk-based options.

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