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DSH Management Solutions - Who We Are...
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DSH Management Solutions, LLC (“DMS”) founded by Robert Gricius, CPA, President and CEO offers full cycle DSH/340b revenue management by integrating retrospective, prospective and concurrent management strategies and processes that provide hospital’s the opportunity to improve net reimbursement of Federal and State DSH funding. DMS is distinguishable from its competitors in that it has developed over seven years the only integrated DSH/340b revenue management system in the industry.
Our approach sets a new paradigm for the management of this revenue stream; we typically follow the large national and regional firms for whom this is a tangential product line; this is all we do. Typically, we increase DSH reimbursement by 6-10% when following other vendors and more so when we are the initial provider. Regardless of where your Health System is in the approach to this cycle, DMS can add value to the process.
Our proprietary DSH/340b revenue management system (MDSS®) is a remote hosted, HIPAA compliant SQL-server-based proprietary application that builds a multi-terabyte client-specific “universal” Medicare/Medicaid eligibility data warehouse that reads in, validates and cross-references hospital inpatient and outpatient demographic, payer, clinical, revenue code and GL transaction data. This data repository is constructed by sending and receiving, on a recurring basis, millions of records not only from the local State, but all “par” States, and Medicare that are used to construct Title XIX and Title XVIII recipient specific longitudinal benefit histories. Integration of the benefit database with hospital-specific detailed clinical, demographic and revenue code/cdm data and federal/state mandated benefit coverage rules-based tables produces the most robust DSH/340B management system in the industry.
This system enables access to previously untapped or modified eligibility data sources and by programmatically integrating mandated Title XIX/XVIII mandated benefit coverage rules from a National or State-specific perspective. The substantial investment of time and resources made to develop this capability and national network categorizes DMS as a “direct submitter” which provides our clients with the ability to submit an auditable, unlimited, no cost, number of eligibility queries to all these States and Medicare in order to validate, at a granular level, the proper inclusion or exclusion of select days in the Federal DSH formula.
Overview:
Ø 100 Hospital clients; Over 400 DSH reports filed and audited
Ø Direct access to 32 states Medicaid eligibility databases
Ø Direct access to the Medicare entitlement database
Ø Endorsed by Florida, Tennessee, Mississippi and Virginia Hospital Associations as the premiere DSH/340b provider
Ø Sole “outsourced” vendor for DSH/340b management services for one of the largest pharmaceutical services companies in the world.
Ø DMS results are backed by a 100% ROI performance guarantee
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