HCS, LLC Excluded Unit Target Exceptions Requests

Healthcare Consulting Services, LLC (HCS), can help recover part or all of unreimbursed costs for units excluded from PPS by filing target exception requests.

Units excluded from PPS are reimbursed for operating costs based upon a target amount per discharge. This target amount is determined from base year activity. Many units have experienced changes in various areas since the base year. These increases in the cost per discharge are not reimbursed through the cost report. Target exception requests can be filed in order to recover costs for a variety of reasons including:

Increased average length of stay from the base year

Increased ancillary service intensity

New ancillary services

Ancillary services for which there was no base year utilization

Increased routine service intensity

HCS has staff who can calculate the anticipated reimbursement related to one or all of the areas indicated above. We will also work with the unit’s clinical staff to properly document the reasons for the increased costs. We will provide you with a letter to be filed with the intermediary including the necessary support.

Often an analysis of the unit’s costs will also indicate other opportunities for obtaining appropriate reimbursement including:

	Medicare and Medicaid Cost Report Analysis
	Target Amount (e.g., updates) Review
	Target Rebasing Request

These are only some of the areas in which HCS has trained professionals. If you are interested in scheduling an excluded unit target exception request for your Hospital or are interested in learning more about it, please call Tina Severs at (800) 546-1048, Ext. 355 or e-mail at tsevers@hcs-healthcare.com.

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