In the beginning.

Quality Reimbursement Services (QRS) was formed in 1991, when a small group of seasoned hospital reimbursement specialists in Los Angeles came together to offer Medicare cost report expertise. They quickly became known for offering a higher level of service for DSH and Crossover Bad Debt work. Most consultants at the time would “advise” hospitals of corrections that should be made to cost reports – but QRS would go the “extra mile” and actually make the reopening requests and file the appeals for client hospitals.

Adding Healthcare Litigation to Medicare Cost
Report Services.

It wasn’t long before QRS recognized the need for hospital advocacy in Federal Court. In 1992, QRS was the lead firm in “Loma Linda Medical Center v. HHS”. Until this case, hospitals had no way of knowing how their SSI percentages were being calculated for DSH reimbursements. The Loma Linda case cracked the “black box” that was SSI impact on DSH, and forced CMS to provide PSA reports with the SSI percentages to hospitals that formally requested the information with a Data Use Agreement ( DUA). This was a “landmark” case that not only benefitted QRS client hospitals, but all US providers thereafter.

Expanding Medicare Cost Report and Healthcare Litigation services.

Today, QRS has over 50 employees in seven offices nationwide serving more than 350 client hospitals. Medicare cost report services have evolved to include cutting-edge S-10/Uncompensated Care consulting. Healthcare Litigation has expanded to include in-house council, supplemented with the most experienced Federal Court healthcare litigators in the country. Federal Court appeals have conservatively yielded over $900 million in government reimbursements to client hospitals. And with settlements expected in cases like Allina II, 2-Midnight, ATRA and Predicate Facts/Standardized Amount, that number will most certainly grow significantly.

340B for Hospitals that have never had 340B.

Since the very early days of QRS, the ability to find incremental cost report Medicaid and SSI days has helped hospitals qualify, not only for DSH reimbursements, but for 340B eligibility as well. And in that time, it became apparent many hospitals that meet the adjusted DPP threshold for 340B, do not take advantage of the program. A big reason being, lack of 340B expertise to run a successful program and manage a very complex set of 340B compliance regulations. So, QRS developed a 340B program specifically for hospitals that have never had a 340B program before – by providing just that expertise.

UC DISABILITY SOLUTIONS turns uncompensated care into revenue.

Finding additional eligible days, is also a secondary benefit of QRS’s UC DISABILITY SOLUTIONS service. The primary benefit of the program is turning uncompensated care into revenue. To do this, QRS supplements the hospital’s Medicaid Eligibility program by using AI software tools to identify uninsured SSI/SSDI candidates that were not captured by the hospital’s Eligibility program. UC DISABILITY SOLUTIONS then advocates for the candidates throughout the awards process. In the end, the hospital is able to invoice Medicaid or Medicare for services, where before, costs would be written-off as charity or uncompensated care.

For more information on QRS services, please click on “Services” or see “Contact” and talk with us directly.