Appeals and Reopenings

After the cost report is finalized and an NPR has been received, you have 180 days to file an appeal. We can assist you in determining whether an issue should be appealed. This recommendation will be based on the estimated reimbursement impact of the issue and the basis for the adjustment being appealed.


A cost report reopening can be initiated by either the provider or the FI/MAC within three years of the issuance of the NPR. A reopening is initiated when new information is received showing that the cost report does not properly represent cost of services rendered. We can assist you in determining whether a reopening request is warranted as well as prepare the reopening request.

Audit Assistance

Each cost report is subject to the scrutiny by the Fiscal Intermediary (FI) or Medicare Administrative Contractor (MAC) prior to being finalized. Non-compliance can result in millions of dollars in repayments and fines. As previous Auditors, we have a unique blend of knowledge and experience that allows us to assist your hospital through the audit process ranging from the initial Auditor's request list to representation during the final exit conference.

Medicare Cost Report Preparation

Healthcare providers struggle each year to file their Medicare cost reports within the established CMS imposed deadlines. We understand the CMS regulatory environment and can assist you in interpreting laws, regulations, and program instructions to ensure you receive maximum reimbursement, while maintaining compliance.


Over the past 30 years we have prepared hundreds of Medicare cost reports for hospitals, skilled nursing facilities, critical access hospitals, home health agencies, and home office cost statements. We are available to prepare the entire Medicare cost report or specific sections including medical education, disproportionate share adjustment, bad debts, wage index review, square footage studies, and others to meet your organizational goals.

Reimbursement and Regulatory Impact Analysis

We have a thorough understanding of reimbursement principles and systems.  We analyze proposed regulatory changes and assist you in determining the impact on your organization. Examples include annual updates to DRG weights, wage index, psychiatric, rehabilitation updates, and benchmarking services.

Cost Report Support

The healthcare world revolves around Medicare! The Medicare cost report, a very powerful business tool, is one of the most complex documents to be filed annually by all healthcare facilities. Even with a highly trained reimbursement staff, Medicare‚Äôs complex, ever-changing laws, regulations, and instructions can be overwhelming. Our cost report services ensure your compliance while optimizing your hospital's reimbursement potential.