Medicare · Medicaid · TRICARE
Cost reports prepared by people who used to audit them.
Reimbursement is usually “handled.” It is also where allowable days, wages, bad debt and uncompensated care go unclaimed, and where a missed revalidation can stop cash. We make that position accurate and defensible.
Full preparation, an independent review of someone else’s work, or one defined project. You do not have to replace a process to examine it.
What do you need help with?
Pick oneHow we help
Cost report preparation
Medicare, Medicaid, and TRICARE — filed as a financial statement, not a form.
If the report is light, the settlement is light — and the public record is light with it. Nobody sends a letter to tell you.
Learn moreBoth sides of the desk
Hospital reimbursement and Medicare contractor experience
Every payment model
Cost-based and prospectively paid, for-profit and not
Teaching to critical access
Large systems and single rural hospitals
A standing cadence
Regular reviews of open matters, not just at filing time
- 01Government ReimbursementCost reports and independent reviews, DSH and S-10, wage index, bad debts, reopenings, appeals and expert witness work.If the report is light, the settlement is light. Nobody sends a letter to tell you.
- 02Compliance & EnrollmentRevalidations, change of ownership, initial enrollment and change-of-information filings.Not a documentation nicety. It is whether claims get paid.
- 03Provider-Based AttestationsVoluntary filings for new or acquired provider-based entities.The payment difference is real. So is the take-back if status was assumed and never attested.
- 04Operations & AdvisorySettlement accruals, department profitability, critical access conversion and acquisition due diligence.The cost report is part of what you are buying. It rarely reads like the deal deck.
He doesn’t just prepare reports — he ensures the hospital understands the underlying drivers, risks, and opportunities.
Six-question check
Worth a conversation, or not yet?
Answer as the person who would have to explain the report. You will get a short briefing of where to look first. Not an audit, not a quote.
Who can explain your Medicare cost report — not just sign it?
The person who could walk a board member through a variance.
Who we serve
Same discipline. The exposure changes with the provider.
Acute care
Prospective payment still turns on the cost report: wage index, disproportionate-share days, outliers, transfer DRGs, and Worksheet S-10. Those factors do not announce themselves when they are light.
See the servicesHow we work
How an engagement works
The scope matches the issue.
- 01Start from the filings you haveWe do not begin with a generic maturity score. We start with the cost reports, the settlement accounts, the enrollment record, and the questions your finance team is already carrying.
- 02Read them the way an auditor willPreparation uses a standard methodology. Reviews apply analytics against your own history. The product is a position, and workpapers, a Medicare Administrative Contractor reviewer can follow.
- 03Act only where dollars or risk actually sitThat might be this year’s filing. It might be a reopening, an S-10 review, a wage-index audit, a bad-debt log, a square-footage survey, a CHOW, or testimony. The scope matches the issue.
- 04Keep a cadence after the filingClients describe a standing review of open reimbursement matters with their accounting staff — deadlines, contractor requests, revalidations — so nothing depends on someone remembering a portal.
Our team
The people who do the work
- AMAdam MarcinPrincipalFounding principal. Former director over cost reports, settlements, DSH, appeals, and diligence for a 47-hospital portfolio.
- CGClay GoodManagerCost reports, DSH, S-10, wage index, and the systems that keep the workpapers reliable.
- JBJoel BooneDirectorModels, settlements, square footage, and bad debt — reported so an operator can act on them.
- CGChuck GreenFounder emeritusBegan as a Medicare auditor. Has been facility CFO, chain reimbursement director, and consultant.
Bring the latest cost report, or the question you have been postponing.
A conversation with a principal or manager about a filing, a review, or one specific issue.