During these deliberations, our representatives passionately advocated for our clients’ interests. The focal points of the discourse encompassed future budget planning and the imperative need to enhance reimbursement rates for critical healthcare services, specifically in the domains of urgent care, primary care, and outpatient specialty services.

We articulated a compelling case underscoring the indispensable role played by our private physician groups and urgent care clinics. This perspective was framed within the context of serving the extensive membership of over 2.3 million MassHealth beneficiaries. The emphasis throughout was on the pivotal contribution these entities make in ensuring comprehensive access to healthcare across the entire continuum of care for our constituents.

This strategic engagement marks a pivotal advancement in acknowledging the vital healthcare services our clients deliver to the most vulnerable patients and underserved communities throughout the state. It represents a noteworthy step forward in fostering a healthcare landscape that is responsive to the needs of our diverse population.

To learn more about Edelstein’s Healthcare Consulting services, contact Joanna Lambert at jlambert@edelsteincpa.com.

Edelstein provides a competitive advantage with Healthcare Consulting for private practices and institutions embedded in a full-service accounting firm.

In addition to our broad range of tax services, our suite of consulting services includes:

• Comprehensive buy and sell-side transaction support
• Compensation models and industry-leading benchmarking
• Revenue cycle management
• Contract negotiations and vendor oversight
• Payor relations and compliance
• General practice management and advisory

New and established healthcare entities of all sizes and specialties look to Edelstein for its exceptional brand of consulting. Our strategic guidance provides solutions to achieve and exceed your organization’s goals.

To learn more about how we can help, contact Joanna Lambert via email at jlambert@edelsteincpa.com, or call her at 351-222-4987.

• Financial implications of COVID Relief Bill and PPP “Second Draw” Loan and CARES Act Provider Relief Funds
• Impact of a hard market in HPL/GL marketplace
• Burdens on healthcare practices – physician liability, data privacy, and revenue streams
• Legal implications and limitations of the COVID immunity statute

This virtual roundtable will be moderated by Jarett Landman, M.S., P.A.-C., COO at Sports Medicine North Orthopedic Surgery, Inc. in Peabody, MA. The panelists for this important conversation are:

James A. Bello – Partner and Practice Group Leader – Healthcare and Medical Malpractice at  Morrison Mahoney LLP.

Jim focuses on the defense of physicians, nurses, and other healthcare professionals in medical malpractice actions. He routinely defends high exposure medical malpractice cases to verdict in a wide variety of medical specialties. Jim also regularly represents healthcare professionals in disciplinary matters before the boards that license them, and before institutional credentialing committees.

Jim practices in Boston, MA, and Manchester, NH, and counsels hospitals, clinics, long-term care facilities, drug and alcohol treatment centers, and other healthcare organizations regarding risk management issues and government investigations.

Jonathan P. Gorski, CPA, MBA -Partner at Edelstein & Company LLP.

Jonathan has over 25 years of experience advising physician practices and other healthcare organizations helping them manage their business and financial operations. In addition to tackling the specific challenges facing healthcare practices today, Jonathan helps them maximize operational and financial efficiencies, which translate directly to the bottom line.

Clients value Jonathan’s personal approach and commitment to their success. They say that he has an ability to balance objective, fact-based advice with a real-world perspective. His ability to build rapport resonates with both new and existing clients.

Matthew P. Newell, CPCU, ARM, LIA -Managing Director – Healthcare at HUB International New England, LLC.

Matt is a consultative risk management professional and insurance broker, exclusively serving the needs of the healthcare industry for more than 30 years. His core areas of expertise include exposure analysis, non-insurance risk management and design and implementation of tailored insurance coverage to meet clients specific and evolving needs.

Matt is an active participant in local and national healthcare finance and risk management societies as well as local and national medical group management associations. He has earned the Chartered Property Casualty Underwriter (CPCU), Associate in Risk Management (ARM) and Associate in Management (AIM) designations from The Insurance Institutes of America, and is a Licensed Insurance Advisor for property and casualty coverage.

Your hospital or practice may be holding unclaimed property that can weigh down your bottom line if not handled appropriately. To ensure your organization takes full advantage of all of its assets, it’s important to understand the laws relating to unclaimed property, such as wages or unpaid credit balances, and the applicable dormancy periods.

Definitions

Unclaimed property is generally defined as property, held or owed in the ordinary course of business, that the owner hasn’t claimed for a specified period of time, known as the “dormancy period.” All 50 states and the District of Columbia have enacted laws allowing owners to collect unclaimed property. Most states don’t have a statute of limitations on unclaimed property; many audits cover periods dating back anywhere from 10 to 20 years.

Under unclaimed property laws, the party holding the property must transfer the abandoned property to a state custodian after the dormancy period expires. The duration of the period varies by state and by type of property (for example, wages or unpaid credit balances), but usually runs for three to five years. Regardless of which state your hospital is in, the period always commences on the date of the last contact with the property owner.

Laws

Unclaimed property laws typically involve abandoned financial accounts, uncashed checks and refunds, customer overpayments and more. For hospitals, unclaimed property might take the form of accounts payable, payroll, accounts receivable, unapplied cash, patient refunds, write-offs, benefits, open payables and, in particular, unpaid credit balances. These credit balances can result from insurance company overpayments or reimbursement rule changes, duplicate payments, or data transfer problems during billing system upgrades.

Let’s look at an example: A patient makes a $30 co-payment to a hospital for a crushed vertebra on January 29. It turns out that the procedure is fully covered by the patient’s insurance plan. The hospital eventually determines that the patient’s payment is an overpayment, and a credit balance is created. But if the patient can’t be located within the dormancy period, the $30 is considered unclaimed property, subject to remittance to the state.

Under another typical scenario, a hospital’s billing system is set up to record an $800 receivable for a procedure. Under a new contract entered into after the billing system was last updated, the insurer pays the hospital $900. An auditor examining the hospital’s books may identify the $100 difference as an overpayment and potential unclaimed property.

In such a case, the facility then needs to either prove the $100 isn’t unclaimed property (a process called remediation) or risk that it will be counted as such when the auditor extrapolates the hospital’s overall liability for unclaimed property in the audit period based on a sample drawn from potential unclaimed items.

Dormancy periods

To avoid a costly surprise in an unclaimed property audit, hospitals must perform an analysis to determine whether their unclaimed property has aged out of the applicable dormancy period. That can prove tricky, though.

For one thing, you need to look beyond the state where you’re located, because the relevant law and dormancy period depend on the last known address of the property owner. Our current health care payment model also complicates matters, as the example involving the $30 overpayment illustrates. Even though the credit balance may not have actually appeared on the books until April or May, the aging began back in January — the date of the last contact with the patient.

Once it’s determined that an account has aged out of the dormancy period, the hospital must send a due diligence letter to the patient to attempt to return the funds. If a refund can’t be made, payment must be made to the state the patient was last known to reside in.

Dig out the truth

A hospital’s unclaimed property can become almost invisible, buried under layers of daily financial transactions as the organization focuses on providing excellent health care and collecting ongoing revenue. But unpaid credit balances and other unclaimed property ultimately can drag down profits and generate auditing issues. To avoid this, and to make the most of your resources, dig out the truth about your organization’s unclaimed property.

Edelstein & Company was named a Top 10 Medical Practice Management Consulting/Services Company in Healthcare Tech Outlook’s Medical Practice Management Edition. Healthcare Partner, Jonathan Gorski, was highlighted in their piece, ‘Maximizing Financial and Operational Performance.’ Jonathan was quoted saying, “Our staff performs the dual role of CPAs and healthcare consultants, so we can view a project through the multi-experienced lenses of accounting and healthcare.” The piece shared a recent example of when Edelstein’s healthcare team enabled a client to gain $40,000 in just one quarter. To see the full piece, click here and jump to pages 18 and 19.

Read the entire Healthcare Advisory here.

Read the entire Healthcare Advisory.

Read the entire Healthcare Advisory.

Read the entire Healthcare Advisory.