Medicare and Medicaid Appeals

Revenue Entitlement / Medicare and Medicaid Appeals

Our dedicated appeals team has over 210 aggregate years of appeals and regulatory reimbursement experience. We protect your appeal rights and have a 95% success rate of reaching administrative resolution. Our professionals assess your audited cost reports and identify viable appeals and issues and expertly utilize our sophisticated appeals management system to navigate the complex appeal process. We negotiate resolutions of appeal issues with the appropriate federal agencies and auditors with whom we have reliable relationships; and we work directly with legal counsel to navigate the complicated litigation process that begins beyond the administrative appeals level. 

Medicare Disproportionate Share (DSH) Entitlement

Our team utilizes business intelligence tools to accurately report your DSH entitlement.

Transplant Services

We partner with you to assess compliance with the complex transplant reporting requirements and accuracy of the requested revenue entitlement.

Medicare Uncompensated Care

Our team accurately reports your uncompensated care entitlement utilizing our proprietary business intelligence tools.

Medical Education

Our team partners with you to accurately manage all aspects of DGME/IME finance and reimbursement. 

Medicare Bad Debt

Our team expertly identifies, captures, and reports revenue entitlement to assure compliance with complex regulatory requirements and accurate revenue entitlement.

Medicaid DSH and Supplemental Funding Support 

Toyon Associates efficiently prepares cost data to secure Medicaid revenue while maintaining compliance. 

Wage Index and Occupational Mix Services

We thoroughly analyze your wage, benefit, contract labor and home office data for accurate reporting.

Medicare and Medicaid Appeals

Save hours by letting us handle regulation navigation and preparation of accurate, compliant appeals.

  • “Year after year, Toyon demonstrates exemplary client support and dedication to our organization. They are not only receptive to our needs, they also go above and beyond in project execution and making sure we are up to date on all industry regulations.”

    Vice President Reimbursement, Large Multi-State For-Profit Health System

  • "I truly feel that Toyon's Absolute® suite will make your reporting more efficient... once you begin working with Absolute, you'll wonder how you ever worked without it."

    Manager Regulatory Compliance, Methodist Health System

  • "Toyon consistently delivers forward-thinking, value-added results with exemplary customer service. From beginning to end on each project, our entire team, from staff to executive, has felt 100% taken care of."

    Vice President of Strategic Planning and Revenue Cycle, 500+ CA-based Acute Care Hospital

  • "The result [of partnering with Toyon]... cost reports completed on time and on budget, audit adjustments had virtually disappeared, and the system had achieved annual reimbursement improvements in the $10s of millions."

    Director of Reimbursement, Large Multi-State Health System

  • "We have worked with Toyon on a variety of projects over the years and they have become an important and trustworthy part of our team. We use their Absolute® product at many of our facilities and it is truly best in class."

    Vice President of Reimbursement & Revenue Integrity, 75+ Nationwide Healthcare System

Get started with Toyon today.

info@toyonassociates.com
(888) 514-9312

Concord CA | Costa Mesa CA | Knoxville TN