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Indirect and Graduate Medical Education Recovery

Comprehensive Reimbursement, Inc. (CRI) has the regulatory and audit experience necessary to ensure resident FTE caps and counts are accurate and appropriate reimbursement is realized. CRI has extensive experience working with a wide variety of teaching hospitals, and our experienced team members can help you meet some of your most complex challenges.

Focus Areas Include

  • Review of Affiliation Agreements for compliance with Medicare regulations
  • Hospital and non-provider settings where residents rotate outside of the hospital setting
  • Reimbursement issues related to residents in newly certified residency programs
  • Treatment and agreements related to proper reporting of residency Rural Track Programs
  • Calculation of the resident FTE's during initial reporting periods to ensure proper calculation of the three-year rolling average for eligible FTE's
  • How resident rotations are to be counted for IME and GME reimbursement
  • Proper reporting of Section 5503 FTE cap adjustments
  • Working with new teaching hospitals to establish the per resident amount (PRA), which is set in the first full year of the program, and ensuring the FTE caps are set correctly in the fifth full year
  • Compiling new program estimated revenues from residents, preceptors, operating expenses, and estimated IME and GME reimbursement based on your specific hospital structure