PAYING THE CORRECT AMOUNT FOR YOUR ACQUISITION?
This service is utilised by an organisation interested in acquiring healthcare providers. Utilising our third party payer calculation engine and adjudication system, we analyse and value the “net revenue” of the healthcare organisation being acquired, the “target” entity.
Net Revenue means the difference between the total charges billed by Target under the applicable Payer Contracts with respect to Target’s patient population for the immediately preceding twelve (12) month period and the reimbursement Target expects from payers with respect to such total billed charges under the applicable Payer Contracts.
This service includes all contractually obligated payers: managed care, Managed Medicare, Managed Medicaid, Traditional Medicare, and Tricare.
Exela begins the process by loading all contractual agreements, scanning, indexing, and profiling all agreements, and calculating the contractual allowance and expected reimbursement for the Target’s patient population based on the information and documentation supplied by acquiring organisation, our “Client”.
A key component to a successful valuation analysis begins with correct patient registration. We verify the correct provider payer code assignment for those Payer Contracts containing more than one product line with different reimbursement rate structures and incorrect assignments, thereby, correcting a key component in arriving at a true valuation.
Exela compares our calculations to those provided by our Client and provide our findings in our Standard Valuation Reports.
In addition, we furnish the Account Calculation Detail reflecting the expected reimbursement by revenue code as it appears on the bill. We attach the respective actual contractual agreement to each account. These two items allow for easy access and printability.
Exela’s experienced professional staff of certified public accountants, registered nurses, and accountants, are assigned to assist on such engagements.
Exela’s fees are based on number of facilities to be acquired and analysed.
If you are acquiring the receivables, couple our valuation services with a Retrospective Underpayment Identification and Recovery Analysis. This will provide additional dollars to put toward the purchase price as well as ensuring contract compliance.
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