Michael P. Hammond, Cpa Email & Phone Number

Waukesha, Wi, Us

United States

Wauwatosa, Wi

Responsibilities:Develop algorithms to recapture overpayments to providers for healthcare services paid in excess of stated contract language and/or CMS regulations. Modified edits designed to prevent incorrect payments prior to their release.Major Accomplishments:•Created multiple algorithms to identify and recoup overpayments•Rewrote numerous edits designed to work more efficiently and accurately•To date algorithm and edit creation/modifications identify over $600k of annual overpayments and over $200k of one time overpayments

Wauwatosa, Wi

Responsibilities:Investigated data for patterns of overpayments. These findings were turned over to teams which then built algorithms and edits to prevent and recapture the overpayments.Major Accomplishments:•Co-created policies and procedures for a new team to search for patterns •Created models to search data for patterns of overpayments

• Seasonal-Tax season only (Jan-Apr)• Interview clients to determine how to report annual activities on tax returns• Assess documentation for tax return implications• Complete and compile tax returns for clients• Research atypical transactions to determine appropriate tax return reporting• Review tax returns for correct and accurate inputs

Responsibilities:The responsibilities in this role are similar to the Government Reimbursement Analyst role noted below. In addition, prepare the calculations to determine the net hospital patient revenue for all payer types for financial reporting purposes.Major Accomplishments:• Assisted in redesigning the process we use to calculate balance sheet specific reserve accounts and other contractual allowance accounts. In addition, we revised the manner in which we reconcile these accounts. The result was to generate more accurate and easier to produce calculations.• Did research to analyze the number of beds in the hospitals that fit the Medicare definition of available beds. The adjustment to the number of beds reported to the Medicare program will materially increase the Medicare reimbursement the hospitals receive.

Responsibilities:The maintenance of the pricing and coding of a 50,000 line chargemaster for services performed and items supplied by the hospital, in addition to the proper use of these charges. Also responsible for monitoring the function of various systems that generate these charges, as well as coordinating maintenance needed to keep them operational.Other Duties:• Responsible for directing the development, maintenance, and review of the CSM chargemaster files• Manage the implementation of global updates that effect the chargemaster• Direct the processing, review and audit of daily revenue and charge entry reports to ensure proper charge entry, revenue reporting, and billing• Coordinate problem resolution, improvement, and follow up of charge entry process• Communicate with department heads and managers to facilitate their needs as to proper charging for services provided• Research updates regarding billing and coding issues related to reimbursement requirements and guidelines of government and private and insurance contracts• Retained responsibilities listed under Governmental Reimbursement Analyst below Major Accomplishments:• Participated in the installation of a revolutionary system that automatically generates a charge based on documentation in the medical record of the procedure performed and the supplies used.• Conducted 3 separate across the board price adjustments that increased gross revenue for billed services by over 20%.• Put into service a new Chargemaster maintenance system that allows for easier researching and adjusting of the various codes included in each charge.• Turned over 75% of my staff who were promoted out of the department inside of one year. I was able to replace the staff that left with personnel who have a variety of skill sets to cover all of the functions required to be performed by the department.

Responsibilities:The preparation of Medicare Cost Reports and the coordination of the audits of these reports. Calculate the expected reimbursement for Medicare receivables for financial reporting purposes. Assisted in estimating the reimbursement for proposed service lines and the impact on reimbursement of changes in Medicare nad Medicaid regulations.• Prepare Cost Reports for Medicare and Medicaid filing• Review and adjust contractual allowances to accurately reflect revenues• Aide in the revision of organizational policies and procedures to comply with changes in Medicare & Medicaid law• Analyze and report the reimbursement implications on changes in business policy and procedure• Analyze and report the reimbursement impact of changes in Medicare and Medicaid law• Calculate estimated reimbursement for budgeting purposes• Develop system reports for various analysis purposesMajor Accomplishments:• Created a series of templates to pull data out of a database that created the supporting documentation to compile the Medicare Cost Reports, which have saved a tremendous amount of time and improved accuracy.• Assisted in the analysis and rollout of the operational changes needed to adapt our systems to a major change in Medicare reimbursement methodology.• Designed a system to capture physician administrative time which, when reported on the Cost Reports, contributed to a material increase in Medicare reimbursement.

• Coordinate the preparation and analysis of Cost Reports• Calculate potential impacts of audit adjustments• Analyze and identify methodologies to track co-sts of procedures• Communicate with intermediary auditors and resolve potential audit adjustments• Prepare appeals for unresolvable audit issues• Research and evaluate new programs, reimbursement opportunities and key business issues affected by changes in Medicare and Medicaid regulations• Develop reimbursement maximization strategies• Conduct reimbursement maximization training for clinical managers• Train staff on the use of specialized software used to complete the Cost Reports• Educate new employees about the Medicare program• Review corporate policies & procedures for compliance with Medicare law• Prepare calculations used to revise Medicare payments

• Prepare Cost Reports for Medicare and Medicaid filing• Review and adjust contractual allowances to accurately reflect revenues• Review and adjust Medicare and Medicaid payables and receivables• Analyze and report the reimbursement implications on changes in business policy and procedure• Analyze and report the reimbursement impact of changes in Medicare and Medicaid law• Calculate estimated reimbursement for budgeting purposes

• Review research accounts and prepare journal entries to ensure accurate reporting• Complete financial reports as required by research funding entities• Assemble and review consolidation entries for financial statements• Prepare consolidated financial statements

• Audit Medicare Cost Reports for accuracy and compliance with Medicare law• Propose adjustments to correct errors and improper application of Medicare regulations• Assist health care providers with the interpretation of federal health care statutes

• Drill Sergeant• Tank Crew

• Paratrooper• Parts Load List Clerk

Bachelor'S Degree, Accounting And Related Services

High School Diploma