Case Study: Leading Medicare Company achieves 100% IME/GME reimbursement with TransUnion

Clients Receive Maximum Medicare Reimbursement for Indirect and Direct Graduate Medical Education

A Leading Medicare Company, a 500+ bed teaching facility with more than 400 interns and residents each year, needed help maximizing Medicare reimbursement for indirect and direct graduate medical education costs. While it was confident in recovering IME payments for Medicare Part A, it suspected some Medicare Advantage claims were being missed or delayed due to missing or misreported patient information. TransUnion’s STINGRAY™ solution was used to identify and track these harder-to-find accounts.

TransUnion implemented automated eligibility matching and daily claim tracking to locate Medicare Part C eligibility segments, confirm HIC numbers, and reconcile prior billed accounts. The result was full recovery of the entitlement due, with specialists resolving non-conforming claims and helping the hospital receive $2.3 million in IME revenue over three years.