Scope & Range of Services

Testified Regarding: Physician Payment, Graduate Medical Education Reimbursement, Medicare cost report, Chargemaster, billing practices, HMO contracting, pharmaceuticals, DRG Outlier payments, Skilled Nursing, Renal Dialysis, ESRD Exception Requests. Testified at: United States District Court for Northern Illinois, United States District Court, Western District of Michigan, Medicare Provider Reimbursement Review Board, Arbitration Board, AHLA, Ft Lauderdale, Florida. Recently lectured at the Health Care Finance Association’s Annual Institute in Nashville and for the Ministry of Health in China.

As an experienced consultant and financial manager I bring to the table over 19 years of experience in healthcare finance working with over a hundred healthcare entities ranging from single physician practices to large academic medical centers. My expertise ranges from physician and hospital billing practices to administrative and strategic planning challenges faced by healthcare providers. I have expertise in renal dialysis reimbursement work with renal providers throughout the nation. Often my projects are intimately intermingled with regulatory issues.

During my tenure first as Manager of Reimbursement, and then Director of Financial Systems at Rush University Medical Center in Chicago several of my achievements in reimbursement were nationally recognized. Presently, I carry out the dual role of running my own consulting firm as well as academic duties at Rush Medical Center in Chicago. I have assisted several major accounting firms in the valuation of healthcare practices and Medicare reimbursement. I publish nationally on healthcare finance issues and frequently have been called upon to testify before a variety of tribunals.

SAMPLE PUBLICATIONS
The Cost of Compliance: A look at How HIPAA Will Impact the Dialysis Provider’s Bottom Line,
Using the OIG Model Compliance Programs to Fight Fraud, Healthcare Financial Management,

EDUCATION
UNIVERSITY OF CHICAGO, MBA: Finance, Accounting, Strategic Management, Org. Behavior 2002
DALHOUSIE UNIVERSITY, BS Mechanical Engineering, & BS Chemistry 1988 /1993

PROFESSIONAL EXPERIENCE
President, Ahern & Associates, Reimbursement and Financial Consulting Services 1999 - Present
Medicare Cost Report Preparation and Reimbursement Consultant to major healthcare providers.

Asst. Professor, Healthcare Finance, Rush University Medical Center, 1994 - Present
Lecture healthcare professionals on financial accounting for healthcare entities, focusing on optimal financial management within the context of health insurance billing and payment systems, reimbursement, cost management and compliance with regulatory mandates.

Director of Financial Systems / Manager of Reimbursement , Rush University Medical Center, 1993 - 2000
-Obtained payment from Medicare for significant portions of bad debt previously not reimbursed.
Implemented accurate process for measuring aging of receivables.
-Audited medical records to ensure complete charge capture and ensure that adequate documentation existed to substantiate inpatient-billing detail.
-Analyzed reimbursement and profitability of inpatient Medicare DRG (Diagnosis-Related Group) payments as was as inpatient payments from Medicaid, commercial insurance and HMO’s (Health Maintenance Organization’s).
-Reviewed and updated hospital Chargemaster charges, codes and descriptors for inpatient services, including ancillary services, drugs, radiology and laboratory charges.
-Initiated, designed and implemented Internet based Graduate Medical Education (GME) database used to track all residents accounting for $ 37 million of revenue.
-Responsible for management and implementation of newly purchased network based multi-site billing and scheduling system.
Spearheaded court mandated increase of Medicare Reasonable Compensation Equivalent (RCE) payment for physicians at all hospitals in the United States.