SCA has years of expertise and experience providing the level of services necessary to ensure that each client will become or remain eligible for Medi-Cal DSH payments at the highest threshold possible.
Now that the Hospital Quality Assurance Fee (HQAF) program has shifted from using historical proxy data to actual proven real-time utilization data, SCA has developed systems to work with clients to ensure that the data being utilized for HQAF payment purposes will be reliable and ensure that the appropriate payment is being received.
Medi-Cal Disproportionate Share Improvement Program
- Review and correction of hospital data utilized by the Medi-Cal DSH program to determine hospital program eligibility and payment
- Assist in the preparation and/or review of Medi-Cal DSH workbook to determine payment limit issues
- Evaluate data reporting options to determine if alternative reporting interpretations could be applied
Hospital Quality Assurance Fee (HQAF) Program
- Review and correct all managed care encounter data utilized by the HQAF when determining the “direct payment” component
- Review utilization data contained in the OSHPD annual financial disclosure report that determines the level of the required fee
- Analyze OSHPD patient discharge data and OSHPD outpatient utilization data that is used when determining the “pass-through” component
