What We Do
Regulatory Navigation

Regulatory Navigation Solutions

Optimize reimbursement while ensuring regulatory compliance

Our industry specialist teams of reimbursement experts capture all earned government reimbursement, optimize 340B program savings and support full regulatory compliance.

Medicare Bad Debt

Optimize reimbursement and compliance with lifecycle management of every bad debt claim. Our solution analyzes 100% of claims using proprietary technology to identify and process allowable bad debt claims.

Disproportionate Share Hospital (DSH)

Ensure accuracy and compliance that withstands audit scrutiny. R1 DSH reviews and processes large volumes of data to determine Medicaid eligible days for the DSH calculation.

SSI Redetermination

Realize additional revenue by identifying and recovering underreported Supplemental Security Income (SSI) reimbursement. We recalculate the SSI percentage for each cost report year to determine if there is benefit, then prepare the re-opening requests for those years with increased revenue.

Worksheet S-10

Claim uncompensated care payments with assured compliance and accuracy. R1 Worksheet S-10 combines leading-edge technology and human expertise to determine allowable claim-level uncompensated care write-off amounts for reimbursement.

340B Recovery

Recover more 340B savings from eligible and referred-to providers with R1 340B Recovery. Our contingency-based, technology-enabled solution delivers a compliance-first approach that helps 340B covered entities recover missed savings from 340B eligible prescriptions.

Ranked #1 by KLAS

We’re proud to be recognized for outstanding performance and customer satisfaction excellence in the Government Reimbursement Services category.

A+

Loyalty

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Operations

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Relationship

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Services

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Value

R1 is ranked #1 by KLAS® in Government Reimbursement Services

Partner with purpose to improve performance

Increase reimbursements, assure compliance and recover more revenue across all Medicare programs with R1 Regulatory Navigation Solutions. As an accountability partner, we drive results with decades of experience and deep knowledge of the complex Medicare environment. Our elite team includes former Medicare Administrative Contractor (MAC) auditors, providers and consultants, for informed perspective from all sides.

A handshake at a business meeting highlights the long-term benefits of an RCM partnership.

R1 RCM is very hands on; they are very engaged with us. The firm’s team is always very responsive to our needs and requests, and they help us work through our issues. I value our partnership. When we have questions and concerns about changes in regulations, the firm is always quick to get on a phone call or respond to our questions. Everything falls under the one fee per year. The firm never charges us additionally for anything. If we do other reviews, they are on a contingency basis. But we pay R1 RCM a set amount a year for the bad debt service, and they are responsive all year long. They don’t just end with the deliverable. When we do our cost report, they follow up.”

Government Reimbursement Services KLAS Report, August 2024

Director

I love R1. They have great people. And the software tools they provide make me look good, so how could I not like them? R1 will throw more things in to prove some value, and then they will prove the value and ask me whether I want more work from them.”

Government Reimbursement Services KLAS Report, May 2024

VP/Executive

With R1’s services, we have discovered a substantial amount in terms of additional reimbursement to be pursued from Medicare.”

Government Reimbursement Services KLAS Report, April 2024

Manager

Everybody at the firm is so accessible. The biggest strength of the firm’s service is that their deliverable product is very clear and concise, easy to understand, and consistent in formatting. The firm just talks to us like regular people. Having conversations with each person at the firm is easy. They are very informal, and they get back to us very quickly. Dealing with them is like speaking with anybody. They are approachable and responsive. We have a really nice, personal relationship.”

Government Reimbursement Services KLAS Report, November 2023