Medicare and Medicaid reimbursements are essential to the financial health of every nursing facility, hospice, and home health agency. Unfortunately, budget cuts at the state level mean that facilities often do not receive crossover pay from Medicaid. In the event that Medicaid does not provide crossover pay, our team at 3MC Consulting assists clients in claiming unpaid coinsurance amounts, referred to as Medicare Bad Debt, on their Medicare cost reports. Unpaid coinsurance amounts billed to private payers are also eligible to be claimed for reimbursement on Medicare cost reports after collections have been pursued for at least 120 days, but amounts still remain uncollected. Medicare will pay a portion of coinsurance amounts not paid by a state Medicaid program or private payer and our services are designed to ensure that our clients receive all possible reimbursement.


Even the smallest inconsistency or error on a Medicare Bad Debt log could jeopardize your reimbursement, and it is our goal to keep that from occurring. In addition to sending us all bad debt logs, we request that our clients send the Medicare and Medicaid remittance advices for an extra layer of protection in the event of an audit. We review the bad debt logs and all supporting documents carefully to ensure every aspect of the information is correct. This includes:

  • Patient name
  • Medicare Number
  • Dates of service
  • Indigence status
  • Medicaid number
  • Date the first bill was sent to a private payer
  • Date collection efforts were begun
  • Medicare and Medicaid remittance advice paid dates
  • Medicare deductible and coinsurance amounts
  • Any amounts paid by other sources
  • Medicare Bad Debt or write-off amount
  • Write-off date

Very few accounting firms undertake this tedious review process to the level of detail we have set as a standard, and even fewer have comparable experience serving the health care industry. We prepare hundreds of cost reports each year and are pleased to offer our wealth of knowledge for the benefit of our clients.

Client Resources

For your convenience, we have placed a standard Medicare Bad Debt Log form here for you to download. Please call us at 855.697.4362 if you have any questions.