IHM will review all aspects of prior cost reports and reopening potentials in either Medicare or Medicaid in order to pursue any potential lost money that may be recovered. Each potential reopening will be documented and disclaimed to you before the reopening is pursued. We will not proceed unless approved by you. In our review we will also make note of possible areas that can be improved upon for future reimbursement periods. All this will be done at no charge.
The actual fee for our project will be done on a contingency basis. This means you pay nothing unless you receive money as a direct result from our reopening. We will not bill you a dime until the reopening has been approved and an amount receivable to the Hospital has been determined by the intermediary. At that time our bill to the Hospital will be of the approved amount due upon receipt of the settlement.
If for any reason the intermediary recoups an amount directly related to our reopening then we will be liable to pay back of the directly related recouped amount. Once again this recoupment must be directly related to our reopening, and therefore does not cover any and all recoupments. Some recoupments are naturally done, as you I’m sure are fully aware, so if a recoupment is required it will be reviewed by both IHM and the Hospital to determine the reasoning for recoupment. At that time the appropriate measures will be taken.
We will make available to the Secretary of Health & Human Services and the U.S. Comptroller General, upon request, this contract, the books, documents, and records necessary to verify the nature and extent of the costs incurred by the Hospital for services covered by this agreement.