Brian J. Barbera
Senior Principal

For over 30 years Brian has assisted healthcare providers with reimbursement and regulatory issues, with particular expertise with Medicare/Medicaid reimbursement.  He is recognized throughout the country for his technical knowledge of governmental reimbursement guidelines and regulations.

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AREAS OF SPECIALIZATION

  • Medicare, Medicaid, and other third-party cost report preparation

  • PRRB Appeals

  • Exception Requests

  • Regulatory research

EDUCATION

Bachelor of Science, Business Administration, Accounting
Indiana University of Pennsylvania, Indiana, PA

EXPERIENCE

Comprehensive preparation of Medicare, Medicaid and third-party cost reports.

Coordination and completion of Medicare administrative contractor (“MAC”) audits for providers, including preparation of supporting documentation, review and analysis of proposed and final audit adjustments.

Preparation and submission of position papers and related documentation to the Provider Reimbursement Review Board for Medicare cost report appeals. Extensive experience with the MAC in achieving administrative resolutions to cost report appeals.

Preparation of exception requests for psychiatric and rehabilitation (TEFRA providers), skilled nursing facilities and renal dialysis providers.

Provide reimbursement research and analysis related to the development of new facilities and services.

Develop compliance programs to reduce exposure to various government initiatives.

Assist providers in understanding and optimizing Pennsylvania Worker’s Compensation reimbursement.

National leader for a healthcare reimbursement and compliance specialty firm.

Leader in the healthcare reimbursement and regulatory group for a “Big” accounting firm.

Capital Blue Cross, a Medicare fiscal intermediary, auditing providers regarding cost reports and other reimbursement issues.