James J. O’Connell

For more than 39 years, Jim has assisted healthcare providers with reimbursement and regulatory issues, including significant experience with Medicare/Medicaid reimbursement. He has more than 31 years of consulting experience and also spent 8 years at the provider level.


  • Medicare/Medical Assistance cost report preparation
  • PRRB Appeals
  • Exception Requests
  • Regulatory research


Bachelor of Arts, Business Administration
University of Pennsylvania, Philadelphia, PA


Comprehensive Medicare and Medicaid cost reporting.

Coordination and completion of fiscal intermediary audits, including supporting documentation and analysis of proposed and final audit adjustments.

Prepare and submit position papers and related documentation to the Provider Reimbursement Review Board for Medicare cost report appeals. Direct interactions with Medicare fiscal intermediary to achieve resolutions to cost report appeals.

Perform reimbursement research and analysis related to proposed and final regulatory changes, changes in hospital operations, and the development of new facilities and services, including whether services should be delivered as provider based or free standing.

Conduct education and training seminars about cost report preparation and Medicare reimbursement regulations, including prospective payment systems for inpatient acute care hospitals, skilled nursing facilities, inpatient rehabilitation hospitals and long-term acute care hospitals.