Timothy M. Mosco, M.S.
Tim has over 25 years of experience assisting healthcare providers with reimbursement and regulatory solutions. He is nationally recognized as an expert on hospital charge process issues, and is recognized in Pennsylvania as one of the foremost experts in Pennsylvania workers’ compensation reimbursement and regulatory issues.
AREAS OF SPECIALIZATION
- Pennsylvania Workers’ Compensation Reimbursement & Regulations
- Hospital billing and coding compliance
- Hospital CDMs and CDM standardizations
- Charge process and revenue cycle improvement
- Electronic remittance advice data mining
Masters of Science, Finance
Carnegie Mellon University, Pittsburgh, PA
Bachelor of Science, Business Administration, Finance
Indiana University of Pennsylvania, Indiana, PA
Worked directly with the Pennsylvania Bureau of Workers’ compensation to develop and implement the payment processes for workers’ compensation medical claims. This process remains in use today.
Has assisted hundreds of healthcare providers in the United States and Puerto Rico with HCPCS coding and billing strategies to ensure proactive billing compliance and appropriate reimbursement levels.
Developed data mining techniques to uncover missed revenue and rebilling opportunities for hospitals.
Pioneered work process models for large-scale hospital system CDM standardizations.
Developed data mining and validation techniques that assisted clients with a variety of government audits, including infusion and transfusion billing, laboratory unbundling, advanced beneficiary notifications (ABN) and other issues.
Provided technical and management assistance for audits of hospital laboratories involved in the first “operation bad bundle” case initiated by the U.S. Attorney’s office in the Eastern District of Pennsylvania.
Assisted providers with establishing processes to monitor and maintain their charge description master and charge processes.