Donna Herbert, President & Owner
Donna Herbert is the founder of Financial Consultants of Alaska & Washington (FCAW). Since 1979, she has provided advice and counsel to health care providers in both Alaska and Washington concerning all aspects of budget, finance, and preparation of third-party cost reports.
DONNA’S EXPERTISE AND FOCUS IN HEALTH CARE REIMBURSEMENT CONSULTING:
During the last several years, Donna and her firm have worked on large Billing & Fraud Audits issued by Medicare or Medicaid intermediaries. As a result of such work, the Facilities were taken out of fraud status. Many millions of dollars that would have been paid back were turned around, and the severe penalties associated with the initial audits were eliminated or reduced.
Both she and her staff have worked with many small rural hospitals, for which they have assisted in obtaining Critical Access designations. FCAW specializes in maximizing reimbursement under CAH cost based reimbursement.
Donna has been an expert witness, prepared exhibits, and assisted with legal briefs for many Health Care Facilities’ Court Appeals. Additionally, she has experience with various legal levels including; Hearing Examiner PRRB Hearings, Civil and Supreme Court, and Ninth Circuit District Court. Several of the Supreme Court Cases have achieved national acclaim. As a result of such court cases, her health care clients have been awarded in excess of $90,000,000.
On behalf of many Health Care Facilities in Alaska and the Pacific Northwest states, Donna has provided both acute care and Long Term Care facility training in the areas of: Cost Report Preparation, Accounting, Business Office, Efficiency Studies, Redesign of Accounting Systems, Chart of Accounts, and Charge Master Updates. In the Long Term Care Facilities, the special projects have included RUGS analysis and training. She has been highly successful in designing Financial Strategic and Business Plans, which maximize Facilities’ reimbursement. As a result of the Financial Wellness projects, Facilities have had large increases to their bottom line. She has completed Record Control Projects, Review and Design of HIPAA Procedures and Standards, designed and implemented fraud billing procedures, and trained staff and management to prepare for fraud and RAC audits.
She has obtained special designation status for Facilities, including: Sole Community Hospital, Geographic Reclassification, and Hospital Based Clinic. She has assisted facilities in obtaining increased reimbursement by filing Exception Reports in: Medicare 5% volume, Disproportionate Share, and Medicaid Exceptional Relief.
Her firm has assisted facilities in the collection of unpaid Medicare and Medicaid claims and in overall Accounts Receivable Management. She has designed contractual allowance models and reports, budget forecasting, interim rate reports. Donna has conducted training in the principles of Health Care Finance. She provides training to Hospital Boards and Facilities’ staff managers. As FCAW’s owner, She is fully conversant in the procedures and intricacies of Medicaid and Medicare cost reporting and Health Care principles.
PRIOR TO STARTING HER OWN FIRM, DONNA WAS HEAD OF THE MEDICAID AUDIT UNIT FOR THE DEPARTMENT OF HEALTH AND SOCIAL SERVICES STATE OF ALASKA
Major projects included designing audit programs, and compilation of common forms to reduce and consolidate overall setup for a newly created Medicaid audit unit. She consulted and coordinated with Blue Cross of Washington and Alaska and Region 10 to reduce duplication on cost report forms. Responsibilities included the following: all field audits and cost reports; training of many small rural Facilities on Medicare regulations and overview of required cost report; audited 23 Alaska health care Facilities; personally responsible for the organization and development of the audit unit and the design of all audit programs and systems; served as liaison person for the Commissioner’s Office with the health care providers and the Alaska State Hospital and Nursing Home Association.
EDUCATION:
- Bachelor of Science in Business Administration
- Attended Blue Cross of Washington & Alaska Cost Report & Reimbursement School in Chicago
ORGANIZATIONS & AFFILIATIONS:
- Alaska Technical Advisory Group For The Prospective Payment System
- Alaska State Hospital & Nursing Home Association (ASHNHA)
- Past President and Chairperson of Finance for Bartlett Regional Hospital Board Of Directors
- HFMA
- Rural Health Association