Benefits of Medicare Interim Cost Report Template for Critical Access Hospitals

Benefits of Medicare Interim Cost Report Template for Critical Access Hospitals

 

LUTZ BUSINESS INSIGHTS

 

Benefits of Medicare Interim Cost Report Template for Critical Access Hospitals

Benefits of Medicare Interim Cost Report Template for Critical Access Hospitals

Julianne Kipple, Healthcare Director
Katie Roberts, Healthcare manager

The Medicare cost report has a material financial impact on Critical Access Hospitals (CAHs). Significant changes in hospital utilization, expense swings or changes in service lines can result in large settlements. Cost reports are typically not due until five months after the end of the fiscal year. An interim cost report template can be done monthly or quarterly with financial statements. The template enables the facility to have knowledge of the cash flow and financial impact of the cost report as the fiscal year progresses. It also gives management the ability to provide board members with more accurate monthly financial statements as the cost report journal entry would be included in contractual adjustments.

 

Cash Flow Planning

CAHs typically do not have high days of cash on hand. The interim template allows facilities to anticipate the Medicare settlement as early as possible to help with cash flow management. Waiting until after year-end to calculate the cost report settlement is not ideal as decisions made earlier in the year may have been affected if the amount of the cost report settlement had been known earlier. 

 

Interim Settlement and Rate Changes

Preparing an interim cost report template allows CAHs to compare current reimbursement rates from Medicare to current calculated rates. If the CAH has an excellent start to the fiscal year and revenue has increased while expenses are holding steady, it is likely reimbursement rates are too high, and the CAH has a cost report payable. The template can be used to request a rate adjustment or interim settlement from MACs.

Rates can be adjusted to reduce the payable or receivable before the end of the year. For example, instead of paying a large lump sum at the end of the year, a CAH can slowly reduce the reimbursement received from Medicare and better manage cash flow. The same is true if the opposite has occurred, CAHs can request a rate increase to improve reimbursement during the year from Medicare instead of waiting to get a large check after year-end.

 

Service Line Analysis and Projections

An interim cost report template can be adjusted and recalculated for any anticipated service line changes or projects. Many facilities use templates during strategic planning. For example, a CAH can analyze a potential new service line to see the impact it has on the cost report. The analysis provides the ability for more in-depth decision making on whether the service line is a good fit for the facility from a reimbursement perspective. Moving forward, a hospital can also see in real-time the impact of the new service line on reimbursement.

 

Building Projects

If a CAH is contemplating a new building project, a template is a very useful tool. Calculating the square foot changes the new project may cause, the additional depreciation and interest expense can all be factored into a template to see the impact the new building project may have on the cost report and reimbursement from Medicare in the future. This analysis should be done at the architectural planning phase of the project to ensure there are no unanticipated negative impacts on Medicare reimbursement.

 

Non-Reimbursable Cost Report Center Analysis

Templates can be used to review non-reimbursable departments in a facility. Many times, the non-reimbursable department’s impact on the cost report is not immediately obvious when looking at the face of a cost report. By taking out the costs and other figures tied to the non-reimbursable and recalculating the template, a facility can see what the impact of the non-reimbursable department has on Medicare reimbursement. 

 

COVID-19 Impact and Planning

As the country is trying to navigate these unprecedented times since the COVID-19 virus has hit communities and affected business, the Medicare interim cost report template has become increasingly important to manage reimbursement rates and cash flow better. As revenue declines due to the virus and expenses are unchanging or even increasing, it is likely reimbursement rates are too low. Cash is going to continue to be vital as hospitals try to prepare for the unknown future impact of COVID-19.

We suggest that cost report estimates are done monthly rather than quarterly to better estimate the large impact COVID-19 is having on a facility’s revenue. More cost report guidance is anticipated to be issued on how to handle the substantial amount of HHS funds and PPP loans that CAHs have received. If CMS decides that an adjustment to remove the expenses reimbursed by the HHS funds or the PPP loan is necessary, it could have a large negative impact on the cost report settlements. 

A template allows CAHs to adjust off expenses in the weeks after CMS makes their decision to quickly see the impact that adjustment will have on reimbursement and, ultimately, the settlement. The amount of time a CAH needs to obtain that knowledge will influence how the facility financially pilots through this pandemic. 

If you do not currently have a cost report estimate template and you are interested in having an interim cost report template setup for your monthly financial statements and planning, please contact us or call at 402-496-8800.

ABOUT THE AUTHOR

julianne kipple

402.827.2075

jkipple@lutz.us

LINKEDIN

JULIANNE KIPPLE + HEALTHCARE DIRECTOR

Julianne Kipple is a Healthcare Director at Lutz with over 10 years of professional experience in the healthcare industry. Her expertise is in accounting and consulting services for healthcare facilities, including outsourced CFO services, Medicare and Medicaid reimbursement, and Medicaid Disproportionate Share Surveys (DSH).

AREAS OF FOCUS
AFFILIATIONS AND CREDENTIALS
  • Healthcare Financial Management Association, Member
  • American Institute of Certified Public Accountants, Member
  • Nebraska Society of Certified Public Accountants, Member
  • Certified Public Accountant
  • Certified Healthcare Financial Professional
EDUCATIONAL BACKGROUND
  • BSBA in Accounting, with high distinction, Creighton University, Omaha, NE
  • MBA, Creighton University, Omaha, NE

402.821.2351

kroberts@lutz.us

LINKEDIN

115 CANOPY STREET

SUITE 200

LINCOLN, NE 68508

KATIE ROBERTS + HEALTHCARE MANAGER

Katie Roberts is a Healthcare Manager at Lutz with over four years of experience in accounting. She is responsible for providing accounting and consulting services to healthcare organizations with a focus on outsourced CFO services and reimbursements.

AREAS OF FOCUS
  • Accounting & Consulting
  • Outsourced CFO Services
  • Reimbursements
  • Medicare Cost Reports
  • Healthcare Industry
AFFILIATIONS AND CREDENTIALS
  • Nebraska Society of Certified Public Accountants, Member
  • Healthcare Financial Management Association, Member
  • Certified Public Accountant
  • Certified Healthland Financial Professional
  • Certified Revenue Cycle Representative
EDUCATIONAL BACKGROUND
  • MPA, University of Nebraska, Lincoln, NE

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OMAHA

13616 California Street, Suite 300

Omaha, NE 68154

P: 402.496.8800

HASTINGS

747 N Burlington Avenue, Suite 401

Hastings, NE 68901

P: 402.462.4154

LINCOLN 

115 Canopy Street, Suite 200

Lincoln, NE 68508

P: 531.500.2000

GRAND ISLAND

3320 James Road, Suite 100

Grand Island, NE 68803

P: 308.382.7850

CPT Code Modifiers: Clarification of Commonly Used and COVID Updates

CPT Code Modifiers: Clarification of Commonly Used and COVID Updates

 

LUTZ BUSINESS INSIGHTS

 

CPT Code Modifiers: Clarification of Commonly Used and COVID Updates

cpt code modifiers: clarification of commonly used and covid updates

kim kaye, healthcare consulting senior

 

There are many circumstances when coding more than one Current Procedural Terminology (CPT) code on the same encounter that clarification is needed regarding whether to use modifier 25 or 59. Should it be added to the Evaluation and Management (E/M) visit or the procedure code? Which modifier goes on which code? Here is the answer: Use the 25 modifier for the E/M codes and the 59 modifier for the procedure codes.

 

MODIFIER 25 AND 59

Modifier 25 is used for “a significant, separately identifiable evaluation and management service by the same physician or other qualified health care professional on the same day of the procedure or other service.” For example, a patient arrives at the doctor’s office for a biopsy of a skin lesion, and during the visit, the patient also asks the physician for a prescription for an upper respiratory infection. The modifier would be appended to the E/M code for the supported diagnosis of upper respiratory infections.

Under certain circumstances, it may be necessary to indicate that a procedure/service was distinct or independent from other non-E/M services performed on the same day. Modifier 59 is used to “identify procedures or services, other than E/M services, that are not normally reported together, but are appropriate under the circumstances.” A different session, procedure or surgery, site or organ system, incision/excision, lesion, or injury must be documented. Only if no more descriptive modifier is available may modifier 59 be used.

An example of the appropriate use of the 59 modifier: A physical therapist performed both CPT code 97140 – Manual therapy techniques (e.g., mobilization/manipulation, manual lymphatic drainage, manual traction), on one or more regions, each 15 minutes, and 97530 – therapeutic activities, direct (one on one) patient contact by the provider (use of dynamic activities to improve functional performance), each 15 minutes in the same visit.

Normally these procedures are considered inclusive. If the 59 modifier is appended to either code, they will both be allowed on the claim separately. However, the 59 modifier should only be added if the two procedures are performed in distinctly separate 15-minute intervals. If the therapist performs the procedures simultaneously, then the 59 modifier should not be used.

 

Public Health Emergency Special Modifiers

How to bill appropriately for services related to COVID-19 is a high priority for most healthcare entities. Described below are examples of the more common modifiers used during the Public Health Emergency (PHE).

As a result of this PHE, apply the following to claims for which Medicare payment is based on a “formal waiver” including, but not limited to, Section 1135 or Section 1812(f) of the Act:

  1. The “DR” (disaster-related) condition code for institutional billing, i.e., claims submitted using the ASC X12 837 institutional claims format or paper Form CMS-1450.
  2. The “CR” (catastrophe/disaster-related) modifier for Part B billing, both institutional and non-institutional, i.e., claims submitted using the ASC X12 837 professional claim format or paper Form CMS-1500 or, for pharmacies, in the NCPDP format.
  3. Modifier “95” (Synchronous Telemedicine Service Rendered via Real-Time Interactive Audio and Video Telecommunications System) may also be appended but is not required. When billing a telemedicine service (using modifier 95) and another service that requires modifier 25 to be used in addition, the general rule is to report the “payment” modifier before any other descriptive modifier. Since both modifier 25 and 95 can impact payment, list modifier 25 first.

**For details regarding appropriate use of CR and DR Modifiers https://www.cms.gov/files/document/se20011.pdf

 

References:

How to Use ICD-10-CM, New Lab Testing Codes for Covid-19. AAP News. (March 12, 2020). Retrieved on June 11, 2020 from https://www.cms.gov/Medicare/Coding/NationalCorrectCodInitEd/Downloads/modifier59.pdf

Modifier 59. (2017). American Medical Association. Retrieved on June 11, 2020 from https://www.cms.gov/Medicare/Coding/NationalCorrectCodInitEd/Downloads/modifier59.pdf

Medicare-Fee-for-Service (FFS) Response to Public Health Emergency on the Coronavirus (COVID-19). (June 1, 2020). Centers for Medicare and Medicaid Services. Retrieved on June 11, 2020 from https://www.cms.gov/files/document/se20011.pdf

ABOUT THE AUTHOR

402.827.2353

kkaye@lutz.us

LINKEDIN

KIM KAYE + HEALTHCARE CONSULTING SENIOR

Kim Kaye is a Healthcare Consulting Senior at Lutz with 16+ years of experience. She is responsible for providing professional coding assistance, chart audits and chargemaster reviews for clients with a focus on the healthcare industry.

AREAS OF FOCUS
  • Coding Assistance
  • Chart Audits
  • Chargemaster Reviews
  • Healthcare Consulting
AFFILIATIONS AND CREDENTIALS
  • Certified Professional Coder
  • Certified Evaluation & Management Auditor
  • American Academy of Professional Coders, Member
  • National Alliance of Medical Auditing Specialists, Member
EDUCATIONAL BACKGROUND
  • BA, Bellevue University, Bellevue, NE

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OMAHA

13616 California Street, Suite 300

Omaha, NE 68154

P: 402.496.8800

HASTINGS

747 N Burlington Avenue, Suite 401

Hastings, NE 68901

P: 402.462.4154

LINCOLN 

115 Canopy Street, Suite 200

Lincoln, NE 68508

P: 531.500.2000

GRAND ISLAND

3320 James Road, Suite 100

Grand Island, NE 68803

P: 308.382.7850

Supporting Medical Necessity: Is Your Healthcare Organization Compliant?

Supporting Medical Necessity: Is Your Healthcare Organization Compliant?

 

LUTZ BUSINESS INSIGHTS

 

supporting medical necessity: is your healthcare organization compliant?

amy evanich, healthcare consulting senior

 

Submission of complete and accurate medical records is a top priority for all healthcare organizations. According to the Centers for Medicare and Medicaid Services (CMS), Medically Necessary is defined as services or supplies that:

  • Are proper and needed for the diagnosis or treatment of the medical condition
  • Are provided for the diagnosis, direct care, and treatment of the medical condition
  • Meet the standards of good medical practice in the local area
  • Are not mainly for the convenience for patient or doctor

No hospital, provider, or patient wants to hear that a service is not medically necessary. According to Medicare, this can include services such as:

  • Excessive therapy or diagnostic procedures
  • Hospital furnished services that, based on the beneficiary’s condition, could have been furnished in a lower-cost setting, such as the beneficiary’s home or a nursing home
  • Surgeries that are considered cosmetic
  • Dental services
  • Certain footcare services

As a healthcare organization, some policies and processes can be put into place to ensure medical necessity is being met. Most billing offices struggle to keep up with their day to day work, which can make it challenging to analyze medical necessity; however, this proactive approach should be a priority for your hospital.

So, where do you begin when it comes to looking at medical necessity? First, you can analyze payer websites and the Office of Inspector General (OIG) work plan, which sets forth various projects, including OIG audits and evaluations that are underway or planned to be addressed during the fiscal year and beyond. Secondly, if your healthcare organization has started a new service line or has added a new provider, coder, or biller. Changes such as these are all areas that your hospital should be reviewing to ensure medical necessity is met.

When completing a medical necessity review, the Medicare Coverage Database will have links for Local Coverage Determinations (LCD) and National Coverage Determinations (NCD) to help guide your review including:

  • Indications
  • Limitations of Coverage
  • Documentation Requirements
  • Coding Guidelines
  • Billing Guidelines

Be sure to educate all appropriate team members on the audit findings. Spend time educating the provider regarding what documentation is needed to support the services. Eventually, a re-audit will need to be completed to ensure the necessary changes were made. Understanding and determining medical necessity can be very complex for healthcare team members. Evaluating medical necessity for the services provided on a regular basis is an important safeguard to ensure your healthcare organization is prepared if/when an external audit does occur.

 

References:

Centers for Medicare and Medicaid. (2000). Retrieved on February 11, 2020 from cms.gov

Office of Inspector General. (n.d.). Work Plan. Retrieved on February 11, 2020 from https://oig.hhs.gov/reports-and-publications/workplan/index.asp

ABOUT THE AUTHOR

Amy Evanich

402.769.7055

aevanich@lutz.us

LINKEDIN

AMY EVANICH + HEALTHCARE CONSULTING MANAGER

Amy Evanich is a Healthcare Consulting Manager at Lutz with over 11 years of professional experience in the Healthcare industry. She is responsible for medical chart reviews, appeal preparation, Medicare regulation guidance, revenue cycle consulting, interpretation and education, and healthcare billing policies and procedures.

AREAS OF FOCUS
  • Healthcare Reimbursement
  • Audit Response Assistance and Appeal Preparation
  • Medical Chart Review Including Medical Necessity
  • Healthcare Billing
  • Revenue Cycle Consulting
AFFILIATIONS AND CREDENTIALS
  • Registered Nurse (RN)
EDUCATIONAL BACKGROUND
  • Bachelor of Science in Nursing (BSN), Clarkson College, Omaha, NE
  • Master of Science in Nursing Health Care Administration (MSN), Clarkson College, Omaha, NE
COMMUNITY SERVICE
  • Nebraska Action Coalition, Leadership Team

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All content © Lutz & Company, PC

OMAHA

13616 California Street, Suite 300

Omaha, NE 68154

P: 402.496.8800

HASTINGS

747 N Burlington Avenue, Suite 401

Hastings, NE 68901

P: 402.462.4154

LINCOLN 

115 Canopy Street, Suite 200

Lincoln, NE 68508

P: 531.500.2000

GRAND ISLAND

3320 James Road, Suite 100

Grand Island, NE 68803

P: 308.382.7850

Cost Reporting

Cost Reporting

 

LUTZ BUSINESS INSIGHTS

 

cost reporting

KIRK DELPERDANG, HEALTHCARE MANAGER

 

Bad Debts – General

Eligible Medicare bad debts can be claimed for reimbursement through the Medicare cost report. For Critical Access Hospitals (CAHs), the reimbursement percentage was at 100% before FY 2013 – since then, in FY 13, it was reduced to 88%, 76% in FY 14, and 65% in FY 15 (the current rate as of this article).

Certain rules that need to be followed in order to claim Medicare bad debt on the cost report. First, bad debt can only be claimed on a cost report that is deemed “uncollectible,” as defined by CMS. Second, it must be related to covered services derived from the deductible and coinsurance amounts. Lastly, sound business judgement should establish that there was no likelihood of recovery at any time in the future.

A provider must also submit the Medicare bad debt in a specific template (more to come), including all data elements such as:

  • Patient identification
  • Date the first bill was sent to the beneficiary
  • The date collection efforts ceased
  • Deductible or coinsurance amount

 

Bad Debts – Cost Report Documentation Requirements & Templates

On August 17, 2018, a new Federal Register requirement was implemented, impacting bad debts for all cost reporting periods beginning on or after October 1, 2018 – specifically the documentation and submission requirements.

Excerpt from 83 FR 41677 (August 17, 2018)

“Effective for cost reporting periods beginning on or after October 1, 2018, for providers claiming Medicare bad debt reimbursement, a cost report will be rejected for lack of supporting documentation if it does not include a detailed bad debt listing that corresponds to the bad debt amounts claimed in the provider’s cost report.” 

Prior to this new requirement, inappropriate or inaccurate bad debt support “only” resulted in a desk review adjustment.  Now, unreconciled bad debt amounts may lead to a rejected cost report.

 

Home Office/Related Party

Just as Home Offices and management agreements have been around for decades, CMS Pub. 15-I Chapter 10 has been in place, governing the reporting of costs to related organizations.  These related organizations often take the form of a Home Office.  However, these may also be organizations that furnish management services or administrative services, through an agreement between entities.

The evolution of the healthcare industry, specifically with respect to rural healthcare, has forced rural hospitals to find ways to become more efficient and lower overall healthcare costs at their facility.  These advancements, in an ever-changing industry, have some rural facilities engaging in agreements for management and administrative services to save costs.  Medicare is keeping pace with these arrangements in their reviews and cost report submission requirements.

Excerpt from 83 FR 41677 (August 17, 2018)

“Effective for cost reporting periods beginning on or after October 1, 2018, for providers claiming costs on their cost report that are allocated from a home office or chain organization that has a different fiscal year end, a cost report will be rejected for lack of supporting documentation if the home office or chain organization has not completed and submitted to the chain provider’s contractor a Home Office Cost Statement that corresponds to some portion of the amounts allocated from the home office or chain organization to the provider’s cost report. 

Based on these new requirements, it would be prudent to have all related party/home office cost support in order when you file your cost report.

ABOUT THE AUTHOR

402.496.8800

kdelperdang@lutz.us

LINKEDIN

KIRK DELPERDANG + HEALTHCARE MANAGER

Kirk Delperdang is a Healthcare Manager at Lutz with over 25 years of experience. He provides accounting and consulting services to healthcare and related organizations.

AREAS OF FOCUS
AFFILIATIONS AND CREDENTIALS
  • Healthcare Financial Management Association - Nebraska Chapter, Member
  • Nebraska Society of Certified Public Accountants, Member
EDUCATIONAL BACKGROUND
  • BA in Accounting, University of Northern Iowa, Cedar Falls, IA
COMMUNITY SERVICE
  • St. Vincent de Paul, Knights of Columbus, Member
  • Active in various youth sports leagues: Aldrich Elementary, Millard Athletic Association, Millard North Schools, Omaha FC, Skutt Catholic High School and YMCA

SIGN UP FOR OUR NEWSLETTERS!

We tap into the vast knowledge and experience within our organization to provide you with monthly content on topics and ideas that drive and challenge your company every day.

Toll-Free: 866.577.0780  |  Privacy Policy

All content © Lutz & Company, PC

OMAHA

13616 California Street, Suite 300

Omaha, NE 68154

P: 402.496.8800

HASTINGS

747 N Burlington Avenue, Suite 401

Hastings, NE 68901

P: 402.462.4154

LINCOLN 

115 Canopy Street, Suite 200

Lincoln, NE 68508

P: 531.500.2000

GRAND ISLAND

3320 James Road, Suite 100

Grand Island, NE 68803

P: 308.382.7850

Assignment of E/M Levels Emergency Room

Assignment of E/M Levels Emergency Room

 

LUTZ BUSINESS INSIGHTS

 

assignment of e/m levels emergency room

nancy thygesen, healthcare manager

 

The hospital must assign Emergency Room Evaluation and Management codes (E/M) codes for all ER visits. The E/M code is billed in Revenue Code 450 –Emergency Room on the UB-04.

Below are a few of the items we see when reviewing Emergency Room records and levels:

  • Hospital approved ER criteria not applied correctly, and the incorrect E/M level is assigned which results in over coding or under coding
  • Incorrect points assigned and therefore the wrong E/M level is billed; many facilities use a point system to assign levels of care based on the services rendered
  • Incorrect E/M level assigned from the computer-generated ER criteria software
  • Documentation/services do not substantiate the E/M level assigned
  • ER Criteria outlines that a level 5 visit (99285) is automatically assigned if the patient is admitted to the hospital or transferred even if the documentation/services provided do not justify a level 5
  • The discharge status code billed does not substantiate the E/M level assigned (i.e., discharge status 01 to home and E/M level 5 assigned)

We recommend all facilities have an ER matrix, ER criteria, or ER acuity sheet that is used to determine the E/M level assigned for each visit rendered in the ER.

The ER matrix/criteria/acuity sheet must be applied consistently to all hospital ER visits. Suggestions for applying the ER matrix:

  1. The staff who assign the ER E/M levels must understand the criteria and the documentation required to substantiate each level
  2. Require the ER Matrix be completed for each ER visit to substantiate the E/M level assigned
  3. Implement a review process to include:
    • Confirmation that the matrix is applied properly and consistently to all claims and the correct E/M level is assigned; a Pre-bill review is recommended
    • Establish a formal process to change an assigned E/M level based on the pre-bill documentation review. Providers and HIM should be involved in establishing the process.
    • Educate the staff who assign the E/M levels and Providers if changes are made in the criteria
    • Educate the staff who assigned the E/M level when the documentation does not substantiate the E/M level assigned
    • Review the ER matrix annually and make updates to the criteria as needed

It is important to have a process in place to make sure the criteria are accurately applied, the correct E/M level is assigned, and reviews are done to assure the documentation and services substantiate the level assigned. These processes will assist in assuring you are receiving the proper payment, not under or over coding, and supporting medical necessity. if you have any questions, please contact us.

ABOUT THE AUTHOR

402.827.2368

nthygesen@lutz.us

NANCY THYGESEN + HEALTHCARE MANAGER

Nancy Thygesen is a Healthcare Manager at Lutz with over 35 years of experience in Health Information Management Consulting. Her primary responsibilities include performing chargemaster reviews and providing coding, reimbursement and educational services for hospitals, physicians and other healthcare providers.

AREAS OF FOCUS
AFFILIATIONS AND CREDENTIALS
  • Nebraska Health Information Management Association, Member
  • American Health Information Management Association, Member
  • Registered Health Information Administrator
EDUCATIONAL BACKGROUND
  • Bachelor’s degree in health information management, College of St. Mary’s, Omaha, NE
COMMUNITY SERVICE
  • Church Volunteer

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We tap into the vast knowledge and experience within our organization to provide you with monthly content on topics and ideas that drive and challenge your company every day.

Toll-Free: 866.577.0780  |  Privacy Policy

All content © Lutz & Company, PC

OMAHA

13616 California Street, Suite 300

Omaha, NE 68154

P: 402.496.8800

HASTINGS

747 N Burlington Avenue, Suite 401

Hastings, NE 68901

P: 402.462.4154

LINCOLN 

115 Canopy Street, Suite 200

Lincoln, NE 68508

P: 531.500.2000

GRAND ISLAND

3320 James Road, Suite 100

Grand Island, NE 68803

P: 308.382.7850

Lutz adds Coleman and Underberg

Lutz adds Coleman and Underberg

 

LUTZ BUSINESS INSIGHTS

 

Lutz adds coleman and underberg

Lutz, a Nebraska-based business solutions firm, recently added Emily Coleman and Maddison Underberg to its Lincoln and Omaha offices.

Emily Coleman joins Lutz’s Lincoln office as a Receptionist. She is responsible for creating an exceptional experience for clients and visitors. In addition, she will manage all client inquiries, coordinate communication, and perform other administrative duties as needed. Coleman received her Bachelor’s degree in marketing from the University of Nebraska-Lincoln.

Maddison Underberg joins the firm’s healthcare department as a Staff Accountant. She will work in Lutz’s Omaha office. Underberg is responsible for providing accounting and consulting services to healthcare organizations with a focus on outsourced CFO services and cost reports. She graduated from Midland University with a Bachelor’s degree in accounting.

 

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We tap into the vast knowledge and experience within our organization to provide you with monthly content on topics and ideas that drive and challenge your company every day.

Toll-Free: 866.577.0780  |  Privacy Policy

All content © Lutz & Company, PC

OMAHA

13616 California Street, Suite 300

Omaha, NE 68154

P: 402.496.8800

HASTINGS

747 N Burlington Avenue, Suite 401

Hastings, NE 68901

P: 402.462.4154

LINCOLN 

115 Canopy Street, Suite 200

Lincoln, NE 68508

P: 531.500.2000

GRAND ISLAND

3320 James Road, Suite 100

Grand Island, NE 68803

P: 308.382.7850