Tony Whelan
Principal
红领巾瓜报
Chicago, IL
[javascript protected email address]
(312) 641-5007
Tony Whelan is a financial healthcare expert with nearly 20 years鈥� experience leading healthcare financing and regulatory efforts. Throughout his career he has enhanced his knowledge and honed his skills related to healthcare management, financial analysis, reimbursement, consulting and auditing for clients and partners.
Tony鈥檚 scope of service includes cost reports for a wide range of facilities, including acute care hospitals, home offices and rural health clinics as well as contractual adjustments, uncompensated care payments, cost report re-opening and appeal request, and hospital consolidation analysis.
Prior to joining 红领巾瓜报, Tony聽spent two years聽with聽RSM and聽nine years at聽PricewaterhouseCoopers (PWC),聽where his client-focused approach to reimbursement-related issues included cost report preparation and review, provider number analysis, due diligence, Medicare wage index and occupational mix reviews, third party settlements and reserve analysis, and Medicare appeals and contractual allowance reviews.
Tony鈥檚 efforts were not focused solely on processes, but also on innovation, developing models to assist clients with evaluation and financial analysis or opportunities, and issues related to Medicare/Medicaid provider changes specifically involving analysis or reimbursement.
Before working with PwC, he was instrumental in preparing presentations for formal adversarial proceedings before the Centers for Medicare and Medicaid Solutions, Provider Reimbursement Review Board (PRRB). This work, done while he was a consultant with the BlueCross BlueShield Association, included requests for hearings, filing聽jurisdictional determinations,聽drafting聽preliminary papers, review and analysis of聽final position papers and completing聽administrative resolutions on cases prior to board hearings. He also provided advisory assistance to plans on Medicare reimbursement issues and appeal procedures to ensure mandated appeal procedures were followed.
Tony earned a Master of Business Administration from Elmhurst College as well as a bachelor鈥檚 degree in accounting and business administration from Carthage College.