Merit Healthcare Consulting

What Merit Healthcare Consulting does

Merit Healthcare Consulting, Inc. is a privately-held healthcare financial consulting firm founded in 1997 and headquartered in Hazleton, Pennsylvania. The company specializes in Medicare and Medicaid reimbursement optimization for hospitals and healthcare systems, serving over 100 hospital clients across at least seven U.S. states including Pennsylvania, New Jersey, Mississippi, North Carolina, South Carolina, Florida, and Ohio. Named clients include Hospital of the University of Pennsylvania, Albert Einstein Medical Center, Temple University Hospital, Thomas Jefferson University Hospital, and multiple facilities within the Mercy Health, Merit Health, and Bayfront Health systems.

The firm's core technology is a suite of three proprietary data matching software products that cross-reference hospital records against Medicare Electronic Remittances and Medicaid eligibility databases. The DSH Medicaid Data Match Product captures Disproportionate Share Hospital revenue while ensuring full compliance with DSH regulations. The Bad Debt Data Match Product identifies allowable bad debts by validating Medicare patient status and Medi-Medi (Medicare/Medicaid dual-eligible) eligibility. The IME Managed Care Data Matching Product detects patients misclassified as regular HMO days who are actually Medicare HMO days, recovering lost Indirect Medical Education reimbursement. A fourth product category — organ acquisition compliance software — is also referenced on the company website.

Merit Healthcare operates on a sales-led, direct engagement model. Revenue is generated through professional services fees and outcome-based pricing, including contingency reopenings (no fee unless additional reimbursement is recovered), fixed-fee current submission reviews, and IME engagements priced as a fraction of recovered reimbursement. The firm is founder-led by David A. Eschenbach, who serves as primary contact, and the company appears to be independently owned with no disclosed institutional investors, acquisitions, or parent company affiliations. The organizational footprint of 11–50 employees and a single Hazleton office indicate a boutique operating model with limited scale leverage.

Name

Merit Healthcare Consulting

Legal name

Merit Healthcare Consulting, Inc.

Website

https://merithc.com

Company type

Private

Founded year

1997

Operating status

Operating

Headcount range

11–50 employees

Short description

Merit Healthcare Consulting is a boutique, founder-owned healthcare financial consulting firm that sells proprietary data matching software and contingency-based reimbursement services to hospitals seeking to maximize Medicare and Medicaid revenue across DSH, Bad Debt, and IME categories.

Ownership category

akta.pro rank

Product category

Healthcare Reimbursement Consulting

NAICS

Other Management Consulting Services (541618)

SIC

Services-Management Consulting Services (8742), Hospital & Medical Service Plans (6324)

akta.pro primary industry

Data, Analytics & AI Consulting (BPAHAEAF)

akta.pro secondary industry

Payer-Provider Data Exchange (X12, prior auth, claims/clinical attachment) (HLACABAK)

Keywords

• Healthcare reimbursement consulting
• Medicaid data matching
• Medicare bad debt recovery
• DSH revenue optimization
• IME managed care auditing

Headquarters

HQ city

Hazleton

HQ country

United States

HQ region

North America

Offices1 record

Markets served

GTM type

B2B

Offering type

Services

Cost components

Personnel, Technology or R&D, Operations, Marketing or Sales

Revenue model

1. Healthcare Reimbursement Consulting: Consulting services focused on healthcare financial consulting and reimbursement optimization. Services include DSH Submissions, Audits and Reopenings. Revenue is generated through consulting fees charged upon client satisfaction.
2. DSH Medicaid Data Match Product: Software product helping hospitals capture DSH Revenue with compliance assurance. Sold as a professional service engagement.
3. Bad Debt Data Match Product: Contingency-based service where Merit Healthcare reviews past bad debt submissions with no payment unless additional reimbursement is found. Also offered on a fixed fee basis for current submissions.
4. IME Managed Care Data Matching Product: Service to identify claims eligible for reimbursement for Medicare Managed Care Days. Cost is typically a fraction of recovered reimbursement, allowing the service to pay for itself.

Pricing tiers

Go-to-market motion1 record

Distribution channels1 record

Marketing channels1 record

Core offering

Merit Healthcare Consulting provides healthcare financial consulting services focused on Medicare and Medicaid reimbursement optimization for hospitals and healthcare systems. The firm deploys three proprietary data-matching software products — DSH Medicaid Data Match, Bad Debt Data Match, and IME Managed Care Data Matching — to help providers capture eligible Disproportionate Share Hospital revenue, properly submit Medicare bad debt listings, and recover reimbursement for misclassified Medicare HMO days. Engagements cover DSH Submissions, Audits, and Reopenings, and are typically delivered as consulting engagements using the firm's proprietary software.

Product overview

Merit Healthcare Consulting offers a suite of three proprietary healthcare financial consulting software products focused on Medicaid and Medicare reimbursement optimization. The product portfolio includes the DSH Medicaid Data Match Product for capturing disproportionate share hospital revenue, the Bad Debt Data Match Product for Medicare bad debt compliance and recovery, and the IME Managed Care Data Matching Product for identifying misclassified managed care days. These products work together to help hospitals maximize reimbursement while maintaining regulatory compliance through data matching processes against Medicare Electronic Remittances and Medicaid eligibility systems.

Differentiator

Problem solved

Functional benefit

Products and services

• DSH Medicaid Data Match Product Proprietary software that enables hospitals to capture all Disproportionate Share Hospital (DSH) revenue due while ensuring 100% compliance with current DSH regulations. Supports DSH Submissions, Audits, and Reopenings. For hospital finance and reimbursement teams.
• Bad Debt Data Match Product Proprietary software that ensures proper submission of Medicare bad debt listings by capturing all allowable bad debts through a data match process using hospital data, Medicare Electronic Remittances, and Medicaid eligibility checks. Available on contingency reopening basis or fixed fee for current submissions. For hospital patient financial services and reimbursement teams.
• IME Managed Care Data Matching Product Proprietary software that uses a data matching process to identify patients misclassified as regular HMO days when they are actually Medicare HMO days eligible for higher Indirect Medical Education (IME) reimbursement. Reviews prior and current periods to recover lost reimbursement. Cost is typically a fraction of recovered reimbursement. For hospital finance and reimbursement teams.

Quantifiable outcome

• Product pays for itself in additional Medicare Bad Debt found and reduced audit adjustments
• +1 more outcomes

Named customers12 records

Segments1 record

Ideal customer profiles1 record

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Feature3 records

Scale indicators1 record

Recent moves5 records

Expansion highlights4 records

Direct peers

• ECG Management Consultants: ECG is a healthcare-focused management consulting firm serving hospitals and health systems on strategic, financial, and operational issues including reimbursement strategy. Comparable to Merit in target customer (hospitals) and consulting delivery model.
• BESLER Consulting: BESLER is a healthcare financial consulting firm that helps hospitals optimize Medicare reimbursement, particularly in the areas of DSH, bad debt, and wage index — directly overlapping Merit Healthcare's core product portfolio. Both firms serve as embedded specialists for hospital revenue cycle teams.
• PYA (Pershing Yoakley & Associates): PYA provides healthcare consulting including reimbursement optimization, revenue cycle, and regulatory compliance services to hospitals and health systems. It competes with Merit in the mid-market hospital consulting space with a broader service portfolio.
• BerryDunn Healthcare Consulting: BerryDunn provides healthcare consulting including Medicare/Medicaid reimbursement, revenue cycle, and compliance services to hospitals and provider organizations. Comparable in service scope and mid-market hospital customer profile.
• CLA (CliftonLarsonAllen) Healthcare: CLA operates a healthcare practice serving community hospitals and health systems with reimbursement optimization, revenue cycle, and financial consulting. Closely comparable in target customer profile to Merit's mid-market hospital focus.

Broad incumbents

• Deloitte Healthcare Consulting: Deloitte's Healthcare practice serves large hospital systems on revenue cycle optimization, reimbursement strategy, and regulatory compliance. It represents a Top-tier incumbent that competes for enterprise healthcare consulting engagements.
• CohnReznick Healthcare: CohnReznick provides healthcare advisory including revenue cycle, reimbursement, and regulatory services to hospitals, health systems, and post-acute providers. Comparable as a mid-tier accounting firm with healthcare reimbursement specialization.
• FTI Consulting Healthcare: FTI Consulting operates a global healthcare and life sciences practice providing reimbursement strategy, regulatory compliance, and financial advisory to hospitals and payers. It represents a much larger incumbent that competes for the same consulting wallet.
• Moss Adams Healthcare Consulting: Moss Adams is a major accounting and advisory firm with a dedicated healthcare consulting practice including reimbursement optimization, revenue cycle, and value-based care services for hospitals and health systems.
• Forvis (formerly BKD) Healthcare Consulting: Forvis is a Top-10 accounting and consulting firm with a sizable healthcare reimbursement and revenue cycle practice serving hospitals. It competes with Merit at the larger health system end of the market with broader advisory capabilities.

Market position

Competitive moat4 records

Key highlights6 records

Customer concentration

• LinkedInlinkedin.com/company/merit-healthcare-consulting

Revenue estimate

Valuation estimate

Number of profiles

Profiles1 record

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Merit Healthcare Consulting