Posted by: rvaks on: February 15, 2012
The 12/31/11 FYE Medicare Cost Reports are going to be due in a few short months. Are you prepared??? Register today to attend one of our comprehensive online seminars and be ready to tackle your Cost Reports with ease. As a reminder, we offer webinars in the following area:
Classes are live, via an internet meeting software, and are kept small so participants can have an involved, interactive experience. Register today! Visit us at www.ppsassistant.com/seminars or call (800) 447-2540.
Posted by: rvaks on: February 14, 2012
There were a lot of changes recently put out by CMS for the Skilled Nursing Facilities Medicare Cost Report, the SNF 2540 form. So many, in fact, that the name of the form has changed from 2540-96 to the 2540-10. These changes are all in effect for cost reports beginning 12/1/10.
The following is a highlight of the major changes:
A webinar with the changes was recently held to show our clients exactly where the changes were. This well attended seminar gave its participants the tools and confidence to be able to work on their Cost Reports using the updated software.
Posted by: rvaks on: February 13, 2012
CMS recently announced changes to the Rural Health Clinic / Federally Qualified Health Centers Medicare Cost Reports. These changes are effective for Cost Reports with a FYE of 12/31/11 and later.
The following is a highlight of the major changes:
Lines 7.01 (Medical Nutrition Therapist) and 7.02 (Diabetes Self Management Training) were added as new position categories. This was done to facilitate the collection of full time equivalent (FTE) and visit data for RHCs and FQHCs.
Lines 18.01 through 18.06 were added to implement section 4104 of ACA which eliminates coinsurance and deductible for preventive services furnished by RHCs and FQHCs, effective for dates of service on or after January 1, 2011.
The Med-Calc Cost Report software is being updated to reflect the changes.
Posted by: rvaks on: February 11, 2012
Now with the new changes to the SNF Medicare Cost Report, questions have come up as to which is the correct version to file for partial year situations. In accordance with TDL 11452, providers with short period cost reports beginning on or after 12/1/10 and ending prior to 11/30/11 should continue to file on the 2540-96.
Posted by: rvaks on: March 28, 2011
ECR files have a standard naming convention of eight characters and a three character extension.
Two letters that represent the type of facility (ex. HH = HHA, SN = SNF, HS = Hospice, …)
The six digits of the provider number
Period
Two digit extension for the calendar year of the cost report period end
The letter ‘A’ if this is the first Cost Report or the letter ‘B’ if it’s the second during this calendar year
Posted by: rvaks on: March 24, 2011
The Print Image file is a compressed text file that contains the printed worksheets of the Medicare Cost Report. With the PI file, an auditor can view the cost report pages on a computer screen. The PI file has a three line encryption of a little over 70 characters at the end of the electronic file which gets printed to the Medicare cost report signature page.
SAMPLE ECR FILE (select lines only for illustration)
| 1 1 065555200800120083663G31P00120091412008274 |
| 1 7 16:50 |
| 2A000000 00100000000100CAP REL COSTS – BLDGS & FIXTURES |
| 2A000000 00200000000200CAP REL COSTS – MOVABLE EQUIPMENT |
| 3S200000 004000030010/15/1990 |
| 3S700004 0010000301 36 |
| 3A000000 0040000100 316282 |
| 4 1 It2kTR.hL3ml:LNF5cqckxrljVCfm0 |
| 4 1 1 q:APi0HwokBQNhPNYWYX1Ov68LC6A. |
| 4 1 2 JPPE08t.hP0dler9 |
The Type 1 record had identifying information on the provider number, start and end date of the cost report, cost report software vendor code, date cost report was created, and date of cost report software update. (2008274 means this software release meets CMS specifications of the 274th day of 2008, which is Sept. 20, 2008. The second line of this records shows the military time when the ECR was generated.
Type 2 records show labels used for cost centers and overhead allocation statistics (square feet, time spent, etc.) The third line of the above says the Worksheet A line 1 will be used for Capital Related Costs (property costs) of the Building. The fourth line of the above says the Worksheet A line 2 will be used for Capital Related Costs of the Equipment.
Type 3 records show input in the cost report and the cost report location. The fifth line of the above says that Worksheet S-2 line 4 column 3 shows the Medicare certification date as 10/15/1990. The sixth line says that Worksheet S-7 Part IV line 1 column 3.01 shows 36 Medicare days falling under the RUG category found at line 1. The seventh line says that Worksheet A line 4 column 1 shows costs of $316,282.
Type 4 records have the three lines of encryption code that are generated based upon the lines above it in the text file . Since the encryption code is printed to the Medicare cost report signature file, the signor is attesting that the correct ECR is the one that would generate the same encryption code that is printed here on the Signature Page. If any information of the text file would get altered, then the Type 4 encryption code would be different when the encryption code is rerun by the Fiscal Intermediary, and it would be known that the text file has been altered and cannot be relied upon.
Posted by: rvaks on: March 21, 2011
ECR stands for Electronic Cost Report. CMS requires most of the Medicare cost reports to be submitted in an electronic file format rather than on paper. CMS approved software must be used to generate the ECR. The software actually produces two files; 1) the ECR file and 2) the PI (Print Image) file. Both of these files must be transmitted in an electronic format , typically by burning onto a CD, and submitted to the Fiscal Intermediary, together with a printed and signed Signature Page.
The ECR is in a text format, and each field will have input for a given cell of the cost report and its location (Worksheet, line, and column). The ECR file has a three line encryption of a little over 70 characters at the end of the electronic file which gets printed to the Medicare cost report signature page.
Posted by: rvaks on: March 17, 2011
Those providers which can have a settlement, have another worksheet on their Medicare cost report that compares interim payments with Medicare reimbursement deserved, and the difference is the settlement, which can be positive or negative. The reimbursement deserved can be based upon costs, such as a Critical Access Hospital or a Rural Health Clinic, or can be based upon a predetermined rate per day/visit/case, generally referred to as PPS – Prospective Payment System rates. There may also be other elements which can effect a settlement, such as certain pass-throughs of costs for PPS providers, bonus payments, or Medicare bad debt.
Posted by: rvaks on: March 14, 2011
The forms of the Medicare Cost Reports are divided by different letter series. Most begin with an S series, which records identifying information on the provider (address, date of Medicare certification, etc.) and volumes of services.
The second series is the A series , which records the costs of the Trial Balance by cost centers, staring with overhead cost centers. The last cost centers are for services deemed as non-reimbursable by Medicare.
The A series also allows for reclassifications and adjustments to expenses.
In the B series, overhead costs are allocated to other cost centers based upon a utilization statistic (square feet, time studies, etc.). I
In the C and D series, a cost per day and/or service is computed and multiplied by Medicare volume to arrive at Medicare costs.
If there is possibility for a settlement, this is calculated on a separate worksheet, usually part of an E series.
In addition, most Medicare Cost Report also have worksheets for Balance Sheet accounts, Revenues , and Changes in Fund Balances. These are found in an F or G series.
Posted by: rvaks on: March 10, 2011
There are several different types of Medicare Cost Reports, required from various providers. Each has its own form number.
