Medicare Cost Report Resources Faith Asper, MHS Director, ResDAC - PowerPoint PPT Presentation

Medicare Cost Report Resources Faith Asper, MHS Director, ResDAC Assistance Desk

Objectives  Understand the CMS cost report section  Find the CMS facility cost report resources  Understand each of the documents  Know how to use each document 2

CMS Cost Report Section http://www.cms.gov/Research-Statistics-Data-and-Systems/Files-for-Order/CostReports/index.html 3

CMS Forms Form Facility that Uses this Form Effective Dates 2552-96 Hospital and Healthcare Complexes Begin dates between 9/30/96-4/30/10 2552-10 Hospital and Healthcare Complexes Begin dates on or after 5/1/10 2540-96 Freestanding SNFs and SNF Health Care Begin dates between 9/30/96-11/30/96 Complexes 2540-10 Freestanding SNFs and SNF Health Care Begin date on or after 12/1/2010 Complexes 1728-94 Freestanding HHAs Begin dates on or after 9/30/94 265-94 Freestanding Renal Dialysis Facilities End dates between 1/1/94-12/30/10 265-11 Freestanding Renal Dialysis Facilities End dates on or after 1/1/2011 1984-99 Freestanding Hospices Begin dates on or after 9/30/99 222-92 Freestanding Health Clinics Begin dates on or after 9/30/92 4

CMS Cost Report Section http://www.cms.gov/Research-Statistics-Data-and-Systems/Files-for-Order/CostReports/Hospital-2010-form.html 5

Resource Documents  Use Hospital Form 2552-10 as an example  Hospital 2010-Reports(Supplemental files and counts) ˗ IME, GME, and DHS payments by Federal Fiscal Year ˗ Cost and Charges by Federal Fiscal Year ˗ Hospital Provider Id Information ˗ Record Counts ˗ Status Counts 7

Reports Download Supplemental files: IME, GME reports, Provide id, CSTS_CHRGS reports Counts: Record counts, report status counts 8

IME, GME, DSH Report  IME, GME, and DHS payments, adjustments, and other statistics by Federal Fiscal Year  Supplemental file that can be used to identify teaching facilities (presence of IME or GME payments) 9

Hospital Provider ID Information  Supplemental file  Includes provider number, name, address, zip code 10

Record Counts  This file is cecessary to verify the number of records found in the actual data files. 11

Report Status Counts  This file is not essential, but provides another check on the records that are found in the RPT file. 12

Cost and Charges Report  Supplemental file that comes from Worksheet C, Part I  Includes total cost, inpatient, and outpatient charges 13

Documentation Download 15

HCRIS Data Dictionary  Healthcare Cost Report Information Systems (HCRIS)  Useful to identify code values 16

HCRIS Data Model  Essential document to show linking key, variable positions, variable type, and length 17

HCRIS Facility Numbering  Supplemental file to provide the code ranges to determine the type of facility.  Values are the last 4-positions of the provider number  Source is Internet Only Manuals (IOM) 100-07 State Operations, Chapter 2, Section 2779  http://www.cms.gov/Regulations-and- Guidance/Guidance/Manuals/Downloads/som107c02.pdf 18

HCRIS State Codes  Supplemental code table to identify the first two positions of the provider number.  Some states have multiple codes (i.e. California) 19

HCRIS Table Description & SQL  Supplemental file that shows variables in each file, variable type, and length. 20

Crosswalk  Essential file if trying to use old and new forms.  Provides the old variable position and the location in the new forms 21

CSTCODES  Essential file to provide cost center lines and cost center code ranges and descriptions. 22

Readme Update  Essential file that provides important notes related to using the data files. 23

Worksheet Codes  Essential file that provides the list of all worksheet codes used in the cost report data 24

Provider Reimbursement Manual 15-2 26

Provider Reimbursement Manual 15-2  The PRM 15-2 contains ˗ Instructions for how providers are to complete the cost report forms ˗ Cost report forms ˗ Specifications on how data are to be submitted  The PRM 15-2 provider specific chapter should be downloaded because these documents are necessary to understand the data 27

Provider Reimbursement Manual 15-2  Pr2_40: Written instructions  R3P240F: Cost report forms  R3P240S: Cost report specifications 28

Provider Reimbursement Manual 15-2 Instructions 29

Provider Reimbursement Manual 15-2 Cost Report Forms  Essential to see where information is located. 30

Provider Reimbursement Manual 15-2 Specifications 31

Provider Reimbursement Manual 15-2 Specifications, Table 3 – List of Data Elements  Essential document to identify variables and usage (field type) 32

Summary of Essential Documents  Record counts  HCRIS Data Model  Crosswalk  CSTCODES  Readme  Worksheet Codes  PRM 15-2 ˗ Cost report forms ˗ Specifications ˗ Instructions 33

Medicare Cost Report Resources Faith Asper, MHS Director, ResDAC - PowerPoint PPT Presentation

Medicare Cost Report Resources Faith Asper, MHS Director, ResDAC Assistance Desk Objectives Understand the CMS cost report section Find the CMS facility cost report resources Understand each of the documents Know how to use each

Medicare Cost Report Download Faith Asper, MHS Director, ResDAC Assistance Desk Objectives

Unnamed B/D What is it? Do I need it? How do I get it? How much does it cost? Medicare What

MEDICARE PREPARATION Topics Understanding Medicare Enrolling in Medicare Working

Medicare Reimbursement 101 Medicare Payments and Cost Reporting December 2019 Julie DiFrancesco

CRFB.org Types of Medicare Expansion Medicare Buy-In/Eligibility Change A Public Option

Introduction to Medicare Cost Reports 4/4/2013 Faith Asper, MHS Director, ResDAC Assistance

Introduction to Medicare Cost Reports Faith Asper, MHS Director, ResDAC Assistance Desk

Definitions of Cost in Medicare Utilization Files Barbara Frank, MS, MPH Director of

The Major Issues Affecting Medicare Going Forward Stuart Guterman Vice President, Medicare and

3 Section Medicare Fraud and You Prevent, Detect, Report W HAT IS S ENIOR M EDICARE P ATROL ?

MEDICARE BASICS Welcome to Medicare Presented by the Aging & Disability Resource Center of

Original A/B Medicare and Medicare Advantage Part C or Medicare Advantage Whats The

Medicare Part D: Cost Management Issues Jack Hoadley Research Professor Georgetown University

Facility Settlement Sub-System Hospital and Clinic Reimbursement Division Department of Health

Cost Report Capital Cost Operating Cost (Up front cost) (Annual cost over time) Utilities

Medicare Open Enrollment and Transitioning from the Health Connector to Medicare SHINE Overview

The Medicare Tsunami Bigger than Medicare Set Asides Stronger than the Medicare

Cost Shift Analysis Report Nancy Dolson Department of Health Care Policy and Financing Our

Adult Care Cost Report Training By Susan Kesler Office of the Controller Overview I. Some

Welcome to Kaiser Permanente Presenting Medicare 101 and the Kaiser Permanente Medicare health

vulnerable from a cost perspective to the volume of service(s) provided to a Medicare patient.

Medicare: Parts A and B and Donna McCormick Medicare Advocacy Project Medicare Greater

Your New Medicare Card Information for People With Medicare 2018 1 What does the new

Welcome to Kaiser Permanente Presenting Medicare 101 and the Kaiser Permanente Medicare health

Medicare Cost Report Resources Faith Asper, MHS Director, ResDAC - PowerPoint PPT Presentation

Medicare Cost Report Resources Faith Asper, MHS Director, ResDAC Assistance Desk Objectives Understand the CMS cost report section Find the CMS facility cost report resources Understand each of the documents Know how to use each

Medicare Cost Report Download Faith Asper, MHS Director, ResDAC Assistance Desk Objectives

Unnamed B/D What is it? Do I need it? How do I get it? How much does it cost? Medicare What

MEDICARE PREPARATION Topics Understanding Medicare Enrolling in Medicare Working

Medicare Reimbursement 101 Medicare Payments and Cost Reporting December 2019 Julie DiFrancesco

CRFB.org Types of Medicare Expansion Medicare Buy-In/Eligibility Change A Public Option

Introduction to Medicare Cost Reports 4/4/2013 Faith Asper, MHS Director, ResDAC Assistance

Introduction to Medicare Cost Reports Faith Asper, MHS Director, ResDAC Assistance Desk

Definitions of Cost in Medicare Utilization Files Barbara Frank, MS, MPH Director of

The Major Issues Affecting Medicare Going Forward Stuart Guterman Vice President, Medicare and

3 Section Medicare Fraud and You Prevent, Detect, Report W HAT IS S ENIOR M EDICARE P ATROL ?

MEDICARE BASICS Welcome to Medicare Presented by the Aging &amp; Disability Resource Center of

Original A/B Medicare and Medicare Advantage Part C or Medicare Advantage Whats The

Medicare Part D: Cost Management Issues Jack Hoadley Research Professor Georgetown University

Facility Settlement Sub-System Hospital and Clinic Reimbursement Division Department of Health

Cost Report Capital Cost Operating Cost (Up front cost) (Annual cost over time) Utilities

Medicare Open Enrollment and Transitioning from the Health Connector to Medicare SHINE Overview

The Medicare Tsunami Bigger than Medicare Set Asides Stronger than the Medicare

Cost Shift Analysis Report Nancy Dolson Department of Health Care Policy and Financing Our

Adult Care Cost Report Training By Susan Kesler Office of the Controller Overview I. Some

Welcome to Kaiser Permanente Presenting Medicare 101 and the Kaiser Permanente Medicare health

vulnerable from a cost perspective to the volume of service(s) provided to a Medicare patient.

Medicare: Parts A and B and Donna McCormick Medicare Advocacy Project Medicare Greater

Your New Medicare Card Information for People With Medicare 2018 1 What does the new

Welcome to Kaiser Permanente Presenting Medicare 101 and the Kaiser Permanente Medicare health

MEDICARE BASICS Welcome to Medicare Presented by the Aging & Disability Resource Center of