Cost Reporting

Inpatient acute care hospitals and long term care hospitals are required to file annual Medicare and Medicaid cost reports to ensure accurate payment rates and, in some instances, to verify that reimbursement from the Medicare and Medicaid programs do not exceed the cost of providing services. Inpatient acute care hospitals and long term care hospitals are required to file the Centers for Medicare and Medicaid Services (CMS) 2552-96 Cost Reporting form and various Medicaid cost reporting forms.

These reports are complex and cumbersome and require:

• A comprehensive understanding of the CMS Provider Reimbursement Manual (PRM);
• Knowledge of Medicare and Medicaid reimbursement methodologies, including the Acute Care Prospective Payment System (PPS) and the long term care Prospective Payment System (LTC PPS).

PCG Expertise

PCG consultants have extensive experience with CMS cost reporting requirements and provide clients with unmatched cost reporting services, including:

• Collection of data in a consistent and efficient fashion to minimize clients’ administrative burden;
• Completion of all pertinent worksheets within the Medicare and Medicaid cost reports;
• Preparation and submittal of a cost reporting binder that is properly organized and contains the necessary supporting documentation on cost finding methodologies;
• Completion of appeals or reopening of requests to capture additional costs to increase Medicare and/or Medicaid reimbursement;
• Complete support when reports are audited by CMS or Medicaid agencies;
• Rate setting reviews to ensure payment rates accurately reflect costs so that revenues are optimized;
• Assistance with preparation of highly compliant Medicare bad debt logs to minimize disallowances;
• Submission of an annual management letter to our clients that outlines findings for process improvements and highlights pertinent changes to federal and state regulations that could potentially impact reimbursement to clients.

Additional cost reporting services include completing charge master reviews to ensure charges properly reflect the current market prices and identifying and implementing alternative reimbursement methodologies to increase revenues for our clients.

Among our clients:

• State of Alaska
• State of Arizona
• State of Florida
• State of Illinois
• State of Louisiana
• Commonwealth of Massachusetts
• State of Texas

Attachments

Click on the image to download our information sheet on this service.