Updated: 7/24/2010

RHC Cost Reporting Resources

2010 Cost Report Presentation for Spring, 2010 RHC Update Seminar prepared on April 15 2010.pdf

Here is a presentation on Medicare Bad Debts that I emailed to one client today. It was helpful in explaining Medicare Bad Debt reporting.

https://www.highmarkmedicareservices.com/calendar/parta/pdf/tc-handouts-010610.pdf

May 5, 2010. The MACs are reminding RHCs to get your credit balance report in. They were due on April 30, 2010 for the first quarter. Remember those are different from the cost reports and are due quarterly.

2010 RHC Cost Report Cover Letter with RHC Notebooks

Here is the complete 120 page book in a PDF format. If you want to order the Cost Report Workbook and CD with all of our Cost Reporting files and Documents the cost is $100.00. Hard to beat this deal, though. Download it for free by following the link:

2010 RHC Cost Report Workpaper Notebook (120 Pages)

The P S and R report may be a problem this year with the new IACS system. If you have a problem obtaining your P S and R by April 30^th; let us know and we have contact at Cahaba that has been successful in obtaining the reports relatively quickly. Here is the checklist for 2010 and I added a link for some work we did on the comparison between provider-based RHC reimbursement and RBRVS payment.  I have included our Medicare Cost Report Workpapers, Physician Compensation Tables and Tab Sheets or Summary pages that we use to summarize the data for Medicare in our standard Workpaper set that is presented to the Medicare Administrative Contractor (MAC). The updated information includes a section for the reporting of H1N1 Flu vaccine which is new this year.

2010 RHC Upate Workpapers including Physician compensation tables and new data summary sheets

2010 RHC Cost Report Checklist

2010 Visit Checklist for Cost Report

2010 P S and R and IACS Information

RHC Cost Reports and Contingency Reviews

If your rural health clinic is not above the Medicare reimbursement maximum of $77.76 for 2010; then, you should consider having us prepare your cost report. Last year 100% of our clients were at or above the reimbursement cap and the cost reports were filed conservatively as we did not have a single cost adjustment in our cost reports. Our recent refilings and contingency work has indicated that a number of clinics are not getting the maximum reimbursement rates and it is not due to low costs. It is due to incorrectly prepared cost reports.

 

We have been working with Medicare and Medicaid cost reports since 1981 or 29 years of experience. That experience has proven results. HBS has recovered over $500,000 in lost Medicare and Medicaid reimbursement by re-filing Medicare and Medicaid cost reports. We can look at the previous year's cost reports on a contingency basis and if we will only be paid if we find something. The fee is 25% of the Medicare increased reimbursement when it is credited to your account. If you are below the cap it just makes sense to have your cost report reviewed.

 

Even if we do not find increased reimbursement; we will send you a free benchmarking report comparing how your clinic compares to other clinics in physician compensation, charges per Medicare visit, reimbursement per Medicare visit, physician visits, NP visits, PA visits, Flu shot reimbursement, pneumococcal reimbursement, and other key operating variables of a rural health clinic.  To get us started; email us at la_vita_nouva@hotmail.com or call us at (423) 243-6185.

 

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One important piece of information related to cost reports. When you start giving the swine flu injections; please keep a log just like the Medicare log for normal influenza or pneumoccocal. Please keep each of these as a separate log.

Here is the fax number for the Quarterly credit balance report for Cahaba: (205) 733-7022. Just fax the quarterly credit balance report in by the last day of the month following each quarter in order to keep your Medicare funds from being cut off.

Preparing for the 2009 Medicare Cost Report

As hard as it to believe; it is time to get ready to prepare the Medicare and Medicaid cost reports again. We wanted remind our clients about some of the data that is required to complete the Medicare cost report and some things that you can do now to increase your Medicare reimbursement rate.  Here is a listing of the things to do before December 31, 2009 that could help your reimbursement.

 On or around December 31, 2009 empty your bank account by paying all your bills and paying additional money as compensation to the owners.  This will help you increase your Medicare cost per visit and decrease your corporate or individual taxes as well.  Please note that in 2004 some IRS regulations and enforcement actions relate to the declaration of year-end bonuses by physicians.  You should talk to your tax accountant; before paying any year-end bonuses to ensure that the bonus is not considered a dividend under IRS rules.

 In you next corporate meeting declare a bonus for any excess funds collected in the first 75 days of 2010.  This will help you document any bonus that may need to be paid to physician owners during this period.  The Medicare rules for corporations are bonuses to owners must be paid within 75 days of year-end.

 Prepare a CPT Frequency Report with all CPT codes listed for all payers by provider.  We need an individual report for each physician, nurse practitioner, and physician assistant.  This is extremely important for sole proprietors and partners; because, Riverbend has clarified that the value of physician compensation can only be claimed for the visits that the physician is able to document that services were actually rendered by the physician. This could have a dramatic impact on clinics that have claimed the physician compensation allowance for total visits in prior cost reports.

Write off any Medicare Bad Debts before year-end.  Proposed Medicare rules published; but not finalized, will reduce Medicare bad debt reimbursement to 70% of actual cost over the next three years.  Since the bad rules are not final as of this writing; it is in your best interest to go back to the time you were first a rural health clinic and write off any unpaid Medicare deductibles for rural health clinic services.  You should review the Medicare bad debt regulations closely to determine that you have met the guidelines.  It is imperative that you write the account off your accounting records by the 12/31/2009 deadline or you probably face reduced reimbursement in the future.  You should begin working on your Medicare bad debt listing in Microsoft Excel as soon as possible due to the difficulty in obtaining adequate information to obtain reimbursement.

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