Get the training and information you need to improve Medicare reimbursements and financial operating results at your Medicare-designated Critical Access Hospital.
Critical Access Hospitals (CAHs) receive cost-based reimbursement for services rendered to Medicare beneficiaries. Many state Medicaid programs also reimburse on a cost basis with Medicare Advantage Plans, piggy-backing on traditional Medicare interim payment rates. Sound conceptual understanding of the cost-based reimbursement system along with knowledge of the Medicare Cost Reporting forms are essential skills for CAH finance professionals.
This virtual education event is designed to provide CAH finance leaders with a fundamental understanding of the Medicare program’s cost-based reimbursement system, as well as Medicare cost reporting forms and compilation requirements. After attending this program, participants will better understand cost reporting basics, as well as strategies to employ to ensure an accurate and complete Medicare cost report and Medicare reimbursement.
Topics will include:
- Introduction to the Medicare Critical Access Hospital program and key CAH Conditions of Participation that impact reimbursement
- Basic principles of cost-based reimbursement and the Medicare apportionment formulary
- The relationship between cost report settlements, patient volume, and hospital Medicare contractual allowances and adjustments
- Medicare cost report forms, Medicare cost apportionment formulas, and compilation requirements:
- The purpose of each cost report worksheet
- Data required for each worksheet
- How the cost report “flows” to determine a hospital’s Medicare program settlement amounts
- Underlying cost reporting issues that affect reimbursement and final settlement, as well as cost reporting strategies and practices that yield appropriate Medicare reimbursements
- Detailed cost reporting issues such as:
- Cost Report Questionnaire (now incorporated into cost report, previously a separate report CMS-339)
- Reporting requirement for patient statistics
- Medicare allowable cost principles, cost allocation methodology, and cost apportionment process
- How to review the Medicare Cost Report for overall accuracy, including settlement estimates
- Compilation and work paper compilation practices that result in accurate and complete Medicare cost reimbursements.
- Overview of cost reporting compilation and reporting methods that can improve cost-based reimbursements
- Discussions on material allowable cost issues such as:
- Physician compensation costs and allowable emergency department physician staffing costs
- Interest costs and other capital cost issues
- Other Medicare defined non-allowable costs
- Cost allocation strategies that yield appropriate hospital reimbursements
Note: Participants will receive a copy of QHR Health’s cost report review checklist and handouts to assist with annual cost report compilation process
Register above. In order to be awarded the full credits, you must respond to the polling questions asked during each session and complete the evaluation.
Learning Objectives:
- Learn cost-based reimbursement methodology
- Understand Medicare Cost Reports worksheets used to determine Medicare Cost Reimbursement
- Review other issues specific to CAH reimbursement from the Medicare program
- Develop and enhance technical knowledge of reimbursement methodologies, cost reporting requirements, underlying cost reporting, revenues, statistics on cost report forms, and settlement data
- Understand how Medicare costs are calculated within cost report forms, and how the various worksheets are completed
- Knowledge of allowable versus non allowable costs
- Technical understanding of the Medicare cost report forms that allocate general service cost center costs to patient care and non-reimbursable cost centers within the cost report
- Reporting of hospital patient care revenues and patient days statistics
- Reporting of Medicare program revenues, patient statistics, and payment data on the appropriate worksheets and lines within cost report forms
- Appropriate and accepted cost allocation statistics and methodologies within the cost report
Who Should Attend:
- CFOs
- Revenue cycle and reimbursement professionals
- Controllers or accounting staff (and others involved in the cost report compilation process)
- Financial analysts
- Cost accountants
Presenters
Introduction to the CAH Program
Principles of Cost-Based Reimbursement
Cost Reporting Process and Certification
Introduction to Cost Report Forms
Cost Report Worksheet S
Worksheet A Series: Reporting Costs
Review of Days 1 & 2 / Q&A
Worksheet B: Cost Allocations - General Service Costs
Worksheet C: Reporting Revenues
Worksheet D: Cost Apportionment, Worksheet E: Settlement Process Worksheets
Worksheet M: Medicare Provider Based Rural Health Clinics
Reviewing the Cost Report Before Filing