Critical Access Hospital Reimbursement & Medicare Cost Reporting Virtual Boot Camp

October 27-29, 2020

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, finance professionals will understand cost reporting basics, as well as strategies to employ to ensure an accurate and complete Medicare cost report and Medicare reimbursement.

Topics covered will include:

  • Introduction to the Medicare Critical Access Hospital program and key CAH Conditions of Participation that impact Medicare 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 and Medicare cost apportionment formulas within the forms. Major cost report worksheets will be discussed in detail, including compilation requirements:
    • The purpose of each worksheet within cost report forms
    • 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 reimbursements and final settlement, as well as cost reporting strategies and reporting 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 such as patient days and observation days
    • Medicare allowable cost principles, Medicare cost allocation methodology, and the Medicare cost apportionment process
    • How to review the Medicare Cost Report for overall accuracy including the cost report settlement estimates
    • Compilation and work paper compilation practices that will result in accurate and complete Medicare cost reimbursements and cost report documentation
  • Discussions on cost-based reimbursement 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 by minimizing cost allocation to non-reimbursable cost centers and non-cost-based reimbursed services
    • Proper matching of costs revenues and Medicare program revenues
    • Review of the Medicare cost report and key data points to always verify before filing a Medicare cost report

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 below. In order to be awarded the full credits, you must respond to the polling questions asked during each session and complete the evaluation.

We recommend this course for healthcare finance professionals of a CAH, or a system that owns or operates a CAH, including:

  • CFOs
  • Revenue cycle and reimbursement professionals
  • Controllers or accounting staff members (and others involved in the cost report compilation process)
  • Financial analysts and cost accountants

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

Presenters for this event:

This event will feature some of the best and brightest we have to offer. Click on a presenter's name to view their bio.

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