Medicare beneficiaries who don’t get to file their cost reports on time blame the long list of required documents and the technical process of filling each one up. Aware they may be of their cost report deadlines, they still fail to provide all the necessary paperwork because they lack the know-how, resources and time.

This is one of the main reasons why hiring a professional CPA is more beneficial than struggling to complete the challenging process alone. After all, you can only attain the full benefits of your Medicare insurance after you’ve submitted the required documents. Failure to comply with this policy will only mean that your earlier efforts to record all hospital and medical bills will be wasted, if not void.

This article aims to outline what needs to be done to file a complete cost report, as well as explain what disadvantages you could face if you cannot meet the requirements within the given timeframe.

What does a Medicare cost report contain?

Your Medicare cost report should contain official forms or valid copies of every cost, charge or transaction that you exchanged with a healthcare partner. The coverage for these transactions includes all nursing, home health, hospital and hospice services. This may also include billing for prescribed medicine and specialized treatments.

What is the objective of the Medicare cost report?

The objective of the Medicare cost report is to review all the billing records incurred from hospital services, and determine whether or not Medicare has been able to provide the full amount promised in the coverage agreement.

Why is it important to hire a professional to file my Medicare cost report?

• Leave the technicalities to the experts.

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It is highly beneficial to hire the services of a professional when filing your Medicare cost report because the task itself can be too technical and time-consuming to do alone. Unless you are confident with your background in costing, there is a possibility that you could overlook tiny details.

Among the terms you need to be familiar with include:

• gross and net revenue
• expenses incurred
• qualified payer mix
• wage indices
• total patient visits
• total insurance amount (sole/collective)

• Guarantee the complete submission of all required forms.

With all the paperwork you need to gather and accomplish, it’s likely that you could miss out on a file or two. Here is a partial list of all the required forms you need to submit in your cost report:

• Adjustments, or WS A-8
• Census Data, or WS S-3 (Part 1)
• Patient Treatment Revenues, or WS C
• Provider Questionnaire, or WS S-2
• Reclassifications, or WS A-6
• Settlement Charges and Data
• Statistical Allocation of Overhead Expenses, or WS B-1
• Summary Trial Balance of Expenses, or WS A
• Uncompensated Care, or WS S-10
• Wage Index, or WS S-3 (Part 2)

This is just a partial list of the required documents. There may be additional forms depending on your particular case.

• Ensure on-time submission and avoid penalties.

Hiring a professional will also help you submit all of the requirements on time. This is crucial because it is only through a timely submission that you can determine the amount to be reimbursed by Medicare. Without your complete documents, health agencies will have no basis for summing up how much they can charge and collect from the government.

On-time submission is the key to getting your money early, as well as avoiding unwanted expenses through penalties.

• Have the time to focus on other tasks.

Enlisting the services of a professional will also ensure that you don’t lose time for your other tasks, whether at home or at work. This way, you can enjoy the peace of mind that comes with getting quality and complete work done, without you having to worry about a thing.

If you are interested in talking to a professional about cost report preparation services, you can talk to us. At Hazzouri Accounting, we are dedicated to simplifying tedious preparation processes, whether it’s your taxes or your insurance. Call us at 734-844-1614 today to know more.

To stay connected with Hazzouri Accounting visit our social media accounts: Facebook fan page / Twitter Feed / Google+ Account

The end of May signals the deadline for filing the cost reports for all those with Medicare or Medicaid. This can be a very tiring and tedious task so we have prepared a quick breakdown of what you need to get done, and what you will face if you don’t comply within the set timeline.

What are Medicare cost reports?

Medicare cost reports are a series of official forms that document every transaction, from costs to charges, connected to healthcare treatment services such as:

• Hospital services
• Hospices
• Nursing services
• Home health services

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The cost reports should reflect whether or not Medicare indeed paid the sufficient amount in exchange for the medical services of any of the health institutions mentioned above.

The common terms included in these reports include, but are not limited to: gross and net revenue, expenses incurred, qualified payer mix, a wage index, number of patient visits, and total insurance amount.

Here are among the official pages required in the submission of the cost report:

• Summary Trial Balance of Expenses, or WS A
• Reclassifications, or WS A-6
• Adjustments, or WS A-8
• Statistical Allocation of Overhead Expenses, or WS B-1
• Patient Treatment Revenues, or WS C
• Settlement Charges and Data
• Provider Questionnaire, or WS S-2
• Census Data, or WS S-3 (Part 1)
• Wage Index, or WS S-3 (Part 2)
• Uncompensated Care, or WS S-10

The timely submission of all these documents is critical because they determine how much can be reimbursed from past and future medical transactions done with Medicaid or Medicare. These documents are the basis for calculating how much health agencies can collect from the government. Moreover, the CMS (Centers for Medicare Services) and Congress use these documents to obtain useful data for the benchmarking of industry rates and pushing future policy reforms.

What happens if I miss the deadline?

Submitting complete and comprehensive cost reports on time is beneficial to you because you are able to collect money or confirm the medical insurance that you signed up for. More importantly, you deter paying unnecessary costs and fees just because you didn’t file the needed documents on time.

What can I do so I don’t miss the deadline?

Getting all this paperwork done can be a huge pressure, especially if you are running a tight schedule. We are here to help take some of the load off your shoulders by listing down some of the most common tips for compiling the cost reports every May.

• Review your list of clients and employees – Before you start compiling all the documents needed for the cost reports, be sure to do a final count on all the clients under you for the previous year. It will be harder for you to keep track of those who have left when you’re already in the middle of all that paperwork. The same goes for keeping track of your current staff.

• Learn to use computer software to help build our database – Take advantage of software, apps or programs that can automate billing requests and all the other documentation necessary for doing health services.

• Start compiling the needed forms early – It will take some discipline to start compiling all the requirements before May even sets in. However, it is the surest way to avoid unnecessary fees from filing too late or not filing at all.

• Hire a professional to do the job for you – If you cannot attend to the process of filing the cost reports by yourself, it is highly advised that you seek the assistance of a professional accountant. Not only will you have more time to attend to other facets of your business, you can also be assured that the job will get done effectively and efficiently— every step of the way.

If you are interested in hiring a skilled and certified public accountant to help with your 2016 cost reports, get in touch with Hazzouri Accounting. Call us at 734-844-1614 today!

You can also learn more by going to our social media accounts: Facebook fan page / Twitter Feed / Google+ Account

The home health care business is growing rapidly due in part to the country’s aging population. As far back as 2008, U.S. News & World Report listed it as one of the best small businesses to start. This is saying a lot in the midst of a small business explosion from many other industries. As usual, however, there are tradeoffs.

First of all, the home health care business is highly regulated. This is hardly surprising since we’re dealing with people’s lives and wellbeing here. The services and quality of care provided by each home health agency must meet strict standards set by the government. This includes many licenses and other requirements not needed in other types of businesses, even before starting operations.

Most of your patients will be on the Medicare program, which has additional rules and regulations. Probably the biggest headache related to Medicare faced by home health agencies is the annual cost report preparation. The reports themselves are notoriously complicated. In fact, the Centers for Medicare and Medicaid Services (CMS) themselves, to whom these reports are submitted, estimated that over 200 hours of work are needed for these cost reports. The laws and procedures also change significantly almost every year. Failing to keep abreast of these changes can be very costly in the form of suspended payments or missed reimbursements.

In a related blog post, we discussed the aspects of Medicare already being reviewed for this year. In this one, we will discuss some of the changes being proposed right now. These entail the collection of information from the public for improvements in Medicare/Medicaid, especially in line with the Affordable Care Act, which are currently up for comments.

CMS-10410 Medicaid Program: Eligibility Changes under the Affordable Care Act of 2010

For people eligible for Medicaid based on their Modified Adjusted Gross Income (MAGI), eligibility will now be redetermined only once each year unless there is a change in circumstance. This limit is also applied to redetermination of eligibility for the Children’s Health Insurance Program (CHIP). Agencies mandated to redetermine eligibility are also required to first use information already available to them rather than wasting time collecting the same data all over again. In line with the Paperwork Reduction Act (PRA), all information for collection, dissemination and sharing will be primarily done in electronic form.
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CMS-2552-10 Hospital and Hospital Health Care Complex Cost Report

The CMS is proposing changes involving the worksheets to be accomplished by hospital-based federally qualified health centers (FQHC) and hospital-based hospices for their annual cost reports in line with the ACA. For cost reporting periods starting October 1, 2014, FQHCs no longer need to complete Worksheet S-8 as well as Worksheets M-1, M-2, M-3, M-4 and M-5, but rather will complete Worksheet S-11, Parts I-III and Worksheets N-1 through N-5. This is for FQHCs that meet the requirements under 42 CFR 413.65(n).

Hospices will no longer complete Parts I and II of Worksheet S-9, but will still complete Parts III and IV. The K series Worksheets are now replaced with the O series Worksheets for hospices. Medicare rules and regulations are complex and ever-changing. The cost reports themselves are already complicated, time-consuming and costly annual undertakings that all home health care providers need to go through. This is why almost all thriving home health care businesses know to leave this aspect of the business to the experts.

Hazzouri Accounting has over 16 years of expertise in Medicare cost report (MCR) preparation, processing, and filing. We serve the local communities and businesses of Michigan and the surrounding areas. Our focus is on building lasting relationships with our clients as a sincerely helpful friend. We are open at the regular 9 to 5 weekdays, with after hours and Saturdays by appointment. We are closed on Sundays. Please call us at 734-844-1614 or use our online contact form for any questions.

You can also come follow us on our social media accounts:  Facebook fan page / Twitter Feed / Google+ Account

If you run a home health care business, most of your patients will probably be from Medicare. This means that there will be numerous rules and regulations to comply with for your home health care business to be admitted to the Medicare program. Private insurance plans usually have the same rules and regulations as well. These requirements cover many different aspects such as record keeping, billing procedures, and even how you screen your patients.

The Office of the Inspector General (OIG) oversees the proper administration of the Medicare program and continuously looks for ways to improve it. Each year, it comes out with a work plan enumerating what potential problem areas of the Medicare program they aim to address to streamline operations and save potentially billions of dollars for the government. Here are some of the highlights from the 2015 work plan.

Provider-Based Facilities

Medical facilities owned and operated by hospitals can be given “provider-based” status even though they are often located off-site. They operate and bill as the hospital’s outpatient departments. However, this usually means that they charge much more than freestanding clinics for the same services, a concern that was raised as far back as 2011. The OIG intends to review whether provider-based facilities actually meet the CMS criteria and whether the higher billings are justified.

Patient Classification

The OIG identified overpayments of up to millions of dollars for short in-patient stays that should have been classified as outpatient. The new criteria now require in-patient stays to be at least two nights (“two midnight rule”). The OIG also has initial findings pointing to the mislabeling of “established” outpatients as “new.” “New” patients should not have been registered as a patient of the facility within the previous three years.

Salaries and Wage Index

The OIG intends to review whether limits should be set on the salary amounts reimbursed by Medicare. While there are currently no specific limits set, they should only, to a “reasonable” extent, cover operations in line with patient care. The OIG also previously identified hundreds of millions of dollars overpaid for incorrect wage indexes for Medicare payments, leading to policy changes by the CMS. The OIG intends to assess whether these policy changes have addressed the problem, and may again review the wage index data used by facilities in their reports.

Duplicate or Excessive Education Payments
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OIG plans to review data from the CMS Intern and Resident Information System (IRIS) to assess how effective it is in identifying and preventing any duplicate or excessive payments for graduate medical education (GME). They will also review the calculation of indirect medical education (IME) payments and their compliance to set regulations and guidelines.

Compliance to Billing Requirements by Independent Clinical Laboratories

Independent clinical laboratories have been increasing exponentially, totaling over $8 billion worth in 2010. With the OIG “following the money,” so to speak, they’ve increasingly subjected these laboratories to audits and investigations. They will probably continue to do so for the foreseeable future, with a report on this expected within the year.

Specialization-Specific Claims/Payments

Dental services are generally not covered by Medicare – with some exceptions. The OIG has identified many cases of reimbursement for dental procedures that are not supposed to be covered. This includes improper record keeping or reporting. On the other hand, the OIG also aims to assess whether children with Medicaid are getting all their needed dental benefits, while also reviewing a proliferation of unnecessary procedures being carried out on them.

Anesthesia services are also being reviewed by the OIG, since services personally performed by an anesthesiologist (AA) are billed double that of services performed under an anesthesiologist’s direction (QK). Starting last year, it has been required that only services performed by the actual anesthesiologist be coded and billed as AA while QK should be used at any time the patient is left with a nurse anesthetist or other health care professional. Like dental procedures, only certain chiropractic services are covered by Medicare. These are limited only to certain conditions and only those that are necessary. This does not include, for example, maintenance procedures.

Hazzouri Accounting has over 16 years of expertise in helping local home health care businesses comply with government requirements. We specialize in Medicare / Medicaid cost report preparation for home health agencies. Call us at 734-844-1614 or use our online contact form to get started!

Visit our social media accounts to stay up to date with us:  Facebook fan page / Twitter Feed / Google+ Account

Medicare/Medicaid cost reports (MCR) is probably the biggest challenge home health agencies face each year. The reports are complicated. The laws and procedures keep changing, and time is yet another constraint. Those who run home health agencies often do not have a solid medical background. It is usually effort enough to try and understand what Medicaid is and the nuances of Medicaid eligibility. Coupled with the MCR paperwork, one would think you’d have to be a doctor, a lawyer, and an accountant all in one.

In addition, the CMS is determined not to make things any easier. According to their website:

1. Cost reports are due on or before the last day of the fifth month following the close of the cost reporting period. For cost reports ending on a day other than the last day of the month, cost reports are due 150 days after the last day of the cost reporting period.

Very specific. And also very “zero tolerance,” as can be seen in the next stipulation:

2. No extensions will be granted except when provider’s operations are significantly adversely affected due to extraordinary circumstances over which the provider has no control. An example would be a flood or fire that forces a provider to cease operations and to transfer its patients temporarily to other providers outside of the impacted area. The contractor would still be required to obtain CMS approval.

 
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It makes no difference how long you’ve been at the home health agency business – Medicare/Medicaid Cost Reports (MCR) are a complex and ever-changing thing. If you missed the deadline last May, you are just one of many. Unfortunately, this almost always means a 100% rate of claims suspension. However, you do have an extra 60 days to still get the MCR in. Given the estimate by the CMS, you may be fast running out of time. Even if you still had a full 60 days (which you don’t), working 8 hours a day, 5 days a week, you would still only have 70 hours left to do it.

If you already missed the deadline last May, don’t make the same mistake again. Hazzouri Accounting has over 16 years expertise in taxes and other accounting services, including MCR preparation and processes. We are a proud and active member of the local Michigan community and are happy to serve the surrounding areas. We meet for your accounting needs but build a lasting relationship as friends.

Khaled Hazzouri is a certified public accountant with a Master’s degree from Wayne State University. We provide complete and hassle-free tax preparation services, whether individual or business. We take the paperwork and second guessing out of all your start-up tax and accounting, income tax returns, payroll, bookkeeping, and all other tax and accounting needs.

We are located at 2200 N Canton Center Rd. #170, Canton, MI 48187. Our service hours are weekdays, 9:00 – 5:00 p.m. After hours and Saturdays by appointment only, Sundays closed. We will be happy to answer any and all questions. Please call us at 734-844-1614 or use the contact form on our website.

You can also come find us on the web:  Facebook fan page / Twitter Feed / Google+ Account