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

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

Despite the state of the US economy, the home healthcare industry remains one of the strongest businesses today. According to the US Bureau of Labor Statistics, home healthcare jobs will grow 5.5 times faster than all other non-farm industries until at least 2020. The aging population of the US, coupled with the rising incidence of chronic conditions among those at retirement age, has and continues to create great demand for home healthcare.

There is also growing concern over the inflated and unnecessary costs being incurred by elderly chronically ill patients in the traditional hospital setting. The Affordable Care Act aims to address this by pushing for a fee-for-performance model instead of the existing fee-for-service model. This, in turn, will shift the focus of healthcare providers to keeping patients healthy and minimizing the need for hospitalization.

However, it’s not to say that starting and running a home healthcare agency will be a walk in the park. Licensing requirements can be very demanding and cost report preparation is infamously complicated, especially with regards to Medicare. Staffing can be a challenge, especially for those just starting out in the industry. High setup costs, cost-effectiveness, and ROI are also common issues with home healthcare agencies. So how can you streamline your home health agency business in your quest for success?

The Basics

As with any business, you should put in the effort to come up with a well-researched business plan, including an in-depth description of your operational policies. This is particularly important for a home healthcare business, which is why many jurisdictions require a formal business plan (among other things) to get a license in the first place.

Finding both quality staff and potential clients is a hurdle for many. Working with a local college with a nursing and nursing aide program can be helpful, as these institutions are able to assess their graduates’ performance over several years, which is all but impossible for walk-in applicants. They also have an interest in finding employment for their graduates, and will usually welcome a partnership with home healthcare agencies. Similarly, networking and partnering with other types of healthcare providers, such as hospitals and rehabilitation centers, can lead to a significant number of referrals for discharged patients and other potential clients.

 
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Home Health Software and Technology

Home health software such as those provided by McKesson or Axxess can significantly streamline your agency’s documentation and paperwork, while also ensuring compliance with industry requirements and updates. They can also speed up billing requests and other processes involved in the clinical, financial, administrative, scheduling, and human resources aspects of your business. All in all, they help to make your day to day operations run smoother and reduce the time and money spent on the more repetitive tasks.

There is also a growing push for the use of remote patient monitoring (RPM) technologies such as glucose meters and blood pressure monitors, which patients can use themselves and upload the results for via computer or even mobile phone. This reduces the need for on-site visits by medical practitioners while also enabling a more real-time monitoring of a patient’s health. And it doesn’t end there – in 2013 alone, over $100 million was invested in new RPM technologies ranging from telemedicine robots to toilet sensors.

Cost Report Preparation

This is probably the single biggest headache in running a home healthcare agency business. As senior citizens are the primary clients of home healthcare, you will need to handle Medicare cost reports. These are extremely complicated forms that can cause tons of trouble if filled out improperly. In fact, the Centers for Medicare and Medicaid Services estimates that over 200 hours of research, preparation, and data analysis is required on average for Medicare cost reports. Getting an experienced Medicare cost report preparation accountant will go a long way in addressing this bottleneck in your operations.

Hazzouri Accounting has years of experience working in the home health agency field with industry-specific knowledge on highly detailed aspects of Medicare and Medicaid. We will prepare or review your filings to ensure that you receive the full amount you are due. Contact us at 734-844-1614 or visit us our cost report preparation services page for your home health agency cost report preparation in 2014. You can also ask a question on our Facebook fan page, Twitter feed, or Google+ listing!

Owners and managers of home health agencies and healthcare providers know that preparing the annual Medicare cost report is a crucial part of running a business.

Medicare cost reports, which are basically a series of forms that indicate the costs and charges linked to healthcare treatment activities, are submitted by hospitals, hospices, skilled nursing facilities, home health agencies, and other such institutions to determine if Medicare paid sufficient amounts to the healthcare provider in question. It contains information such as facility characteristics, expenses incurred, gross and net revenue, payer mix (referring to the number of patients eligible for Medicare, as well as data on those who do not qualify or have private insurance), wage indices, and total number of patient visits. Required cost report pages and supplementary documents include – WS A (Summary Trial Balance of Expenses), WS A-6 (Reclassifications), WS A-8 (Adjustments), WS B-1 (Statistical Allocation of Overhead Expenses), WS C (Patient Treatment Revenues – Total Charges), Settlement (Charges and Data), WS S-2 (Provider Questionnaire), WS S-3 Part 1(Census Data), WS S-3 Part 2 (Wage Index), and WS S-10 (Uncompensated Care).

While Medicare uses the data collected to gauge the scope and impact of the program, the efficient submission of cost reports is equally important for individual home health agencies because cost reports determine the rates of both past and future reimbursements that home health agencies can obtain—the CMS and Congress use the data obtained from cost reports to set industry rates and implement possible policy reforms.

Given the importance of preparing accurate, complete, and comprehensive Medicare cost reports, many home health agencies spend inordinate amounts of time, money, and effort to making sure that they answer all report questions in a satisfactory manner. In fact, research done by the Centers for Medicare and Medicaid Services reveals that an average of two hundred hours is required to ensure the completion of a single Medicare cost report. This can often range from hundreds to thousands of pages, depending on the size of the home health agency submitting it. Because of this, home health agency managers and owners often see the preparation of cost reports as a daunting, complicated task best left to professionals. Even so, not all accountants have the experience and skill set needed to accomplish the job.

 
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To avoid excessive fees and complications, it is best to start preparing your 2014 cost reports early on. You can do this by availing of top-notch 2014 Medicare cost report preparation accounting services from one of the most trusted names in the industry— Mr. Khaled Hazzouri from Hazzouri Accounting.

Khaled Hazzouri is a skilled certified public accountant that can help extricate you and your business from the potential quagmire that a Medicare cost report can be and turn it into an efficient, fuss-free, cost-effective process that will save you valuable time, money, and effort. With years of experience under his belt, Mr. Hazzouri has gained an innate understanding of the reporting and filing process, allowing him to effectively evaluate, analyze, and report on the financial status of your home health agency in a timely manner. He is well-versed in industry standards and is able to produce a specialized, detailed report that fully reflects the strengths and vision of each individual client. His reasonable service rates are complete with an assurance of no surprise fees. And because of this, he has left hundreds of clients satisfied with his professionalism.

From the start of evaluation to the last day of filing your Medicare cost report, Mr. Hazzouri can take responsibility for the entire process, leaving satisfied home health care agencies with the peace of mind necessary  to focus on what really matters most—providing excellent healthcare services to patients and their families.

Click here to learn more about our Medicare cost report preparation services.