How Hospitals Can Submit the Most Accurate Medicare Cost Report

Submitting an accurate Medicare Cost Report is essential for hospitals to ensure proper reimbursement and compliance with Medicare regulations.

Here are 10 key steps to help a hospital submit the most accurate Medicare Cost Report:

1. Understand Medicare Cost Report requirements. Familiarize yourself with the specific instructions, guidelines, and documentation requirements provided by the Centers for Medicare and Medicaid Services (CMS) for completing the Medicare Cost Report. Review the most recent version of the Medicare Provider Reimbursement Manual (PRM) and any other relevant CMS resources.
2. Organize financial and statistical data. Gather all financial and statistical information required for the Medicare Cost Report, such as revenue and expense data, patient days, discharges, and payer mix information. Ensure that the data is accurate, complete, and properly categorized.
3. Maintain detailed records. Maintain detailed and well-organized records of all financial and statistical information used in the Medicare Cost Report. This includes general ledger account balances, trial balances, trial balance adjustments, and supporting documentation such as invoices, contracts, and payroll records.
4. Adhere to the accrual basis of accounting. The Medicare Cost Report should be prepared on an accrual basis rather than a cash basis. Ensure that all revenue and expenses are recorded in the appropriate period, regardless of when the cash was received or paid.
5. Allocate costs appropriately. Follow the Medicare Cost Report instructions for allocating costs between different cost centers and cost pools. Ensure that costs are allocated based on reasonable and consistent methodologies, supported by proper documentation and in accordance with Medicare regulations.
6. Verify coding accuracy. Ensure that all revenue and expense codes used in the Medicare Cost Report are accurate and up to date. Double-check the coding for services, supplies, and other items to ensure proper reimbursement and compliance.
7. Reconcile with supporting documentation. Reconcile the financial data in the Medicare Cost Report with the supporting documentation, such as the hospital’s financial statements, trial balances, and other financial records. Identify and resolve any discrepancies or errors.
8. Perform internal reviews and audits. Conduct internal reviews and audits to validate the accuracy of the Medicare Cost Report. This may involve reviewing the data, calculations, and supporting documentation, as well as ensuring compliance with Medicare regulations. Consider involving a third-party consultant or expert to perform an independent review.
9. Seek professional assistance if needed. If your hospital lacks the expertise or resources to complete the Medicare Cost Report accurately, consider seeking assistance from consultants, accountants, or specialized firms experienced in healthcare reimbursement and Medicare regulations.
10. Submit the Medicare Cost Report on time. Pay close attention to the submission deadlines specified by CMS. Late submission may result in penalties or delays in reimbursement. Ensure that the Medicare Cost Report is properly signed and certified before submitting it to the appropriate Medicare Administrative Contractor (MAC).

Remember that Medicare Cost Reports can be complex and subject to frequent updates and regulatory changes.

It’s important to stay updated on the latest CMS guidance and seek professional advice if necessary to ensure accurate reporting and compliance.

Contact BESLER for help with your hospital’s Medicare Cost Report preparation and submission.