Welcome to this new entry into my Reimbursement Blog! If you are a new reader, I invite you to take a moment and subscribe to the blog through the link at the bottom of this page.
This entry is important to any hospital that is contracting out its annual Medicare/Medicaid cost report preparation. We have noticed an increasing number of the accounting/consulting firms that are providing cost report preparation services are not providing their clients with a complete set of cost report preparation workpapers and an electronic cost report file at the completion of the preparation project.
I highly recommend including language, in any contracts for this service, that requires the preparer to provide a complete set of workpapers at the completion of the project. This is not to much to ask of the preparer and it will halt their efforts to tie themselves forever to your hospital while simultaneously making your job more difficult. At a minimum, hospital’s should require copies of any workpapers provided to the Fiscal Intermediary as a part of the submission process.
I also recommend language that requires the preparer to provide the hospital with the Medicare/Medicaid cost report in electronic form, known as the ECR file. While the hospital may not have the software to run the ECR file, obtaining the ECR file upfront could save the hospital substantial fees should they choose to utilize a different accountant or consultant that has the required software for future cost reports or other special projects.
While including the above language in the contract is certainly helpful, hospital management must also make sure that their accountants and/or consultants comply with the terms of the contract by actually providing the data to them at the completion of the project.
In most instances, reputable accounting and consulting firms will provide both the workpapers and ECR files upon the request of a current or former client, but often the data is not produced in a timely fashion and occasionally a fee is attached to the provision of the data. The worst case would be the accountants going out of business (if it can happen to Arthur Anderson- it can happen to your firm), losing the workpapers or being upset with a hospital’s subsequent change in accounting firms. In these cases, the hospital may have no way to get their own workpapers that support their cost report. Getting the data up front as a part of the required deliverable is always a good idea!
I hope this and all future blog entries help you identify the most important reimbursement issues and new developments in the field for you.
Kendall Quisenberry
President
Reimbursement Counselors
(972) 403-9910
