Question: Bill Super (named changed) at Bill Super and Associates, CPA firm is the best and the brightest! We hire him to prepare our cost reports! How can we have any errors on our Medicare cost reports that you could possibly correct for us?
Answer: Bill Supers are out there and they are extremely gifted individuals, but they usually have many clients and are spread very thin! In bigger firms, they may not actually review your Medicare cost report at all! Here are a few ways that we have found that mistakes do happen in this circumstance:
1) Bill Super does not actually prepare your cost report. His less gifted and experienced staff does.
2) Bill Super’s staff makes a keying error when keying data into a spreadsheet.
3) Bill Super’s staff makes a keying error when keying one of the thousands of numbers in the cost report.
4) Bill Super’s staff is overworked at cost report deadline time and cuts a corner or two so they can meet the filing deadline.
5) Bill Super’s staff runs the PS&R incorrectly.
6) Bill Super’s staff has turnover and the new staff does not fully understand what the old staff did.
7) Bill Super’s staff did it just like last year, but was not aware that the circumstances had changed this year.
8) Bill Super’s staff overlooked, ignored or improperly corrected cost report software edits.
9) Bill Super’s staff does not read and fully understand new law and regulations.
10) Bill Super is going through some personal issues that distract him temporarily from his work.
11) The MAC auditor makes a judgment error during the Medicare audit.
12) The MAC auditor makes a keying error during the Medicare audit.
13) The MAC auditor is at their deadline time and cuts a corner to meet the deadline.
14) The MAC has turnover in auditors and the new auditor does not fully understand the situation.
15) The MAC settlement personnel don’t fully understand the MAC auditors’ work.
16) The MAC auditor did it just like last year, but was not aware of the circumstances changed this year.
17) The MAC auditor overlooked, ignored or improperly corrected cost report software edits.
18) The MAC auditor does not read and fully understand new law and regulations.
19) The MAC changed and the new MAC does not know or understand what the old MAC did.
20) The MAC auditor is given improper data or no data at all and makes an incorrect adjustment.
21) The MAC auditor is not sane.
22) The required data was not available to Bill Super’s staff at the time of filing and they did not remember that they needed to amend the report when the data became available.
23) Hospital staff coded an invoice wrong, but it was not big enough in amount for Bill Super’s staff to review.
24) Hospital staff made an incorrect Journal Entry, but it was not big enough for Bill Super’s staff to review.
25) Hospital’s accounting system improperly maps revenue or expense, but the totals were right.
26) Hospital’s Chargemaster needed to be updated to reflect proper revenue codes, services, etc.
27) Hospital’s census data is incorrectly accumulated or stated in census reports.
28) Hospital’s staff produced bad debt listing did not capture all the Medicare allowable bad debts.
29) Hospital staff made a keying error in a spreadsheet prepared for Bill Super’s staff.
30) Hospital staff did not fully understand how to conduct a particular time study and its impact.
31) Hospital staff forgot to conduct a time study.
32) Hospital staff had turnover and some things did not get done during the interim period.
33) Hospital staff did it just like last year, but the circumstances had changed in this year.
34) Hospital staff does not read and fully understand new law and regulations.
35) Bill Super’s staff went over budget on hours and cuts corners to reduce hours and fees written off on engagement.
The cost reporting law, regulations and process are very complex. The process has a lot of human elements. Given adequate opportunity, as there is in the cost reporting process, human beings will make errors! All it takes is one small error in the right place to swing hundreds of thousands or millions of dollars in reimbursement.
