Medicare Cost Report Worksheet S-10 Explained [PODCAST]
Welcome to the hospital finance podcast you're go to source for information and insights that can help you stay ahead of the challenges impacting healthcare finance, and now the host of the hospital finance podcast. Michael, pass not say. I might not and welcome back the wording hospital finance podcast. WORKSHEET has ten has become an increasingly important part of uncompensated care reimbursement to help us understand more about worksheet has ten. I'm joined by Jimmy Mendez who is a senior manager on our reimbursement services team at bessler Jimmy Welcome back to the show. Thank you Mike? Jimmy why don't you start out by explaining why? Worksheet S. ten on the Medicare cost report has become so important. Well Mike work ten is critical to any facility that treats a high number of dish patients. Any facility that has a patient percentage over fifteen percent is entitled to a portion of the uncompensated care pool. This uncompensated care pool is a set of now for fiscal year two thousand twenty that cms allocates to all eligible hospitals. The allocation percentage for each each hospital is directly linked to the uncompensated care. Total reports on Worksheet S. ten. Jimmy Water, some of the key data files that are needed to get started with the preparation of worksheet has ten. These include the following eight thirty five warns a thirty-seven forums age trial balance detailed. Charges General Ledger and financial statements. Insurance Master. Transaction Code Master. Hospital service mapped by patient type. Bad Policies. Charity Policy. Financial assistance policies. Patient demographics. Charge detail. which ones are the most critical Jimmy? Most critical are the transactions which is the in accounting transaction, detail, the charge detail and the patient demographics. Let's start with the patient accounting transaction detail. Essentially you want a complete download of the patient accounting system. This will allow you to identify. All of the transactions applied to patients account over the life of the patients encounter. The payment transactions should be able to reconcile back to the eight thirty five, which are administered advises and the remittance advice. Can I be the patient responsibility? Transaction Code identifying primary secondary and tertiary pairs as well as win. The hospital started building the patient and any charity care discount applied are essential as you want all components of activity beginning with a total charges and ending with the patients outstanding balance to include reductions attributable to bad debts. It is also important to identify the service states. Financial Class and the Geo Department. Number and Geel account number that each transaction hits to ensure that you can reconcile the mass to General Ledger accounts. You mentioned the charge detail elaborate on that critical file for us. Sure, the yeah, the charge detail is essentially a revenue and usage report that has exploded into transaction level by patient. It will contain data such as patient encounter number revenue codes. Charged amount. You need patient ID. Go Department and account. Service states patient type. Patient class among other items. The total should reconcile to your general. Ledger In addition utilizing the revenue codes, you should be able to identify positions and other professional charges. These reconcile to your eight thirty seven and should be excluded. From. And what information should the patient demographics contain? This will include patient name Patient Account Number Unique ID. Social Security number. Address Data Burke. Medical record number. Medicare and medicate number. Collection Agency information among various additional information. The importance of the patient demographics is the ability to identify the specific account and ensure that you have all the correct information tied together from all of your data sources. Jimmy what are some of the issues that may arise that could taint the integrity of the supporting information particularly during an audit. Well a big one is not having a well written and defined charity policy that supports the patient detailed transaction charity right house. There is a risk that a write off. That is not supported by charity. Policy will be deemed an administrative or courtesy. Right off and will need to be excluded from work. She'd asked him. Essentially S. ten should exclude courtesy allowances discounts of patients, not meeting the Hospitals Charity Care Policy. Discounts given to uninsured patients, not meeting the hospital's financial assistance, policy. Bad debt reimbursed by Medicare. And discounts given to patients for prompt payments. Other activity that needs to be addressed includes zero charge on write offs. Right up amount that exceeds patient, responsibility or charges and lack of social security number. And as you may have guessed from Jimmy's comments, tank can be a bit tricky to prepare your in a hospital, and you need assistance preparing your s ten, or if you'd like us to review the work that you've done on your ass, ten just drop a line at updated bessler DOT com. There's also some additional information on our website that you can visit just head on over to the reimbursement services web page for that Jimmy Mendez thanks so much for joining us again today on the hospital finance podcast. This concludes today's episode of the hospital. Finance podcast were show notes and additional resources to help you protect and enhance revenue at your hospital visit. bessler dot com forward slash podcast. The hospital finance podcast is a production of bessler smart about revenue to nations about results.