Cost Reporting 101: A Crash Course in the Basics

[Pages:44]Cost Reporting 101: A Crash Course in the Basics

Paul Traczek, CPA, Partner Holly Pokrandt, CPA, Partner

July 18, 2016

? Wipfli LLP

? Wipfli LLP

Cost Reporting 101: A Crash Course in the Basics

What will be covered today: Critical Access Hospital Reimbursement Principles Medicare Cost Report Mechanics Tips on Where to Focus Efforts Top Ten Questions for a Targeted Cost Report Review

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Basic Critical Access Hospital Reimbursement Principles

If a non-health care business charges $100 for a good or service it provides,

how much does it get paid?

Gas Station

Grocery Store

Plumber

Restaurant

Garbage Service

Clothing Store

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Basic Critical Access Hospital Reimbursement Principles

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Basic Critical Access Hospital Reimbursement Principles

If a health care provider charges $100 for a service it provides, how much does

it get paid?

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Basic Critical Access Hospital Reimbursement Principles

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Basic Critical Access Hospital Reimbursement Principles

Examples of Possible Payments for Health Care Services

Private pay Private pay Medicare Medicaid Insurance #1 Insurance #2 Insurance #3 Etc.

$ 100 -

60 55 90 85 80 ?

To determine the estimated amount a health care provider will be paid, three important pieces of information must be known:

1. Payor type

2. Patient type

3. Specific type of service

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