Uncompensated care reimbursement is driven by the components of Worksheet S-10. Despite these components being clearly outlined — including charity care and uninsured discounts, total non-reimbursable bad debts, and cost-to-charge ratio — they’re often not easily reported.
With reimbursement dollars tied directly to the accuracy of Worksheet S-10, it’s very important to get it right the first time. Before any reimbursement is determined, three factors are considered. Hospitals can’t control the national portion outlined by Factors 1 and 2. However, to some extent, hospitals can control Factor 3 that addresses the hospital’s proportion of uncompensated care relative to that national total.
Below are some best reporting practices for Worksheet S-10:
Start the process early with IT
With the amount of data involved in completing Worksheet S-10 on your cost report, it’s advantageous to partner with IT as soon as possible to confirm all data elements are properly captured. The data needed to process and support your filing efforts often can’t be covered with an off-the-shelf application.
Confirm Financial Assistance Policy (FAP) is being followed
Test accounts providing patient-level detail to ensure financial assistance and charity care for consistency against your policy. Be sure this detail correctly ties to the policy as it relates to the fiscal year.
Utilize a software with strong data processing capabilities
Implement software that can match all the data among various elements and handle the volume of data required for filing. Having a process in place to analyze the data is just as important as correctly capturing all data points with your internal team.
Improved uncompensated care reimbursement processes can also help with an audit. The number of hospital audits is only expected to rise — roughly 600 FFY 2015 Worksheet S-10s were audited — as Worksheet S-10 will likely continue to be used to drive Factor 3 going forward. Keeping an eye on the sample data MACs are currently reviewing can help better prepare you in the event of an audit.
For more detailed information on uncompensated care reimbursement and how to prepare a successful Worksheet S-10, listen to our on-demand webinar.
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The materials available on this page are for informational purposes only and not for the purpose of providing legal advice. You should contact your attorney to obtain advice with respect to any particular issue or problem.