Frequently Asked Questions
We have listed several frequently asked questions and provided brief responses sparing the burdensome regulatory language. We will be adding additional questions as the need arises.
If you would like a more in depth answer that addresses your specific circumstances, please contact our office. We also recommend that you visit the News and Resources section of our website on a regular basis.
- If our staff contacts TFG with several questions or needs additional guidance, will we receive a bill from TFG for the call?
- Absolutely not, we like our clients and want them to be well informed. You will never receive a bill from TFG for phone consultation. You will be notified in writing of any services that are beyond the scope of our engagement letter.
- Will you perform your services on-site or at your location? Will we billed for travel time?
- Rarely will TFG advisors have a need to visit your location but we are available to travel to your location upon request. You will never be billed for travel time but will be billed for direct travel expenses (commercial airfare and lodging). We can either fly out of BTR or MSY. We also have IP Video Conferencing capabilities.
- When is the Medicare Cost Report Due?
- The Medicare Cost Report is due on the last day of the fifth month following the end of the cost reporting period.
- When is the Medicaid Cost Report Due?
- Medicaid Cost Report due dates vary depending on the state and type of provider, send us an email with the specifics and we will let you know.
- Where should we send our Medicare Cost Report?
- When TFG sent the cost report by email, we would have also sent the filing instructions, which details the mailing address of your FI/MAC. If you are not a current client of TFG or no longer have the email that we sent, just send us an email with the name of your FI/MAC, provider number and State and we will forward the filing address.
- What are the consequences for filing a cost report late?
- The provider will go on 100% withhold if the Medicare Cost Report is not received on the 7th day after the due date. Interest may also be assessed on any overpayments. The consequences of filing the Medicaid Cost Report late vary by state. The penalties range from no penalties, payment withhold, or a 1,000 per day penalty depending upon the State Medicaid Program.
- Can we get a due date extension?
- It is extremely unlikely to get a Medicare Cost Report Extension. Several State Medicaid Programs can be more flexible. Contact us with your circumstances and we will let you know the likelihood of extension based upon our experience.
- How do we obtain a PS&R?
- In order to obtain a PS&R you will need to enroll in the IACS system so that you can retrieve the PS&R on-line. FI/MAC’s no longer mail hardcopy PS&R reports. Enrollment in the IACS system is a lengthy process. If you are not currently enrolled, please refer to the resources page of our website for an useful link related to IACS enrollment.
- When should we expect our tentative settlement from the cost report?
- You should receive the tentative settlement within 60 days of acceptance of the Medicare Cost Report. If you have not received your tentative after 60 days or did not receive the full amount of expected tentative, please contact our office. If you are a terminating provider, you may not be eligible to receive a tentative settlement.
- When is the Notice of Program Reimbursement (NPR) issued?
- Generally the NPR will be issued within 1 year of cost report acceptance. However, if the hospital is receiving any DSH or LIP Payments, the issuance of the NPR will be delayed until the cost reporting periods SSI percentage is published by CMS which could take several years. If the provider is subject to an outlier reconciliation the NPR may also take additional time.
- How long do we have to either amend, appeal, or reopen a cost report?
- In general, you can amend a cost report at any time prior to the commencement of the desk review. Once the desk review or audit has began, amendment is at the FI/MAC’s discretion. You can reopen a cost report within 3 years after the date of the issuance of the NPR if you can demonstrate that there is a material misstatement of cost. You can appeal a final determination if the appeal is filed within 180 days of the issuance of the NPR. These timing requirements are strictly enforced so contact our office as soon as possible so that we can help you determine if an amendment, appeal, or reopening is appropriate.
- If contacted by an intermediary, MAC, or state audit contractor about the cost report,
what should we do?
- Get the full contact information and name of the person calling and then direct them to contact our office directly and we will take it from there. Then forward us their contact information by email.
- Upon receipt of any proposed adjustments or NPR, what should we do?
- Please immediately forward the proposed adjustments to our office upon receipt, we usually only have about 10 days to respond. If you receive an NPR, please forward the ENTIRE NPR to our office including any files that may be on disc and retain a copy of the entire NPR for your records, you may need it later.
- Can we recoup bad debt that was not previously claimed on a cost report?
- ABSOLUTELY, PLEASE CONTACT OUR OFFICE ASAP !!!
- Medicare Cost Report Preparation
- Medicaid Cost Report Preparation
- Comprehensive Billing Services
- Audit Adjustment and Dispute Resolution
- Enrollment and Licensure
- Financial Management
- Medicare Bad Debt
- Square Footage Studies
- EHR Incentive
- DSH Audit Survey
- Due Diligence – Third Party
- Outlier Reconciliation Dispute
- Medicare Low Volume PaymentAdjustment Requests
- Extended Repayment Plan
- Medicaid Enhanced Staffing Reports
- Capital Re-Age Requests