D & E Series Title XVIII Settlement (PS&R)

Overview

The Worksheet D & E Series Title XVIII Settlement section in Absolute allows for automated assignments of all PS&R data. Absolute will allocate Medicare revenues from the PS&R to the proper worksheet using either a Direct or Xwalk Assignment method. Other PS&R information, such as DRGs, Outliers, Deductibles/Coinsurance and Net Reimbursement are automatically tabulated and assigned to the cost report worksheets by the software. 

Import PS&R Summaries

Medicare PS&R csv files are obtained from CMS and uploaded into Absolute in the Import PS&R Summaries section of Absolute. For detail on uploading the PS&R detail, see Import PS&R Summaries article. 

PS&R Revenue Code Assignment

The PS&R Revenue Code Assignment section lists all revenues codes in the applied PS&R reports, split up into separate tabs by the provider type (acute, rehab, psych, etc.). Absolute allows the definition of the assignment method of inpatient and oupatient revenue by revenue code for each provider type.

Note: Because the PS&R Assignment section is dependent upon Worksheet C/R&U data, Worksheet C, Part I must be marked complete in order to open this section for editing/completion. 

Assign Revenue To Lines

A tab and assignment set is generated for each classified provider with applicable active PS&R reports (reports which contain revenue that can be assigned to the charge worksheets).

Click a tab (ex. Hospital) to view and edit the assignments for that provider type.

All revenue codes for each provider type must be assigned to a line in order for the stage to be completed. Revenue codes that require action (no prior saved assignment) will display in red text. Preparers typically only need to review and address new revenue codes that were not present in the prior year. Preparers also have the option to update existing assignment methods. 

Revenue codes that don't have revenues in the PS&R for a specific admit type will be greyed out in the applicable column.

Assignment Method

All revenue codes that are not greyed out must have an assignment method set. Click "Click to Select" to choose between Direct Assignment and Crosswalk (Xwalk) Assignment methods.

To apply a specific assignment method to all revenues in a column, select the "Assign Method" header, and choose the assignment method to apply to all revenue codes in that column. 

Crosswalk Assignment Method

The crosswalk assignment method is derived from the uploaded Revenue & Usage data, after all Worksheet C, Part I revenue reclasses have been processed and marked complete. Absolute will look at reclassed R&U data, for Medicare Payers, for that specific Admit Type (IP vs OP) when assigning PS&R charges based on the crosswalk assignment method. 

Direct Assignment Method

Revenue codes can also be assigned to the Worksheet D-3 or D Part V lines using a direct assignment method. This method allows the preparer to directly assign a percentage of a particular revenue code to a cost report line, rather than using R&U data to allocate the charges. Direct assignments are done using operations. 

To add an operation:	Click the + to open the Add Operation form.
Percent:	Enter the percentage to allocate. (ex. 23%). The sum of all the values for a revenue code/admit type combination must total to 100%.
To Line:	Enter the WS D-3 (Inpatient) or WS D Part V (Outpatient) line number the revenue code will be assigned to (or WS I-4 for Home Program Dialysis and Renal Dialysis providers). The line number may be entered by typing it in the text box, or by clicking the Select Line button and selecting the line number from the list.
Source:	To attach a supporting workpaper from the Source Documents pool, click the Source field to select the desired uploaded support paper from the list.
To save the operation:	Click the O button to enter the changes, or click the X button to cancel.
To edit an operation:	Click an operation to open the Edit form. All the fields are now editable and behave the same as adding an operation. After entering desired changes, click the O button to save the changes, or click the X button to cancel.
To delete an operation:	Click the button to delete the operation. The operation will be immediately deleted without confirmation.
Completing the stage:	Once assignments for inpatient and outpatient revenue for all revenue codes and provider types have been entered, the Mark PS&R Assignment Revenue button will be enabled. Click this to complete the stage.

Title XVIII External Values

Refer to the Title XVIII External Values article for detail on this section.