There are often two widespread, often incorrect beliefs about Medicare Cost Reports.
First is the terminology. “Medicare” cost reporting makes it sound as if it only covers Medicare patients. This is not accurate. For most of the key worksheets — there are several dozen — the data generally covers services for all patients. Only fairly late in the cost report calculations that Medicare costs are determined.
Many are familiar with a medical form called the UB-04. It stands for “Universal Bill 2004” and is the name of a billing form used by hospitals and other facility providers. (Physicians typically use the HCFA 1500 form which is somewhat similar.)
What some don’t realize is that Medicare gives the UB-04 its own designation as CMS Form-1450. Few call it that because it serves many different providers and payers than just CMS. Continue reading “About CMS Form 1450…”
The HCFA moniker is a decades-old name that is no longer used except for the HCFA-1500 form. The name comes from the Health Care Financing Administration (HCFA) which was created in 1977 to combine under one administration the oversight of the Medicare program, the federal portion of the Medicaid program, and related quality assurance activities.
In July 2001, agency known as HCFA was renamed the Centers for Medicare and Medicaid Services or what today is abbreviated as CMS.
Nonetheless, the HCFA-1500 form name survived the 2001 renaming exercise and is still used today for physician and non-facility bills.
ChatGPT is a remarkable tool, but it still has its flaws. We decided to ask it to explain Medicare’s Inpatient Prospective Payment System. Here’s some of what it told us:
The Medicare Inpatient Prospective Payment System (IPPS) is a method used by the Centers for Medicare & Medicaid Services (CMS) in the United States to reimburse acute care hospitals for inpatient services. IPPS was established as part of the Social Security Amendments of 1983 and went into effect in 1984. The main goal of IPPS is to control rising healthcare costs by setting predetermined rates for inpatient hospital services. Here is how IPPS works… Continue reading “How ChatGPT describes IPPS”
