Often overlooked is the important role that Worksheet S-10 plays in the overall revenue of any hospital that qualifies for Medicare Disproportionate Share Hospital (DSH) payments. The allocation of Uncompensated Care supplemental payments is directly linked to the worksheet reporting, with reimbursement being distributed based on a percentage of DSH patients treated. This reporting is also being used by some states to determine the Uncompensated Care pool amounts and to distribute Medicaid supplemental waiver payments.
The Importance of Worksheet S-10
As a portion of reimbursement is distributed to hospitals based on their percentage of reported uncompensated care costs, it is important that your facility correctly files its Medicare cost report Worksheet S-10. This will ensure that you obtain the reimbursement that your hospital is entitled to. Doing so effectively can be an extensive process, as it requires that you distinguish between unreimbursed costs, charity care and non-Medicare bad debt.
Accuracy is Key
It is extremely important when filing Worksheet S-10 to pay strict attention to accuracy, accountability, and integrity, otherwise, your facility can be negatively impacted. If Worksheet S-10 is not filed correctly, providers run the risk of not receiving their rightful share of reimbursement since the policies and guidelines did not meet compliance.
In preparing the report, hospitals need to review data from numerous sources such as its trial balance, detailed charges, general ledger, and financial statements. The patient accounting transaction detail and patient demographics are of the upmost importance as they tell the story of the patient’s journey and can be tied back to 835 remittance advices and to the general ledger. Related policies should also be reviewed to ensure that they support charity care and bad debt processes.
If these guidelines are not adhered to, the hospital can come under scrutiny which can affect future payouts. It is important that hospitals optimize the use of the Worksheet S-10, identifying potential gaps in reporting to optimize reimbursement.
Action Steps to Take Today
Audits of Worksheet S-10 are on the rise and requirements are still evolving. It is not too early to ensure that your facility is prepared for this scrutiny. Now is the time to thoroughly review your related policies and to ensure that you are reporting the accurate data on your cost report.
For questions about the Worksheet S-10, or how The Rybar Group can assist you, please contact us today.
Jesse Parker, CPA
Director of Reimbursement