Medicare Claims Processing Manual (Pub. 100-04), Ch. 4 § 10.11.11

Reporting of CCRs for Hospitals Paid Under OPPS and for

Last amended: 2010Year: 2010Length: 198 wordsOfficial source
10.11.11 - Reporting of CCRs for Hospitals Paid Under OPPS and for CMHCs (Rev. 2111, Issued: 12-03-10, Effective: 04-01-11, Implementation: 04-04-11 ) The contractors shall report the OPPS hospital overall or CMHC CCR they calculate, or the Statewide CCR they select, for each provider to the Outpatient Provider Specific File (OPSF; see §50.1 of this chapter) within 30 days after the date of the calculation or selection of the Statewide CCR for the provider. If a cost report reopening results in adjustments that would change the CCR that is currently in effect, the contractor shall calculate and enter the CCR in the OPSF within 30 days of the date that the reopening is finalized. In such an instance, contractors must create an additional record in the OPSF for the provider. The contractor entries in the OPSF shall include the effective date of the CCR being entered. Entries in the OPSF shall not replace a pre-existing entry for the provider. The only instances a Medicare contractor retroactively changes a field in the PSF is to update the CCR when using the FISS Lump Sum Utility for outlier reconciliation or otherwise specified by the CMS Regional Office or Central Office.
Medicare Claims Processing Manual (Pub. 100-04), Ch. 4 § 10.11.11: Reporting of CCRs for Hospitals Paid Under OPPS and for | Justis AI