Home Office Cost Report

Form 1728 94 home health agency.

Home office cost report. Statement of costs of services from related organizations and home office costs. General instructions explain rules and mandatory information. Additionally home office cost allocation statements also need to be submitted as supporting documentation for applicable providers. 877 299 4500 serving the states of co de ia ks md mo mt ne nd sd pa ut va wv wy and the district of columbia.

Hospital based facilities should also submit electronic copies of the medicare cost report. Cms maintains the cost report data in the healthcare provider cost reporting information system hcris. Chapter 10 home office cost hcfa 287 zip chapter 11 t9 provider cost report reimbursement questionnaire form zip chapter 12 hospital hcfa 2552 83 zip. Home office cost statement hocs form cms 287 was developed by centers for medicare medicaid services cms for the use of home offices of chain organizations in reporting the information necessary for the determination of medicare reimbursement to components of chain organizations.

Worksheets include all cost centers. Without the applicable supporting documentation a cost report will be deemed unacceptable and the report will be rejected. Worksheet a 8 3 parts i vi. Cost reports in sfy2003 the department of community health began requiring all free standing home office and hospital based facilities to file their cost reports electronically.

These facilities no longer need to submit paper copies of the cost report. The cost report contains provider information such as facility characteristics utilization data cost and charges by cost center in total and for medicare medicare settlement data and financial statement data. For providers claiming costs on their cost reports that are allocated from a home office or chain organization with the same fy end a cost report will be rejected for lack of supporting documentation if the home office or chain organization has not submitted a home office cost statement to the chain provider s servicing contractor that corresponds to some portion of the amounts allocated from the home office or chain organization to the provider s cost report. 877 220 6289 customer service mycgs.

Worksheet a 8 2 provider based physicians adjustments. All of these requirements affect the acceptability of the cost report. Worksheet a 8 1 part b interrelationship to related organization s and or home office. Form 287 05 home office.

Cost report acceptance ag 390 post office box 100307 columbia sc 29202 3307 amended cost reports amended cost reports follow the same process and can be filed through mcref for cost reporting periods ending on or after 12 31 2017 or through the mail using the same addresses noted above. Postal service palmetto gba attn. Further rules and regulations explain rules for reimbursement.