How To Submit an Interim Payment Request - Updated 12/21/2007
This document provides information relevant to submitting your interim payment requests to the RDS Center. This information will help to explain the processes related to building and submitting a payment request.
This information will help to explain to Authorized Representatives, Account Managers, and Designees the processes related to building and submitting a payment request.
Specifically this document includes information about the following:
- Who can submit a payment request?
- Which Cost Reports can be used when building a payment request?
- When can an interim payment be requested on an application?
- Will I have to review all the costs reported for a Benefit Option before I can include them in a payment request?
- As a Payment Requester, am I able to change cost data?
- How will users submitting payment requests be authenticated?
- Does the RDS Center send any e-mails related to the payment request process?
- Once I submit the payment request, how long before I receive payment?
- What are the various payment request statuses and what do they mean?
- What if the payment cannot be sent due to bank information failure?
- Can costs continue to be reported for a Benefit Option even if previously reported costs have been included in a payment request?
- What situations may result in a payment adjustment?
- How will my bank be able to identify RDS Payments?
- How do I view Cost Reports as a Payment Requester?
- How do I request payment?
Who can submit a payment request?
Only a current Payment Requester can make a payment request. A Payment Requester may be an Account Manager currently assigned the payment request privilege on the application; a Designee currently assigned the payment request privilege on the application; or the current Authorized Representative of the application. An application may have one or more Payment Requesters simultaneously assigned to the application.
An Account Manager with cost reporting or view only privileges may view the Build Payment Request page, however they may not build a payment request.
Which Cost Reports can be used when building a Payment Request?
A Payment Request can include any updated Cost Reports that have been submitted for a Benefit Option. Note: Before the updated Cost Report can be included in the Payment Request, the Payment Requestor MUST first view the Cost Report. For more information on how to view a Cost Report, go to: How to view a Cost Report as a Payment Requester.
When can an interim payment be requested on an application?
- The application must have a current status of either Approved or Approved Appeal.
- The application must have an interim payment frequency (monthly, quarterly, or interim annual). Plan Sponsors electing an annual payment frequency will not be allowed to submit interim payment requests.
- Payment Setup must be complete.
- The Authorized Representative Verification is in "Approved" status for the current Authorized Representative. Please see How To Submit an Authorized Representative Verification Form for more information.
- At least one Benefit Option is eligible for inclusion in the payment request and has been included in the payment requested.
- At least 15 days have passed since the last payment approval if the payment amount was greater than zero or 30 days have occurred since the last payment request; whichever is the later.
- The maximum number of payment requests has not been met for the application. For an application with a monthly payment frequency, up to 12 interim payment requests can be made (11 for those applications that participated in the One-Time Payment). For an application with a quarterly payment frequency, up to 4 interim payment requests can be made. For an application with an interim annual payment frequency, only one interim payment request can be made.
- Plan Sponsors cannot request a Payment Request within the first 30 days of their plan year.
Will I have to view all the costs reported for a Benefit Option before I can include them in a payment request?
Yes. Before a Cost Report can be included in a payment request, it has to be viewed by the Payment Requester to ensure the payment request is accurate.
As a Payment Requester, am I able to change cost data?
No. Only Cost Reporters may change or submit cost data.
How will users submitting payment requests be authenticated?
Any RDS Secure Web Site user submitting a payment request will be required to answer a series of authentication security questions.
Does the RDS Center send any e-mails related to the payment request process?
Yes. An e-mail is sent to notify the Plan Sponsor after a payment has been approved. The e-mail is sent to the Account Manager, and the Authorized Representative is carbon copied (cc).
Once I submit the payment request, how long before I receive payment?
Requested payments will be processed within 30 calendar days from the date of submission of the request.
What are the various payment request statuses and what do they mean?
The Payment Request status will be reflected on the Build Payment Request page, in the Status of Last Request field. The following statuses apply to a payment request.
- Payment Requested: Request was made on the RDS Secure Web Site. This status indicates that a request has been submitted; however the RDS Center has not yet finalized the payment process.
- Payment Processed: The RDS Center has finalized the payment process for this payment request. The Plan Sponsor should have received an email providing the details of the RDS Center payment approval.
- Payment Pending due to EFT failure: The ACH-EFT payment transaction was rejected by the bank. The RDS Center uses the banking information (account number, routing number, and account type) from the application. The Plan Sponsor should have received an email to inform them a change of EFT Information is required, and once a successful pre-note is obtained, the RDS Center will again attempt the payment request. For further information about how to Change Banking Data, go to: How to Change Application After Submission.
- Payment Rejected due to Debarment: The RDS Center must validate that entities and people are not prohibited from doing business with the government prior to making a subsidy payment. If the Plan Sponsor or any of the following people associated with the application (the Authorized Representative, the Account Manager, all Actuaries, and all Designees) are found on the U.S. General Services Administration (GSA) Debarment List or the Office of Inspector General (OIG) Exclusion List, the payment request will be cancelled and the application will be placed in DENIED status, allowing the Plan Sponsor to correct the situation.
What if the payment cannot be sent due to bank information failure?
If you submitted a payment request and the RDS Center could not process your payment because of invalid bank information, your application will be placed in an EFT Reject status, and your payment will be held. You will have to revise and resubmit your bank information. For information on how to change your EFT information, go to: How do I change the EFT information on a submitted application? Once the application is resubmitted with the new EFT information, the application is placed back into the "Submitted" status until the EFT information can be verified. (This process may take up to 15 calendar days.) Once the new EFT information is verified, the application will be placed back in the "Approved" status and the payment will finish being processed at that time.
Can costs continue to be reported for a Benefit Option even if previously reported costs have been included in a payment request?
Yes. A Cost Reporter may continue to transfer mainframe files or report monthly costs via the RDS Secure Web Site regardless of whether previously reported costs have been included in a payment request. All unprocessed costs will be maintained for inclusion in the next payment request.
What situations may result in a payment adjustment?
If adjusted costs are reported for a month(s) that has already been included in a payment request, and the new payment amount is less than the previously paid amount, the difference will be offset against your next payment request.
For example:
In June you submitted costs that resulted in a subsidy payment of $1,000 for March, and included that $1,000 in the payment request.
In July you report up to date costs for March that resulted in a subsidy payment of $800 ($200 less than previously reported), and you submitted costs that resulted in a subsidy payment of $1,500 for April. Your payment request would be $1,300. (The $200 difference from March would be deducted.)
Plan Sponsors will submit an adjusted Cost Report reflecting the corrected amounts for the costs reports that were included in the payment request, and include those revised Cost Reports in a subsequent payment request. Continue to submit revised Cost Reports until the incorrect payment amount is offset.
How will my bank be able to identify RDS Payments?
The RDS payment can be identified by the subheading "CMS- Retiree Drug Subsidy." The payment can be further identified by matching the subsidy dollar amount deposited with the original dollar amount requested. Plan Sponsors will need to internally coordinate this with their bank.
How do I review Cost Reports as a Payment Requester?
It is a requirement to view Cost Reports before including them in a payment request.
As a Payment Requester you will view Cost Reports through the payment request processes and not through the same pages as a Cost Reporter. A Payment Requester will only view costs that are submitted, not costs that are only saved and/or submitted via mainframe in an error condition.
- Log into the RDS Secure Web Site.
- From the Plan Sponsor List with Application Summary page, select the Plan Sponsor ID.
- On the Application List page, find the appropriate Application Number. Select the Request Payment option in the Actions dropdown list.
- Click Go. The Build Payment Request page displays.
- Current Subsidy Amount – Displays the calculated subsidy amount derived from the most recent interim cost reports submitted for the benefit option.
- Old Subsidy Amount – Displays the calculated subsidy amount derived from the interim costs reported for the benefit option that were last included in a payment request.
- Net Subsidy Amount – Displays the calculated difference between the Current Subsidy Amount and the Old Subsidy Amount. The Net Subsidy Amount for the benefit option is the amount of subsidy eligible for inclusion in a payment request. The amount of the payment request will equal the sum of the Net Subsidy amounts for all benefit option included in the payment request.
- Number of Reporting Sources – Displays the number of sources (Plan Sponsor and/or Vendors) eligible to report costs for the benefit option.
- From the Build Payment Request page, find the Benefit Option for which you would like to view costs, and select the Review Costs option in the Actions dropdown list.
- Click Go. The Benefit Option Interim Costs Review page displays.
- Current costs reflect the most recently submitted costs for the benefit option.
- Old costs reflect the submitted costs last included in a payment request.
- Net costs are calculated as the difference between "Current" and "Old" costs. The Net Subsidy Amount is the amount eligible for payment when the benefit option is included in a payment request.
- If you do not want to save the review step at this time, click Cancel.
- Once you have completed the review for a Benefit Option by clicking Complete Review, you may review the costs again at any time by repeating steps 5 - 7. The only difference will be the Complete Review button no longer displays. Click Continue to return to the Build Payment Request page.
- To include the Benefit Option viewed in a payment request, go to: How do I request payment?
Note: At anytime during this step-by-step process if you need additional information on field definitions or edits, click on the Help about this page hyperlink in the Quick Help box on the top right hand corner of the page.
Note: The Request Payment action will only display in the Actions column for Designees and/or Account Managers assigned the Payment Request privilege, and Authorized Representatives. Cost Reporter Designees will not have access to this page.
Additionally, this action will not display unless the application is in an "Approved" or "Approved Appeal" status, payment setup is complete, the application's payment frequency is monthly, quarterly, or interim annual, and the Authorized Representative's Verification status has been completed.
This page reports information by Benefit Options. Specifically:
The first table, Benefit Option Interim Cost Report by Reporter displays the most current allowable retiree costs submitted by each reporting source for the benefit option and the resulting system-calculated subsidy amount. Since the Costs and Subsidy Amount per Month for Benefit Option table at the bottom of the page is aggregated for all reporting sources, you can view the cost reporting information at the reporting source level by selecting from the Actions dropdown either View Costs, or View Audit Trail from the dropdown.
Note: In the first table, Benefit Option Interim Cost Report by Reporter, the Current Allowable Retiree Costs is the sum of allowable retiree costs by Cost Reporter for each month of the plan year.
The second and third table, Costs and Subsidy Amount for Benefit Option and Costs and Subsidy Amount per Month for Benefit Option are displayed in total for all plan months reported to date and for each plan month.
If you do want to save the review, once you have reviewed the Cost Report, scroll to the bottom of the page and click Complete Review. (The Complete Review button does not display for Account Managers with View Only or Cost Reporting privileges.)
Note: You are required to complete the cost report review process at some time (by clicking Complete Review) before it can be included in a payment requested.
How do I request payment?
Only submitted Cost Reports can be included in a payment request. Using the RDS Secure Web Site, a Payment Requester will "build a payment request" by including Benefit Option level Cost Reports in a payment request. These Cost Reports will already include the system-calculated subsidy amounts based on the data submitted in the Cost Report. As a Payment Requester, you will simply decide which Cost Reports to include in the payment request based on the cost data reported by the Cost Reporters associated with the application.
Note: A Cost Report is not considered "Submitted" status if it is only saved via data entry method or is currently submitted with errors via mainframe entry method. Only submitted Cost Reports can be included in a payment request.
Before you can request payment for a benefit option, you must first review the costs reported for that benefit option, and any other benefit option you would like to include in the payment request. For step-by-step instructions on how to review costs as a Payment Requester, go to: How do I review Cost Reports as a Payment Requester?
The step-by-step instructions below assume the Benefit Option Cost Report has already been reviewed.
- Log into the RDS Secure Web Site.
- From the Plan Sponsor List with Application Summary page, select the Plan Sponsor ID.
- On the Application List page, find the appropriate Application Number. Select the Request Payment option in the Actions dropdown list.
- Click Go. The Build Payment Request page displays.
- To include the interim costs for a Benefit Option in a payment request, click the Include in Payment Request checkbox.
- Click Continue. The Payment Request Verification page displays.
- To not proceed with the payment request, click Cancel to return to the Build Payment Request page.
- To submit the payment request, click the I Agree checkbox and answer the two security questions.
- To return to the Payment Verification page without submitting the payment, click Cancel.
- Click Continue to return to the Application List page.
Note: At anytime during this step-by-step process if you need additional information on field definitions or edits, click on the Help about this page hyperlink in the Quick Help box on the top right hand corner of the page.
Note: The Review Status is Cost Reviewed. Once costs are reviewed for a Benefit Option, the Include in Request checkbox will be become enabled if the application is eligible for payment and interim costs were submitted since subsidy was last requested for the Benefit Option.
This page displays the total costs and subsidy amounts requested for all benefit options included in the payment request, broken down by benefit option and total request by plan month/year.
From this page, you may choose to view the most current costs associated with each benefit option by choosing the View Costs from the Actions dropdown, next to the applicable Benefit Option.
To proceed with the payment request, scroll to the bottom of the page and click Continue. The Payment Authorization page displays.
This page displays the total amount of the subsidy request, the current date, the payment agreement, and the Payment Requester's security questions.
To submit the payment request, click Submit. Once the payment is submitted, the Payment Request Confirmation page displays.
This page displays the total amount of the subsidy request, the current date, and the breakdown of benefit options included in the payment request.
Please allow 30 calendar days for the processing of your request. The Account Manager and Authorized Representative listed on this application will be notified via e-mail when the payment is finalized.
