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Covers information such as how to request an appeal and how to withdraw an appeal.
This page contains links to and descriptions for job aids, which are tools that can be used for quick reference while completing specific RDS Program tasks.
This section of the User Roles Support Tool details which user roles are involved in each step of the Application Submission Process.
This sections provides a list of statuses and corresponding descriptions that an RDS application may have at various points through the RDS Program Lifecycle.
This section provides information to assist in preparing cost data for submission to CMS' RDS Center:
The Interim Payment Process is a method the Plan Sponsor uses to submit interim cost reports and make interim payment requests for Qualifying Covered Retirees on an approved RDS application.
This section provides an overview and step-by-step instructions for submitting interim costs.
This section provides an overview and step-by-step instructions for submitting an interim payment request.
Guidance on how to Extract Certain Medicare Part B Costs From RDS Payment Requests
An overpayment occurs when the sum of all interim payments received for an application exceeds the sum of the Reconciliation payment request.
Doubling costs occurs when a Plan Sponsor is reporting for the same months after the first payment request has been completed.
The most common reason for the overstating Gross Retiree Costs error is including costs that are not covered by Medicare Part D, therefore making them ineligible for RDS subsidy during interim payments.
The reduction in retirees error results from a Plan Sponsor failing to process and send in retiree updates during the plan year.
Underestimating Cost Adjustments during interim payments occurs when a Plan Sponsor does not make changes to their Cost Adjustment methodology from one plan year to the next when the Cost Adjustment percentage has increased.
Underreporting Threshold Reduction and Limit Reduction occurs for a couple of reasons: 1) Plan Sponsors do not understand the definition of Threshold Reduction, and 2) Plan Sponsors are not reporting the correct Threshold Reduction and Limit Reduction during interim payments.
This section provides an overview and step-by-step instructions for actions and events in Payment History, as well as information on troubleshooting Payment History.
Understand when a Plan Sponsor is required to coordinate individual retiree cost data and what is needed to report cost data.
Learn what you should do if you change Cost Reporter Vendors.
Learn about the seven actions Plan Sponsors can follow when preparing interim payment requests to ensure the Covered Retiree List is properly communicated and retiree information is managed.