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Step 7: Review Final Costs

This section provides an overview and step-by-step instructions related to completing Step 7: Review Final Costs.
Step 8: Enter Revisions to Final Costs

This section provides an overview and step-by-step instructions related to Step 8: Enter Revisions to Final Costs.
Step 9: Finalize Reconciliation Payment

This section provides an overview and step-by-step instructions related to Step 9: Finalize Reconciliation Payment.
Step 10: Review Electronic Funds Transfer (EFT) Information

This section provides an overview and step-by-step instructions related to Step 10: Review Electronic Funds Transfer (EFT) Information.
Step 12: Review And Submit Reconciliation Payment Request

This section provides an overview and step-by-step instructions related to Step 12: Review and Submit Reconciliation Payment Request.
Conditions and Results for Completing Reconciliation Steps

This section provides information on when each step can be completed, what happens after each step has been completed, and whether a step can be reopened after it has been completed.
Coordination of Individual Retiree Cost Data

This section provides information about when Plan Sponsors are required to coordinate individual retiree cost data, as well as examples for coordinating data.
Extract Certain Medicare Part B Costs From RDS Payment Requests

Guidance on how to Extract Certain Medicare Part B Costs From RDS Payment Requests
Avoid an Overpayment at Reconciliation

An overpayment occurs when the sum of all interim payments received for an application exceeds the sum of the Reconciliation payment request.
Doubling Costs

Doubling costs occurs when a Plan Sponsor is reporting for the same months after the first payment request has been completed.
Overstating Gross Retiree Costs

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.
Reduction in Retirees

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

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

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.
Access Payment History

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.
Appeal an Initial Determination

This section provides an overview and step-by-step instructions for appealing an initial determination.
What to Do if Mainframe Costs are Reported After Cost Reporting is Closed in Reconciliation Step 6 and Before Step 12 is Completed

Find out how to handle this situation in Reconciliation cost reporting.
Coordinating Final Costs

Learn about Plan Sponsor and Vendor responsibilities when coordinating final costs for Reconciliation.
Coordinating Individual Qualifying Covered Retiree Costs

Understand when a Plan Sponsor is required to coordinate individual retiree cost data and what is needed to report cost data.
Changing Cost Reporter Vendors

Learn what you should do if you change Cost Reporter Vendors.