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RDS Program Components

Additional Program Tasks

Quick Access Reports (QAR)

Supplemental Information

Conditions and Results for Completing Reconciliation Steps

User Roles:

AM

AR

D

Program Components:

Reconciliation

Reconciliation steps must be completed in numerical order, but are accessible in View Only at any time. Each step must be "Complete" to proceed to the next step.

Conditions and Results for Completing Reconciliation Steps
Reconciliation Step Conditions and Results For Completing Reconciliation Steps Can The Step Be Reopened After Completed?
Step 1: Initiate Reconciliation
  • Step 1 can be started after the plan year has ended and 16 days from the last payment determination (no payment is in progress).
  • After Reconciliation is started in Step 1, it cannot be changed.
  • After Step 1 is "Complete" the application status changes to "Reconciliation Initiated."
No
Step 2: Review Payment Setup
  • Step 2 can be started after Step 1 is "Complete."
  • After Step 2 is "Complete" the Plan Sponsor can return to Step 2 at any time before Step 12 is "Complete" to make changes to Payment Setup.
  • If Step 2 is revisited, the status must be "Complete" to continue with any subsequent steps.
Yes
Step 3: Request List of Covered Retirees
  • Step 3 can be started after Step 2 is "Complete."
  • A Covered Retiree List can be requested in Step 3 until Step 4 is "Complete."
  • To reopen this step, contact CMS' RDS Center prior to the completion of Step 12, and request that Step 3: Request Covered Retiree List be changed to an "Incomplete" status. It will take CMS' RDS Center up to 5 business days to change this step from "Complete" to "Incomplete" status. All other Reconciliation steps that have already been completed will be changed to an "Incomplete" status and must be completed again. The application's Reconciliation Deadline will not change.
Yes (Must contact CMS' RDS Center)
Step 4: Finalize Covered Retirees
  • Step 4 can be started after Step 2 and Step 3 are "Complete."
  • To reopen this step, contact CMS' RDS Center prior to the completion of Step 12, and request that Step 3: Request Covered Retiree List be changed to an "Incomplete" status. It will take CMS' RDS Center up to 5 business days to change this step from "Complete" to "Incomplete" status. All other Reconciliation steps that have already been completed will be changed to an "Incomplete" status and must be completed again. The application's Reconciliation Deadline will not change.
Yes (Must contact CMS' RDS Center)
Step 5: Start Preparation Of Reconciliation Payment Request
  • Step 5 can be started after Step 2 and Step 4 are "Complete."
  • After Step 5 is "Complete" it cannot be changed.
  • After Step 5 is "Complete" the application status changes to "Reconciliation Cost Reporting Opened."
No
Step 6: Manage Submission Of Final Cost Reports
  • Step 6 can be started after Step 2 and Step 5 are "Complete."
  • After Step 6 is "Complete" the Plan Sponsor can reopen Step 6 prior to the completion of Step 12.
  • A Plan Sponsor may reopen this step after it has been completed by selecting "Allow Reporting." CMS' RDS Center will accept final cost reports submitted by Mainframe and allow data entry cost reporting on the RDS Secure Website.
  • If "Allow Reporting" is selected in Step 6, all subsequent steps change to "Incomplete," and the application status changes to "Reconciliation Cost Reporting Opened."
  • After Step 6 is "Complete" the application status changes to "Reconciliation Cost Reporting Closed."
Yes
Step 7: Review Final Costs
  • Step 7 can be started after Step 2 and Step 6 are "Complete."
  • After Step 7 is "Complete" the Plan Sponsor can reopen Step 7 prior to the completion of Step 12.
  • If "Open Review" is selected in Step 7, all subsequent steps change to "Incomplete" and all revisions in Step 8 are discarded.
Yes
Step 8: Enter Revisions to Final Costs
  • Step 8 can be started when Step 2 and Step 7 are "Complete."
  • After Step 8 is "Complete" the Plan Sponsor can reopen Step 8 prior to the completion of Step 12. However, the question "Do you have revisions to make?" in Step 8 must be answered "No" to proceed with Reconciliation.
  • Returning to Step 8 changes it to "Incomplete" and changes all subsequent steps to "Incomplete."
Yes
Step 9: Finalize Reconciliation Payment Request
  • Step 9 can be started after Step 2 and Step 8 are "Complete."
  • After Step 9 is "Complete" changing Step 6, Step 7, or Step 8 to "Incomplete" will change Step 9 to "Incomplete."

Note: If a Plan Sponsor wishes to enter new costs, Step 6 can be reopened prior to the completion of Step 12 by selecting "Allow Reporting." CMS' RDS Center will accept final cost reports submitted by Mainframe and allow data entry cost reporting on the RDS Secure Website. If "Allow Reporting" is selected in Step 6, all subsequent steps change to "Incomplete," and the application status changes to "Reconciliation Cost Reporting Opened."

No
Step 10: Review Electronic Funds Transfer (EFT) Information
  • Step 10 can be started after Step 2 and Step 9 are "Complete."
  • After Step 10 is "Complete" an email is automatically sent to the Authorized Representative.
  • If there are no changes to the EFT Information after completing Step 10, Step 11 will automatically change to "Complete."
  • After Step 10 is "Complete" changing EFT Information will change Step 10 and Step 11 to "Incomplete."
  • After Step 10 is "Complete" a pre-note failure will change Step 10 to "Error-Needs Attention" and Step 11 to "Incomplete."
  • After Step 10 is "Complete" and EFT Information is rejected in Step 11, Step 10 will change to "Incomplete."
  • After Step 10 is "Complete" returning to Step 9 and changing it to "Incomplete" will change Step 10 to "Incomplete."

Note: If a Plan Sponsor wishes to enter new costs, Step 6 can be reopened prior to the completion of Step 12 by selecting "Allow Reporting." CMS' RDS Center will accept final cost reports submitted by Mainframe and allow data entry cost reporting on the RDS Secure Website. If "Allow Reporting" is selected in Step 6, all subsequent steps change to "Incomplete," and the application status changes to "Reconciliation Cost Reporting Opened."

Yes (by changing EFT Information)
Step 11: Approve Electronic Funds Transfer (EFT) Information
  • Step 11 can be started after Step 10 is "Complete."
  • Approving EFT Information in Step 10 automatically changes Step 11 to "Complete."
  • Rejecting Step 11 changes Step 10 to "Incomplete."
  • After Step 11 is "Complete" and changes are made to the EFT Information in Step 10, Step 11 is changed to "Incomplete."
  • After Step 11 is "Complete" a pre-note failure will change Step 10 and Step 11 to "Incomplete."

Note: If a Plan Sponsor wishes to enter new costs, Step 6 can be reopened prior to the completion of Step 12 by selecting "Allow Reporting." CMS' RDS Center will accept final cost reports submitted by Mainframe and allow data entry cost reporting on the RDS Secure Website. If "Allow Reporting" is selected in Step 6, all subsequent steps change to "Incomplete," and the application status changes to "Reconciliation Cost Reporting Opened."

No
Step 12: Review and Submit Reconciliation Payment Request
  • Step 12 can be started after Steps 1 through 11 are "Complete."
  • After Step 12 is complete, it cannot be changed.
  • After Step 12 is "Complete," the application status changes to "Reconciliation Request Completed."
  • If the Authorized Representative chooses to reject the Reconciliation payment request, Steps 9 through 11 need to be completed again with any necessary changes.
  • If "Reject" is selected in Step 12, Steps 9 through 11 change to "Incomplete."
  • If Step 12 is in "Rejected" status and a status changes on a previous step, then Step 12 changes to "Incomplete."

Note: If a Plan Sponsor wishes to enter new costs, Step 6 can be reopened prior to the completion of Step 12 by selecting "Allow Reporting." CMS' RDS Center will accept final cost reports submitted by Mainframe and allow data entry cost reporting on the RDS Secure Website. If "Allow Reporting" is selected in Step 6, all subsequent steps change to "Incomplete," and the application status changes to "Reconciliation Cost Reporting Opened."

No

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