This section provides an overview and step-by-step instructions for completing Payment Setup.
Payment Setup is critical to the payment process as it affects the "who" and "how" of reporting costs and requesting payments.
Payment Setup is the process where the Plan Sponsor determines who reports cost data for each Benefit Option on the application, how the information is communicated to CMS' RDS Center, and who requests interim payments if the Plan Sponsor selects an Interim Payment Frequency. NOTE: Beginning May 8, 2020, all current and future RDS applications’ Payment Frequency will be set to a maximum frequency of monthly interim payments, consistent with the general payment rules regarding timing set forth in 42 C.F.R. 423.888(b)(1). Although 12 interim payment requests are permitted, a Plan Sponsor may choose to submit fewer than 12 interim payment requests, or forego interim payments and instead choose to submit one final payment request during Reconciliation as described in 42 C.F.R. 423.888(b)(2)(ii). Please refer to Important Enhancement to RDS Payment Frequency for important details.
During the Payment Setup process, the Plan Sponsor identifies individuals and/or Vendors responsible for reporting costs associated with each Benefit Option and requesting payments for an approved application.
Note: Payment Setup only becomes available when an application is approved.
If accessing Payment Setup from the Application List page, the Application Status field displays "Approved" or "Reconciliation Request Complete." If accessing Payment Setup from the Reconciliation Checklist, the Application Status field displays "Reconciliation Initiated," "Reconciliation Cost Reporting Opened," or "Reconciliation Cost Reporting Closed." If the Authorized Representative and Account Manager do not have access to the Payment Setup Menu page, contact CMS' RDS Center for assistance.