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RDS Program Components

Additional Program Tasks

Quick Access Reports (QAR)

Supplemental Information

Step 1: Initiate Reconciliation

User Roles:

AM

AR

Program Components:

Reconciliation

Overview

This section provides an overview of the following topics related to Step 1: Initiate Reconciliation:

Introduction to Step 1: Initiate Reconciliation

Reconciliation includes 12 steps that Plan Sponsors are required to complete for each application after the plan year has ended. The purpose of Step 1: Initiate Reconciliation is for Plan Sponsors to indicate to CMS' RDS Center that they are ready to submit their application for payment settlement. By choosing to complete Step 1, the Plan Sponsor is indicating that they are ready to finalize their Qualifying Covered Retiree List and submit final costs associated with the retiree list for a particular application.

Plan Sponsors that elected an Annual Payment Frequency, or otherwise did not receive any interim payments, and wish to receive a single subsidy payment must use the Reconciliation process to submit a final payment request for an application.

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Timing for Step 1: Initiate Reconciliation

Plan Sponsors should make sure that sufficient time is allocated to complete all 12 steps in the Reconciliation Checklist by the application's Reconciliation Deadline.

For more information on the Reconciliation Deadline, refer to Important Reconciliation Deadline Information.

Reconciliation Step 1 can only be started after the plan year ends. After Reconciliation is initiated in Step 1, it cannot be reversed.

User Role Responsibilities for Step 1: Initiate Reconciliation

Step 1: Initiate Reconciliation may only be completed by the Authorized Representative or Account Manager. Designees with Request Payment privilege may view this step but not complete it.

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Prepare for Step 1: Initiate Reconciliation

A Plan Sponsor can begin Reconciliation for an application when all of the following conditions are met:

  • The application plan year has ended
  • The Reconciliation Deadline has not passed
  • Users must be active

    Note: The Reconciliation Deadline displays in the Details box on all Reconciliation pages including the Reconciliation Checklist page. The Reconciliation Deadline may also be viewed from the Application Status page, all pages that display the Application Information box, and the Benefit Option Final Cost List page.

  • The application is approved
  • All desired interim payment requests have either been processed or canceled

    Note: A Plan Sponsor cannot have a negative interim payment request when they start Reconciliation. If there is a negative interim payment, and it will not be fully offset by a positive payment request on another application, the Plan Sponsor will need to contact CMS’ RDS Center to initiate the cancellation process.

  • At least 16 calendar days have passed from the date of the last interim payment determination

    Note: It is recommended that Plan Sponsors stop interim payments at least 60 days prior to an application’s Reconciliation Deadline to focus on Reconciliation activities.

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What Happens After Step 1: Initiate Reconciliation Is Complete

The status of Step 1: Initiate Reconciliation changes to "Complete" and the Last Updated Date and Last Updated By fields update accordingly. Step 1 is marked with a green check to indicate that it is complete and Step 2 is marked with a blue arrow to indicate that it is the next step. The status of the application will be updated to "Reconciliation Initiated."

After Reconciliation is initiated and Step 1 is complete, RDS Secure Website users cannot report interim costs or request interim payments. Previously reported interim cost data will display in the audit trail accessible through the Final Costs action and Reconciliation Step 5: Start Preparation of Reconciliation Payment Request. Final cost reports will not be accepted by CMS' RDS Center until Step 5 is complete.

After Reconciliation is initiated the status of a Data Entry cost report changes to "Data Entry: Update/Entry Required" in preparation for final cost reporting.

After Reconciliation is initiated and Step 1 is complete, Mainframe cost reports will be rejected until Step 5 is complete.

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Step-by-Step Instructions

This section provides step-by-step instructions to complete Step 1: Initiate Reconciliation.

To access the RDS Secure Website, and navigate to the Reconciliation Checklist page, refer to instructions to access the Reconciliation Checklist.

On the Reconciliation Checklist page:

  1. Click Step 1: Initiate Reconciliation.

     Select [Initiate Reconciliation]

On the Step 1: Initiate Reconciliation page:

  1. Read the warnings and click the checkbox to indicate that you agree to the warnings and instructions.
  2. Click Submit to initiate Reconciliation or click Cancel to return to the Reconciliation Checklist without initiating Reconciliation.

     Click Agreement Checkbox, Select [Submit]

On the Step 1: Initiate Reconciliation Verification page:

  1. Click Confirm to proceed or click Cancel to return to the Step 1: Initiate Reconciliation page without completing this step.

     Select [Confirm]

On the Step 1: Initiate Reconciliation Confirmation page:

  1. Click Continue to go to the Reconciliation Checklist.

     Select [Continue]

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