This section provides an overview of the following topics related to submitting interim costs:
During the Interim Payment process, Cost Reporters submit interim costs to CMS' RDS Center by either manual Data Entry on the RDS Secure Website, or by Connect:Direct to RDS Center Connect:Direct through CMS EFT. Submitted interim cost reports are eligible to be included in an interim payment request. It is critical for costs to be reported accurately for Qualifying Covered Retirees (QCRs) throughout the plan year to avoid an overpayment at Reconciliation. Refer to Avoid an Overpayment at Reconciliation for more information.
Plan Sponsors have the option to receive interim subsidy payments throughout the plan year based on costs submitted to CMS' RDS Center.
All RDS applications have a maximum Payment 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.
For information about how to prepare interim costs, refer to Prepare Cost Data.
For information about how to submit final costs, refer to Finalizing Costs For Reconciliation.
Interim cost reports may be submitted on applications that meet all of the following conditions:
After Payment Setup is complete for the application, Report Costs is available in the Left Navigation menu on the application.
Two different types of sources can report costs for the same application: Plan Sponsors and Vendors.
A Plan Sponsor is considered a single source regardless of the number of individual Cost Reporters assigned to the Plan Sponsor. Likewise, a Vendor is considered a single source regardless of the number of individual Cost Reporters assigned to the Vendor.
During cost reporting, each source's costs are treated as separate and distinct data sets for the application.
A Cost Reporter may be the Account Manager, Plan Sponsor Designee, Vendor, or Vendor Designee. Cost Reporters are assigned Benefit Options within an application during the Payment Setup process.
Account Managers, Plan Sponsor Designees, and Vendor Designees may enter interim costs using the Data Entry submission method on the RDS Secure Website for those Benefit Options assigned to them in Payment Setup. These types of Cost Reporters are required to select an application and Benefit Option prior to entering costs. Additionally, an audit trail of all cost reports either saved or submitted on the RDS Secure Website are viewable by Benefit Option.
A Vendor may report costs using the Data Entry submission method on the RDS Secure Website or by the Connect:Direct submission method. During registration with CMS' RDS Center, Vendors specify their cost reporting method and are assigned a Vendor ID. Each Vendor ID is then pre-associated with the cost reporting submission method specified by the Vendor.
All Vendors must contact CMS' RDS Center to obtain a Vendor ID regardless of whether they are submitting cost reports using Connect:Direct or manual Data Entry on the RDS Secure Website. For more information, refer to the Vendor Quick Start Guide in the RDS Welcome Kit.
For more information about Payment Setup including cost reporting user roles, refer to Payment Setup.
For detailed information on assigning cost reporting methods for an application, refer to Payment Setup.
For detailed information on preparing costs for an application, refer to Prepare Cost Data.
Account Managers and Designees with Report Costs privilege may view or report costs through the Report Costs page on the RDS Secure Website. The Benefit Option Cost Reporting Source List table provides the following cost report information for each benefit option defined for the application:
Note: If N/A displays in this column, no cost reports have been saved/submitted (Data Entry) or processed (Connect:Direct).
Future costs cannot be reported. For example, in a typical January-December plan year, costs for August cannot be reported in July of the same calendar year.
If reporting multiple Application IDs or Benefit Options using Connect:Direct submission, the cost reports do not have to be combined by Application ID or Benefit Option, as long as the reporting month is prior to the current month.
The status of cost reports submitted to CMS' RDS Center can be viewed on the RDS Secure Website for current costs and previously reported costs.
For more information on viewing the most recent cost figures refer to View Current Costs on the RDS Secure Website.
For information on how to view all cost reports submitted for a Benefit Option and a history of the actions taken on these reports, refer to View the Cost Report Audit Trail on the RDS Secure Website.
If reporting or monitoring costs for multiple applications or Benefit Options, use Quick Access Reports (QAR) in the RDS Secure Website to monitor cost reports without having to locate information in each individual application. QAR assists and accelerates cost reporting activities by delivering consolidated cost reporting information. Refer to the Quick Access Reports (QAR) Guide for comprehensive information about these reports.
Data Entry through the RDS Secure Website requires the cost reporter—either the Account Manager or Designee with the Report Costs privilege—to access the RDS Secure Website and manually enter cost data per Benefit Option. Interim cost figures must be entered and saved for each plan month. Only submitted interim cost reports may be included in an interim payment request. For step-by-step instructions, refer to Submit Interim cost reports Using Data Entry on the RDS Secure Website.
A Vendor or a Plan Sponsor reporting final costs by Connect:Direct submission must submit aggregated retiree cost data per Benefit Option for all application plan months. Cost data sent using Connect:Direct is viewable on the RDS Secure Website; however, the cost data reported using Connect:Direct cannot be changed using the RDS Secure Website. To revise cost data originally submitted by Connect:Direct, the revised cost data files must be resubmitted using the Connect:Direct connection. This new data displays on the RDS Secure Website. For information on aggregating data prior to submission, refer to Prepare Cost Data.
RDS does not provide response files for successful cost report submissions. If the Connect:Direct cost report was received and had no critical errors, it displays on the RDS Secure Website approximately 24 to 48 hours after it was sent. Accepted cost reports display with a status of " Connect:Direct: Submitted." Cost reports that are rejected for non-critical errors display with a status of "Connect:Direct: Errors Detected."
Connect:Direct Cost Reports Rejected by CMS' RDS Center
RDS does not provide response files for unsuccessful cost reports. Connect:Direct cost reports that are rejected due to critical errors cannot be viewed on the RDS Secure Website. If a Connect:Direct file was submitted to CMS' RDS Center resulting in critical errors that prevented it from being processed, CMS' RDS Center contacts the submitter to discuss the errors.
The following error conditions are considered critical:
Note: Errors are viewable through Quick Access Reports (QAR).
Cost reports that are rejected by CMS' RDS Center for non-critical errors receive a status of "Connect:Direct: Errors Detected" and are viewable from the Benefit Option Final Costs list. Specific information about the file, cost report, and the corresponding errors can be viewed on the Audit Trail.
The following error conditions cause a Connect:Direct cost report to be placed in "Connect:Direct: Errors Detected" status:
Connect:Direct Cost Reporting Resources
Use the following resources to assist with Connect:Direct cost reporting:
Updating Previously Reported Costs
There is no limit to the number of interim cost reports that may be submitted by a Cost Reporter. This flexibility is granted to ensure Plan Sponsors always report costs accurately.
The Account Manager or Designee with Report Costs privilege may view the Audit Trail which includes interim cost reports and final cost reports.
If costs for a Qualifying Covered Retiree are adjusted, aggregated costs must be recalculated and reported to CMS' RDS Center. Cost Reporters using Data Entry to submit costs may report corrected costs for a month by replacing previously reported costs and resubmitting the cost report on the RDS Secure Website.
Cost Reporters using Connect:Direct file submission may include corrected costs for prior months in the same file as new cost reports, or provide separate files for corrected costs. If multiple files are sent, the last error-free record for the month is retained as the most recent costs for the month and is displayed on the RDS Secure Website.
Limitations to Changing Payment Setup After Interim Costs Are Submitted
The following actions are prevented in Payment Setup after the Cost Reporter has submitted a cost report:
This section provides step-by-step instructions to complete the following tasks for submitting, updating, and viewing interim costs:
To access the RDS Secure Website and navigate to the Dashboard page, review instructions to access the RDS Secure Website.
On the Dashboard page:
Select the Application ID for which you want to report costs.
On the Application Overview page:
Select Report Costs from the left navigation menu.
On the Report Costs page:
Select View/Enter/Update Costs from the Actions dropdown menu on the Benefit Option Cost Reporting Sources List table and select Go.
On the Benefit Option Interim Costs page:
In the Benefit Option Cost Reporting Sources List table, select Update Costs in the Actions column for the desired Month/Year. If the Actions column is blank, this indicates that costs cannot be updated for this Month/Year at this time.
Note: The Benefit Option Interim Costs page contains the most recent interim costs saved to the RDS Secure Website. Costs may be added and edited for each month of the plan year from this page. Only one Month/Year may be edited at a time.
On the Update Benefit Option Interim Costs page:
An asterisk (*) indicates a required field.
Enter aggregated retiree data for the selected month in the following fields:
Select Save to store the entry or select Cancel to return to the Benefit Option Interim Costs page without saving the information.
Notes:
On the Benefit Option Interim Costs page:
A Success message displays indicating that Benefit Option Interim Costs successfully saved. A Warning message also displays indicating that the Cost Report contains cost figures that have been saved by a Cost Reporter on the RDS Secure Website but not yet submitted. Only submitted costs are eligible to be included in the Interim Payment Request.
The Benefit Option Interim Cost Report table refreshes to show updated cost data for the desired Month/Year.
On the Report Costs page:
The Date of Last Report and the Status of Last Report columns on the Benefit Option Cost Reporting Sources List table are updated accordingly for the Benefit Option.
Note: If Estimated Premiums are reported instead of Gross Retiree Costs, it must be consistently reported that way for the entire plan year. Also, all reporting sources (Vendor or Plan Sponsor) for that specific Benefit Option must consistently report Estimated Premiums for the entire plan year.
To access the RDS Secure Website and navigate to the Dashboard page, review instructions to access the RDS Secure Website.
On the Dashboard page:
Select the Application ID for which you want to report costs.
On the Application Overview page:
Select Report Costs from the left navigation menu.
On the Report Costs page:
Select View/Enter/Update Costs from the Actions dropdown menu on the Benefit Option Cost Reporting Sources List table and select Go.
On the Benefit Option Interim Costs page:
In the Benefit Option Interim Cost Report table, select Update Costs in the Actions column for the desired Month/Year. If the Actions column is blank, this indicates that costs cannot be updated for this Month/Year at this time.
Note: The Benefit Option Interim Costs page contains the most recent interim costs saved to the RDS Secure Website. Costs may be added and edited for each month of the plan year from this page. Only one Month/Year may be edited at a time.
On the Update Benefit Option Interim Costs page:
An asterisk (*) indicates a required field.
Enter aggregated retiree data for the selected month in the following fields:
Select Save to store the entry or select Cancel to return to the Benefit Option Interim Costs page without saving the information.
Notes:
On the Benefit Option Interim Costs page:
A Success message displays indicating that Benefit Option Interim Costs successfully saved. A Warning message also displays indicating that the Cost Report contains cost figures that have been saved by a Cost Reporter on the RDS Secure Website but not yet submitted. Only submitted costs are eligible to be included in the Interim Payment Request. The Benefit Option Interim Cost Report table refreshes to show updated cost data for the desired Month/Year.
Enter costs for all applicable months by repeating instructions 6 through 9. Costs may be entered and edited on this page as many times as necessary while the cost report is prepared for submission. The reported costs may be submitted on the Benefit Option Interim Costs page by selecting Submit Costs. For information on how to submit the cost report, refer to Submit Interim Cost Reports Entered Using Data Entry on the RDS Secure Website.
If you are not ready to submit costs, select Cancel to return to the Report Costs page.
On the Report Costs page:
The Date of Last Report and the Status of Last Report columns on the Benefit Option Cost Reporting Sources List table are updated accordingly for the Benefit Option.
Data Entry cost reports may be reported and saved on the RDS Secure Website. However, if the cost reports are not submitted, they cannot be included in an interim payment request.
To access the RDS Secure Website and navigate to the Dashboard page, review instructions to access the RDS Secure Website.
On the Dashboard page:
Select the Application ID for which you want to report costs.
On the Application Overview page:
Select Report Costs from the left navigation menu.
On the Report Costs page:
Select View/Enter/Update Costs from the Actions dropdown menu on the Benefit Option Cost Reporting Sources List table and select Go.
On the Benefit Option Interim Costs page:
Select Submit Costs to include the costs in an Interim Payment Request, or select Cancel to return to the Report Costs page.
Select Cancel to return to the Report Costs page.
On the Report Costs page:
The Date of Last Report and the Status of Last Report columns on the Benefit Option Cost Reporting Sources List table are updated accordingly for the Benefit Option.
View Current Costs on the RDS Secure Website
Costs reported by Manual Data Entry or Connect:Direct submission may be viewed using the View/Enter/Update Costs action. This action displays the last accepted cost figures regardless of whether the costs are saved, submitted, and/or included in a previous payment request.
For information on how to view all cost reports submitted for a Benefit Option, refer to View the Cost Report Audit Trail on the RDS Secure Website.
To access the RDS Secure Website and navigate to the Dashboard page, review instructions to access the RDS Secure Website.
On the Dashboard page:
Select the Application ID for which you want to report costs.
On the Application Overview page:
Select Report Costs from the left navigation menu.
On the Report Costs page:
Select View/Enter/Update Costs from the Actions dropdown menu on the Benefit Option Cost Reporting Sources List table and select Go.
On the Benefit Option Interim Costs page:
Select Cancel to return to the Report Costs page.
The Audit Trail of Benefit Option Interim Cost Reports page displays a list of the Benefit Option cost reports submitted to CMS' RDS Center by reporting source, and a history of the actions taken on these reports. Each cost report submitted by Manual Data Entry on the RDS Secure Website, or Connect:Direct submission without critical errors is recorded in the Audit Trail. Cost reports currently in “Data Entry Saved" or "Data Entry: Update/Entry Required" status are also included in the Audit Trail. The content of each cost report is available in the Audit Trail. The errors detected on Connect:Direct reports are listed on reports with a status of "Connect:Direct: Errors Detected."
For information on how to view Current Cost Reports submitted for a Benefit Option, refer to View Current Costs on The RDS Secure Website.
To access the RDS Secure Website and navigate to the Dashboard page, review instructions to access the RDS Secure Website.
On the Dashboard page:
Select the Application ID for which you want to report costs.
On the Application Overview page:
Select Report Costs from the left navigation menu.
On the Report Costs page:
Select View audit Trail from the Actions dropdown menu on the Benefit Option Cost Reporting Sources List table and select Go.
On the Audit Trail of Benefit Option Cost Reports page:
The Audit Trail of Benefit Option Cost Reports table lists the history of cost report events for a given Benefit Option. Each cost report submitted by Manual Data Entry on the RDS Secure Website or Connect:Direct submission is recorded in the Audit Trail, and each table row represents a cost report event. The content of each cost report and any errors detected can be viewed in the Audit Trail. Events are displayed in descending order by Date/Time Processed.
The following information displays for each cost report event:
Select View Cost Report to view the detail for a selected cost report event.
On the Benefit Option Costs page:
The following detail information is displayed for the cost report event:
The The Benefit Option Interim Cost Report table displays the following information for each Month of the Plan Year:
After reviewing the detail information for the cost report event, select Cancel to return to the Audit Trail of Benefit Option Cost Reports page.
On the Audit Trail of Benefit Option Cost Reports page:
Select Cancel to return to the Report Costs page.
Use the resources on this page to assist with reporting costs through Connect:Direct transmission.
Connect:Direct Report File Elements: This page provides information about the Connect:Direct cost report file format.
Connect:Direct Cost Report Copybooks: This document contains the Connect:Direct Cost Report Copybooks.
Sample Connect:Direct Cost File: This document contains a sample Connect:Direct cost file.