Submit Interim Costs
User Roles:
Program Components:
This section provides an overview of the following topics related to submitting interim costs:
- Introduction to Submitting Interim Costs
- Timing for Submitting Interim Costs
- User Roles and Responsibilities for Submitting Interim Costs
- Preparing for Interim Cost Submission
- Submitting Interim Costs
- Updating Previously Reported Costs
- Limitations to Changing Payment Setup After Interim Costs are Submitted
Introduction 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 Mainframe to RDS Center Mainframe through CMS Extranet. 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.
Plan Sponsors have the option to receive interim subsidy payments throughout the plan year based on costs submitted to CMS' RDS Center. Payment Frequency is selected during the Application Submission Process. Applications with a Payment Frequency of Monthly, Quarterly, or Interim Annual are eligible to receive interim payments.
Resources:
- 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.
Timing for Submitting Interim Costs
Interim cost reports may be submitted on applications that meet all of the following conditions:
- Application must be approved.
- Payment Setup must be complete for the application (Step 6 of Payment Setup must have a "Complete" status).
- The Payment Frequency associated with the application must be Monthly, Quarterly, or Interim Annual.
Note: Applications with an Annual Payment Frequency are not eligible for interim payment requests and may only submit final costs during Reconciliation. Payment Frequency is selected during the Application Submission Process and cannot be changed after the application is submitted and will remain in effect for the plan year.
After Payment Setup is complete for the application, the Interim Costs action is available in the Actions dropdown menu on the Application List page.
User Roles and Responsibilities for Submitting Interim Costs
Cost Reporting Sources
Vendors and Plan Sponsors are the two types of sources that can report costs. Each source's costs are treated as separate and distinct from the costs submitted by another source.
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.
Cost Reporters
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 and the cost reporting method for Plan Sponsor Cost Reporters is also specified in Payment Setup.
Only 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 they have been assigned 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.
Vendors
A Vendor may report costs using the Data Entry submission method on the RDS Secure Website or by the Mainframe transmission 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 a cost reporting submission method as 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 Mainframe or manual Data Entry on the RDS Secure Website.
For more information about Payment Setup including cost reporting user roles, refer to Complete Payment Setup.
Preparing for Interim Cost Submission
Methods for Submitting Interim Costs
Costs may be reported to CMS' RDS Center by two methods: manual Data Entry submission using the RDS Secure Website or Mainframe submission. Any cost report that is submitted using a submission method other than the submission method indicated in the Payment Setup menu is rejected.
Note: For detailed information on cost reporting methods, refer to Complete Payment Setup.
Preparing Interim Costs
For detailed information on how to prepare costs, refer to Prepare Cost Data.
Submitting Interim Costs
The status of cost reports submitted by manual Data Entry or Mainframe to CMS' RDS Center may be viewed on the RDS Secure Website for current costs and previously reported costs.
Notes:
- 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.
Account Managers and Designees with Report Costs privilege may view or report costs through the Benefit Option Interim Cost List page on the RDS Secure Website. The following cost report information for each Benefit Option is available on this page:
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Cost Reporting Source - Displays the Vendor Name and Vendor ID if a Vendor has been assigned the Report Costs privilege for the Benefit Option. Displays the user roles (Account Manager/Designee) assigned to directly report costs for the Plan Sponsor.
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Date of Last Report - Displays the date the Cost Reporter last saved cost figures or last submitted a cost report on the RDS Secure Website or the date a Mainframe submission containing costs for the Benefit Option was last processed.
Note: If No Reports displays in this column, no cost reports have been processed (Mainframe) or saved/submitted (Data Entry).
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Status of Last Report - Displays the status of the last cost report.
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Data Entry: Saved - Data Entry status indicating that the last cost report was saved but not submitted.
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Data Entry: Submitted - Data Entry status indicating that the cost report was submitted and is now available to be included in a payment request.
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Mainframe: Submitted - Mainframe status indicating that the cost report was submitted and is now available to be included in a payment request.
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Mainframe: Errors Detected - Mainframe status indicating that errors were detected in the last report.
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N/A - No cost reports have been processed (Mainframe) or saved/submitted (Data Entry).
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Costs cannot be reported for the future. For example, costs for August cannot be reported if it is currently July. Also, if reporting multiple Application IDs or Benefit Options using Mainframe 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.
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 Mainframe 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 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:
- Change Account Manager privilege from Report Costs to View Only or Request Payment
- Change Plan Sponsor Designee privilege from Report Costs to Request Payment
- Remove Vendor
- Remove Benefit Options for which costs are reported from Cost Reporters (Vendor or Plan Sponsor)
Step-by-Step Instructions: RDS Secure Website Tasks
This section provides step-by-step instructions to complete the following tasks for submitting, updating, and viewing interim costs:
- Enter Gross Eligible Costs Using Data Entry on the RDS Secure Website
- Enter Estimated Premium Costs Using Data Entry on the RDS Secure Website
- Submit Interim cost reports Using Data Entry on the RDS Secure Website
- Update Previously Reported Costs Entered Using Data Entry on the RDS Secure Website
- View Current Costs on the RDS Secure Website
- View the Cost Report Audit Trail on the RDS Secure Website
Enter Gross Eligible Costs Using Data Entry on the RDS Secure Website
To access the RDS Secure Website and navigate to the Application List page, review instructions to access the RDS Secure Website.
From the Application List page:
- Find the appropriate Application ID.
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Select Interim Costs from the Actions dropdown menu and select Go.
Note: The Interim Costs action only displays in the Actions column for Account Managers and Designees assigned the Report Costs privilege during Payment Setup. The Interim Costs action does not display unless the application is approved, Payment Setup is complete, and the application Payment Frequency is Monthly, Quarterly, or Interim Annual.
On the Benefit Option Interim Cost List page:
- Find the appropriate Benefit Option for which costs may be entered.
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Select Enter/Update Costs from the Actions dropdown menu on the Benefit Option Cost Reporting Sources List table and select Go.
Note: The Enter/Update Costs action is only available if the Account Manager, Plan Sponsor Designee, or Vendor Designee is assigned the Report Costs privilege with a "Data Entry" submission method.
On the Benefit Option Interim Cost Data Entry View page:
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Select edit from the Benefit Option Interim Cost Report table to enter or modify a particular Month/Year.
Note: The Benefit Option Interim Cost Data Entry View 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 Benefit Option Interim Cost Data Entry Edit page:
An asterisk (*) indicates a required field.
- Enter aggregated retiree data for the selected month in the following fields:
- * Gross Retiree Cost
- * Threshold Reduction
- * Limit Reduction
- * Estimated Cost Adjustment
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Select Save to store the entry and return to the Benefit Option Cost Data Entry View page or select Cancel to return to the Benefit Option Cost Data Entry View page without saving the information.
Notes:
- The Threshold Reduction is required for at least the first month in the plan year where gross costs were reported.
- Each field must contain a zero if there is no amount to report.
On the Benefit Option Interim Cost Data Entry View page:
- Enter costs for all applicable months by repeating instructions 5 through 7.
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After all costs are entered, select Return to Benefit Option List to save the costs but not submit them to CMS' RDS Center.
Notes:
- Costs may be entered and edited on this page as many times as necessary while the cost report is prepared for submission.
- (UPDATED) displays under the Month/Year when costs have been entered or updated.
- The reported costs may be submitted on the Benefit Option Interim Cost Data Entry View page using the Submit command. For information on how to submit the cost report, refer to Submit Interim Cost Reports Entered Using Data Entry on the RDS Secure Website.
On the Benefit Option Interim Cost List 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.
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Select Return to Application List to return to the Application List page.
Enter Estimated Premium Costs Using Data Entry on the RDS Secure Website
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 the Benefit Option must also consistently report Estimated Premiums for the entire plan year.
To access the RDS Secure Website and navigate to the Application List page, review instructions to access the RDS Secure Website.
From the Application List page:
- Find the appropriate Application ID.
-
Select Interim Costs from the Actions dropdown menu and select Go.
Note: The Interim Costs action only displays in the Actions column for Account Managers and Designees assigned the Report Costs privilege during Payment Setup. The Interim Costs action does not display unless the application is approved, Payment Setup is complete, and the application Payment Frequency is Monthly, Quarterly, or Interim Annual.
On the Benefit Option Interim Cost List page:
- Find the appropriate Benefit Option for which costs may be entered.
-
Select Enter/Update Costs from the Actions dropdown menu on the Benefit Option Cost Reporting Sources List table and select Go.
Note: The Enter/Update Costs action is only available if the Account Manager, Plan Sponsor Designee, or Vendor Designee is assigned the Report Costs privilege with a "Data Entry" submission method.
On the Benefit Option Interim Cost Data Entry View page:
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Select edit from the Benefit Option Interim Cost Report table to enter or modify a particular Month/Year.
Note: The Benefit Option Interim Cost Data Entry View page contains the most recent interim costs saved on 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 Benefit Option Interim Cost Data Entry Edit page:
An asterisk (*) indicates a required field.
- Enter aggregated cost data for the selected month in the following fields:
- * Estimated Premium Cost
- * Estimated Cost Adjustment (as applicable)
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Select Save to store the entry and return to the Benefit Option Interim Cost Data Entry View page or select Cancel to return to the Benefit Option Interim Cost Data Entry View page without saving the information.
Notes:
- If Estimated Premium Costs 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 the Benefit Option must also consistently report Estimated Premium Costs for the entire plan year. Estimated Premiums may only be reported on Fully-Insured plans, not Self-Funded plans.
- If rebate and price concession data is included with the Estimated Premium Cost amount, do not report an Estimated Cost Adjustment amount.
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Each field must contain a zero if there is no amount to report.
On the Benefit Option Interim Cost Data Entry View page:
- Enter costs for all applicable plan months by repeating instructions 5 through 7.
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Select Return to Benefit Option List to return to the Benefit Option Interim Cost List page without submitting the cost report to CMS' RDS Center.
Notes:
- Costs may be entered and edited on this page as many times as necessary while the cost report is being prepared for submission.
- (UPDATED) displays under the Month/Year when costs have been entered or updated.
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The reported costs may be submitted on the Benefit Option Interim Cost Data Entry View page using the Submit command. For information on how to submit the cost report, refer to Submit Interim Cost Reports Entered Using Data Entry on the RDS Secure Website.
On the Benefit Option Interim Cost List page:
- The Date of Last Report and Status of Last Report columns on the Benefit Option Cost Reporting Sources List table are updated accordingly.
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Select Return to Application List to return to the Application List page.
Submit Interim Cost Reports Entered Using Data Entry on the RDS Secure Website
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 Application List page, review instructions to access the RDS Secure Website.
From the Application List page:
- Find the appropriate Application ID.
- Select Interim Costs from the Actions dropdown menu and select Go.
Note: The Interim Costs action only displays in the Actions column for Account Managers and Designees assigned the Report Costs privilege during Payment Setup. The Interim Costs action does not display unless the application is approved, Payment Setup is complete, and the application Payment Frequency is Monthly, Quarterly, or Interim Annual.
On the Benefit Option Interim Cost List page:
- Find the appropriate Benefit Option for which costs may be entered.
-
Select Enter/Update Costs from the Actions dropdown menu on the Benefit Option Cost Reporting Sources List table and select Go.
Note: The Enter/Update Costs action is only available if the Account Manager, Plan Sponsor Designee, or Vendor Designee is assigned the Report Costs privilege with a "Data Entry" submission method.
On the Benefit Option Interim Cost Data Entry View page:
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Select Submit to submit the interim costs to CMS' RDS Center to be included in the payment request or select Return to Benefit Option List to return to the Benefit Option Interim Cost List page without submitting the cost report.
Note: The Benefit Option Interim Cost Data Entry View page displays a list of the most recent interim cost reports for each month of the plan year. If interim cost figures have been saved for a plan month, (SAVED) displays under the Month/Year until the interim cost report is submitted. Figures adjusted after submission of the interim cost report appear with the word (UPDATED) in the plan month until the interim cost report is resubmitted.
On the Benefit Option Interim Cost Data Entry Verification page:
- Review the entries carefully to ensure that the data is correct and ready to be included in the interim payment request.
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Select Confirm to complete the submission process or select Cancel to return to the Benefit Option Interim Cost Data Entry View page without submitting the cost report.
On the Benefit Option Interim Cost Data Entry Confirmation page:
- Print this page for your records.
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Select Continue to return to the Benefit Option Interim Cost List page.
Note: The interim cost report is submitted to CMS' RDS Center and is eligible to be included in an interim payment request.
On the Benefit Option Interim Cost List 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.
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Select Return to Application List to return to the Application List page.
Update Previously Reported Costs Entered Using Data Entry on the RDS Secure Website
To access the RDS Secure Website and navigate to the Application List page, review instructions to access the RDS Secure Website.
From the Application List page:
- Find the appropriate Application ID.
-
Select Interim Costs from the Actions dropdown menu and select Go.
Note: The Interim Costs action only displays in the Actions column for Account Managers and Designees assigned the Report Costs privilege during Payment Setup. The Interim Costs action does not display unless the application is approved, Payment Setup is complete, and the application Payment Frequency is Monthly, Quarterly, or Interim Annual.
On the Benefit Option Interim Cost List page:
- Find the appropriate Benefit Option for which costs may be entered.
-
Select Enter/Update Costs from the Actions dropdown menu on the Benefit Option Cost Reporting Sources List table and select Go.
Note: The Enter/Update Costs action is only available if the Account Manager, Plan Sponsor Designee, or Vendor Designee is assigned the Report Costs privilege with a "Data Entry" submission method.
On the Benefit Option Interim Cost Data Entry View page:
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Select edit from the Benefit Option Interim Cost Report table to modify a particular Month/Year.
Note: The Benefit Option Interim Cost Data Entry View 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 Benefit Option Interim Cost Data Entry Edit page:
An asterisk (*) indicates a required field.
- Enter the modified amount(s) for the selected month in the following fields:
- * Gross Retiree Cost
- * Threshold Reduction
- * Limit Reduction
- * Estimated Premium Cost
- * Estimated Cost Adjustment
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Select Save to store the entry or select Cancel to return to the Benefit Option Interim Cost Data Entry View page without saving the information.
Notes:
- If Estimated Premium Costs 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 the Benefit Option must consistently report Estimated Premium Costs for the entire plan year. When reporting adjusted costs, always report the entire months' costs again, not just the adjusted amount.
- Each field must contain a zero if there is no amount to report.
On the Benefit Option Interim Cost Data Entry View page:
- Enter costs for all applicable months by repeating instructions 5 through 7.
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After all costs are entered, select Return to Benefit Option List to return to the Benefit Option Interim Costs List page without submitting the cost report.
Note: For information on how to submit the modified cost report, refer to Submit Interim Cost Reports Entered Using Data Entry on the RDS Secure Website.
View Current Costs on the RDS Secure Website
Costs reported by Manual Data Entry or Mainframe submission may be viewed under the View Current Costs action. This action is not available when the Status of Last Report on the Benefit Option Interim Cost List page is "Mainframe: Errors Detected" or "No Reports." The viewable Benefit Option Interim Cost Summary page 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 Application List page, review instructions to access the RDS Secure Website.
From the Application List page:
- Find the appropriate Application ID.
-
Select Interim Costs from the Actions dropdown menu and select Go.
Note: The Interim Costs action only displays in the Actions column for Account Managers and Designees assigned the Report Costs privilege during Payment Setup. The Interim Costs action does not display unless the application is approved, Payment Setup is complete, and the application Payment Frequency is Monthly, Quarterly, or Interim Annual.
On the Benefit Option Interim Cost List page:
- Find the appropriate Benefit Option for which costs may be entered.
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Select View Current Costs from the Actions dropdown menu on the Benefit Option Cost Reporting Sources List table and select Go.
Note: There must be at least one successfully submitted cost report for the View Current Costs action to display.
On the Benefit Option Interim Cost Summary page:
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After viewing the last accepted costs reported, select Continue to return to the Benefit Option Interim Cost List page.
Note: The Benefit Option Interim Cost Summary page is View Only. To update Mainframe cost reports, a new file must be submitted using the Mainframe submission method in order to modify the data. For information on updating Data Entry cost reports, refer to Update Previously Reported Costs Entered Using Data Entry on the RDS Secure Website.
View the Cost Report Audit Trail on the RDS Secure Website
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 Mainframe 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 Mainframe reports are listed on reports with a status of "Mainframe: 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 Application List page, review instructions to access the RDS Secure Website.
From the Application List page:
- Find the appropriate Application ID.
-
Select Interim Costs from the Actions dropdown menu and select Go.
Note: The Interim Costs action only displays in the Actions column for Account Managers and Designees assigned the Report Costs privilege during Payment Setup. The Interim Costs action does not display unless the application is approved, Payment Setup is complete, and the application Payment Frequency is Monthly, Quarterly, or Interim Annual.
On the Benefit Option Interim Cost List page:
- Find the appropriate Benefit Option for which costs may be entered.
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Select View Audit Trail from the Actions dropdown menu on the Benefit Option Cost Reporting Sources List table and select Go.
Note: There must be at least one successfully submitted cost report for the View Audit Trail Action to display.
On the Audit Trail of Benefit Option Interim Cost Reports page:
The following information displays on the Audit Trail of Benefit Option Interim Cost Reports page for each action taken on a submitted cost report.
- Date/Time Processed – Displays the date and time CMS' RDS Center processed a cost report when an action was taken by a Cost Reporter or Payment Requester.
- Status – Displays the status of the cost report based on the action that was taken. Statuses include:
- Data Entry: Submitted – Data Entry status indicating that the cost report was submitted on the RDS Secure Website.
- Mainframe: Submitted – Mainframe status indicating that the cost report was submitted without errors.
- Mainframe: Errors Detected – Mainframe status indicating that the cost report was submitted with errors.
- Included In Payment Request – Indicates that the cost report was included in a payment request.
- Report Reviewed – Indicates that the Payment Requester reviewed the cost report.
- Date/Time File Created (Mainframe Submission Only) – Displays the date and time supplied in the Mainframe file submission.
- Cost Reporter/Payment Requester – Displays the name of the individual who reported costs on the RDS Secure Website, reviewed the cost report, or submitted the payment request.
- Errors/Warnings Detected – Displays the number of errors and warnings detected in a Mainframe cost report. The number of errors only appears if the status of the cost report is "Mainframe: Errors Detected". Data Entry submissions with errors are not permitted on the RDS Secure Website.
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Select View Cost Reports from the Actions dropdown menu on the Audit Trail of Benefit Option Interim Cost Reports table and select Go.
On the Benefit Option Interim Cost Report page:
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After viewing the cost report, select Continue to return to the Audit Trail of Benefit Option Interim Cost Reports page.
Use the resources on this page to assist with reporting costs through Mainframe transmission.
Mainframe Report File Elements: This page provides information about the Mainframe cost report file format.
Mainframe Cost Report Copybooks: This document contains the Mainframe Cost Report Copybooks.
Sample Mainframe Cost File: This document contains a sample Mainframe cost file.