User Roles Support Tool: Interim Payment

User Roles:

AM

AR

D

Program Components:

Interim Payment

The Interim Payment Process is a method the Plan Sponsor uses to submit interim cost reports and make interim payment requests for Qualifying Covered Retirees on an approved RDS application. The following identifies the actions and associated user roles with interim payments.

Compile Incurred Costs AM

During the Compile Incurred Costs stage of the Interim Payment Process, the Cost Preparers compile incurred costs of Medicare Part D drugs for Qualifying Covered Retirees by Benefit Option and Plan Month.

The function of the Cost Preparer happens outside of the RDS system and may or may not be the same individuals assigned the Report Costs privilege on the RDS Secure Website.

Report Compiled Costs AM D

During the Report Complied Costs stage of the Interim Payment Process, Cost Reporters will report cost data to CMS' RDS Center for Qualifying Covered Retirees by Manual Data Entry on the RDS Secure Website or by Mainframe. A Cost Reporter may be the Account Manager, Plan Sponsor Designee, Vendor, or Vendor Designee.

Build and Submit Payment Requests AM AR D

During the Build and Submit Payment Requests stage of the Interim Payment Process, the Payment Requester carefully reviews previously submitted cost data, builds the payment request by selecting which Benefit Options to include, and submits the request to CMS’ RDS Center.

A Payment Requester is an individual that has been granted the permission to build and submit payment requests using the RDS Secure Website. The Request Payment privilege is assigned at the application level. The Request Payment privilege is assigned during Payment Setup, which must be completed before payments can be requested. The Request Payment privilege is always assigned to the Authorized Representative, and may also be assigned to the Account Manager or a Designee.

Determine and Render Payment AM AR D

During the Determine and Render Payment stage of the Interim Payment Process, CMS' RDS Center validates the payment request, makes payment adjustments to the request if necessary, sends the subsidy payment using Electronic Funds Transfer, and notifies the Plan Sponsor of the payment status.

The Account Manager, Authorized Representative, or Designee with Request Payment privilege may review payment requests, Payment Determinations, Payment Adjustments, EFT Pre-notes, and EFT payment events from the Payment Event History page on the RDS Secure Website.