User Roles Support Tool: Payment Setup

User Roles:



Program Components:

Payment Setup

The Plan Sponsor will make decisions in Payment Setup to determine who will report cost data for each Benefit Option, how the information will be transmitted, and who will request interim payments if the Plan Sponsor has elected 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.

Payment Setup requires the assignment of at least one Cost Reporter for every Benefit Option. The following identifies the actions and user roles associated with Payment Setup. 

Complete or Change Payment Setup AM AR

The Account Manager and the Authorized Representative may complete or change Payment Setup.