Use the Vendor Quick Start Guide to help you get started in your role as an RDS Vendor representative. Whether you are managing retiree enrollment or submitting cost data on behalf of a Plan Sponsor (or both), you and your Plan Sponsor should maintain close communication to successfully participate in RDS. Review Communicating With Your RDS Vendor for an overview of when your Plan Sponsor should be working with you, and what information should be shared with you throughout an RDS application's lifecycle.
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As a new Vendor representative, there are a number of things to verify early on to help you successfully work with your RDS Plan Sponsor:
- Communicate your Vendor ID(s). Each Vendor is required to request a Vendor ID from CMS' RDS Center. Communicate Vendor IDs to the appropriate Plan Sponsor(s) so they can be entered in the RDS Secure Website as applicable. If you are submitting cost data, your Plan Sponsor will need to enter your Vendor ID in Payment Setup. If you plan on submitting cost data using both Connect:Direct and Data Entry (RDS Secure Website), your Vendor organization will need a Vendor ID for each cost reporting method. If you are sending and receiving retiree information using Connect:Direct, your Plan Sponsor will need to enter your Vendor ID in Application Submission Process Step 7: Retiree Electronic Data Interchange (EDI) Methods and Sources.
- Obtain access well before deadlines. Maintain close communication with your Plan Sponsor to ensure you are aware of deadlines, and make sure you have the access you need well before a deadline. If you are submitting or managing retiree or cost reporting information using the RDS Secure Website, your Plan Sponsor's Account Manager or Authorized Representative will need to invite you to register as a Designee. Work with your Plan Sponsor to ensure you've been assigned the appropriate privileges (View/Send/Receive Retiree Data for retiree management or Report Costs for cost reporting). Additionally, if you are submitting cost data, your Plan Sponsor needs to associate you with your Vendor ID in Payment Setup in order for you to view or report costs.
Consider setting up one person in your organization as a Vendor Composite Report Recipient to receive Quick Access Reports (QAR) so that your organization can view all cost reports submitted with your Vendor ID.
|User Management – User Roles Support Tool||If a Plan Sponsor has added you as a Vendor Designee, you must maintain an active RDS Secure Website user account while participating in RDS. Refer to this section of the RDS Welcome Kit User Roles Support Tool for helpful tips for maintaining an active user account.|
|Important Application Deadline Information||Are you submitting a Valid Initial Retiree List for a Plan Sponsor's annual plan application? The Valid Initial Retiree List (in addition to the application) must be submitted by the Plan Sponsor's Application Deadline, or the application will be denied. Refer to this page for common Application Deadline dates, and confirm the date with your Plan Sponsor.|
|Important Reconciliation Deadline Information||Are you submitting or managing retiree or cost reporting information for a Plan Sponsor during the Reconciliation process? Refer to this page for common Reconciliation Deadline dates, and confirm the date with your Plan Sponsor.|
If you are managing or submitting retiree information on behalf of a Plan Sponsor, keep the following information in mind:
- Confirm your connection is working. If you are working for a Vendor that is new to RDS and are planning to send retiree or cost files using Connect:Direct, work with CMS' RDS Center to help you establish the proper connection, file names, and file structure. This setup must be completed once for each Vendor. Before transmitting production data to CMS' RDS Center using Connect:Direct, Vendors must contact CMS' RDS Center for information about how to send test files to ensure that proper connectivity is established.
- Encourage your Plan Sponsor to have copies of retiree notifications sent to the RDS Secure Website. If you are submitting and receiving retiree information using Connect:Direct, encourage your Plan Sponsor to consider setting the notification method as RDS Center Mainframe to Vendor Mainframe with a copy sent to the RDS Secure Website. This will allow your Plan Sponsor to review Retiree Response Files and Weekly Notification Files on the RDS Secure Website, aiding communication throughout the application plan year. If the Plan Sponsor has assigned you as a Designee with the View/Send/Receive Retiree Data privilege, you may also access the RDS Secure Website to review retiree information.
- Ensure you have the correct Unique Benefit Option IDs (UBOIs) from your Plan Sponsor. The retiree file must reference the UBOI exactly as it is entered on the Plan Sponsor's application. If CMS' RDS Center cannot find a match on any of the UBOIs entered on the retiree file to any UBOI on the application, the entire retiree file will be rejected. Ensure you have the correct plan year start and end dates as well.
- Coordinate Connect:Direct retiree file header and trailer records. If you are submitting retiree information using Connect:Direct and want to submit information for multiple applications in your file, coordinate the header and trailer records appropriately. If there is an error in one application, the entire file will not be processed by CMS' RDS Center.
|Retiree Management - RDS User Guide||Visit the RDS User Guide for detailed information about retiree processing, including guidelines and step-by-step instructions for completing tasks such as uploading retiree files and processing Retiree Response Files and Weekly Notification Files.|
|Sample Retiree File Spreadsheet Job Aid||If you are submitting a retiree file using the RDS Secure Website, refer to the editable Sample Retiree File spreadsheet and corresponding instructions to help create and upload the retiree file.|
|Retiree Processing Resources - RDS User Guide||Refer to these resources to better understand file layouts for either RDS Secure Website or Connect:Direct transmission, RDS Reason Codes, and errors when uploading a retiree file on the RDS Secure Website.|
|Troubleshooting Exchanging Retiree Information With CMS' RDS Center - RDS User Guide||Whether you are submitting retiree files or processing information on behalf of a Plan Sponsor, visit this resource to help resolve the most common issues in retiree processing.|
If you are managing or submitting interim or final cost data on behalf of a Plan Sponsor, remember the following tips:
- Sign up for Quick Access Reports. RDS Secure Website Quick Access Reports (QAR) assist and accelerate the cost reporting activities of Vendors and Plan Sponsors by delivering consolidated cost reporting information. QAR can be used to view a summary of cost reports and errors. They can tell you whether cost reports submitted using Connect:Direct were accepted or rejected, which cost reports require attention, when Reconciliation has been initiated, whether cost reporting is open or closed, if Payment Setup is incomplete, Application Status, Reconciliation Deadline, retiree counts per Unique Benefit Option Identifier (UBOI), if multiple Cost Reporters are assigned to a UBOI, how the current cost file compares to the previous file, and more. The data viewable in QAR is based on user role.
Your Vendor organization may only specify one individual who has a current and active RDS Secure Website account to receive the reports, so designate someone who will be diligent about communicating reports within your organization.
- Verify Payment Setup is correct. If you are submitting cost data on behalf of your Plan Sponsor, work with the Plan Sponsor's Account Manager to confirm that Payment Setup lists your Vendor organization as the Vendor submitting cost reports.
Note: QAR can help you verify that you are assigned correctly in Payment Setup since each Unique Benefit Option Identifier (UBOI) assigned to your Vendor organization will appear on the report regardless of whether or not a cost report was submitted.
- Coordinate cost file header and trailer records. If you are submitting cost information using Connect:Direct and want to submit information for multiple applications in your file, coordinate the header and trailer records appropriately. If there is an error in one application, the entire file will not be processed by CMS' RDS Center.
- Understand your access during Reconciliation. If you are a Vendor Designee assisting with the Reconciliation process, note that you do not have access to the Reconciliation Checklist and Reconciliation Step 6: Manage Submission of Final Cost Reports. You must access cost reporting through the "Final Cost" action available on the Application List page. Additionally, you must wait until Reconciliation Step 6 to report costs. The status of the application will be "Reconciliation Cost Reporting Opened."
- Learn how the Mandatory Payment Reduction is applied. If you are managing or submitting final cost information during Reconciliation, it's important to understand how the 2% Mandatory Payment Reduction affects Reconciliation final payments. Plan Sponsors and Vendors should prepare cost data as usual. Do not deduct 2% from the cost information before submitting it to CMS' RDS Center—the RDS Secure Website automatically applies the reduction to the subsidy amount during the Reconciliation process.
|Quick Access Reports (QAR)||If you are managing cost reporting information for multiple applications, RDS Secure Website Quick Access Reports (QAR) can help. Refer to this guide for comprehensive information on requesting and understanding QAR.|
|Complete Payment Setup - RDS User Guide||The Plan Sponsor's Account Manager or Authorized Representative is responsible for assigning your organization as a cost reporting Vendor during the Payment Setup process. This section of the RDS User Guide provides information such as an overview of the Payment Setup Process steps, guidelines, common mistakes to avoid, and step-by-step instructions to complete Payment Setup.
Note: It's important for your Plan Sponsor to understand Payment Setup guidelines before initiating Payment Setup.
|Change Payment Setup - RDS User Guide||If your Vendor organization is not set up correctly to report costs in Payment Setup, the Plan Sponsor's Account Manager or Authorized Representative will need to make updates through the Change Payment Setup process. This section of the RDS User Guide provides information such as Payment Setup changes by step, limitations to making changes, and user roles and privileges to change Payment Setup, as well as step-by-step instructions to change Payment Setup.
Note: It's important for your Plan Sponsor to understand the limitations when making changes to Payment Setup.
|Prepare Cost Data - RDS User Guide||Review this section of the RDS User Guide for cost reporting guidelines and detailed cost reporting examples.|
|Submit Interim Costs - RDS User Guide||If you are submitting costs for a Plan Sponsor's interim payment request, refer to this section of the RDS User Guide for general information about interim cost reporting, step-by-step instructions to submit interim costs on the RDS Secure Website, and guidelines for submitting costs using Connect:Direct.|
|Reconciliation - RDS User Guide||If you are a Designee assigned the Report Costs privilege, review this section of the RDS User Guide for general information and step-by-step instructions for completing Reconciliation Steps 5 through 9.|
|Mandatory Payment Reduction in CMS' Retiree Drug Subsidy Reconciliation Payments||Refer to this document to learn more about which Reconciliation payment requests are affected by the 2% mandatory payment reduction and how the reduction is applied.|
Want More Information?
The RDS Program offers extensive support to the Plan Sponsor community, in addition to the resources referenced in this guide. To learn where to find all the information available to you, visit the How to Use This Site page.