2005 HAR Education and Information Session

1. 2005 HAR Education and Information Session Joe Schindler, MHA Jonathan Peters, MHA Amy Camp, MDH Kristin Loncorich, MDH

2. Updates and Changes for FY 2005 • Contract Staffing Section changed to FTE’s and Contract Amounts • Self-Pay Adjustments line added to Section 20 of HAR • Cover Page fields become Auto-Fill • Medicare Advantage to be placed under Medicare Managed Care line in HAR • Stricter auditing of mental health information • Important Conditional Comments included in HAR

3. Lines that are Auto-Fill Areas that are highlighted in yellow are now auto-filled Please ensure that the information that is automatically filled in is accurate.

4. New Contract Staffing Section This section was added due to the difficulties hospital preparers reported in collecting contracted staff headcounts. Numbers and amounts reported in the staffing sections should be hospital only.

5. New Data Transmission Method Available • Hospitals now can set up an SFTP login with MHA to submit their HAR and other electronic documents • Transmission encrypted and secure • Both MHA and sender receive confirmation of delivery • More safe and secure than postal mail or e-mail • This new method is highly recommended by MDH and MHA for data transmission • Please contact MHA to setup a login and password

6. Preparation for Starting the HAR • Records and Reports • Prior Year’s HAR • Audited Financial Statement • Medicare Cost Report • Internal Financial Statements • PS & R • Payroll Records • Divide and Conquer • Divide the workload among hospital departments • Complete a section a time, not large portions all at once • Spread the work over an extended time frame • Don’t procrastinate

7. Excel Tips and Tools • View the HAR as pages instead of as a spreadsheet • “Page Break Preview” option under the view menu • “Normal View” will revert it back to the spreadsheet view • Track Changes made to HAR Lines • “Track Changes” option under the “Highlight Changes” option on the “Tools” menu • Knowing what numbers were previously entered can be useful • Find All Feature • Alternative to using the Name Box • Will display all occurrences in formset at once • Select the one that has the EXACT line number listed

8. Page Break Preview • Using the “Page Break Preview” option can make finding accounts easier • Option is located under “View” on the Menu Bar • To switch back, select “Normal”

9. Tracking Changes • Tracking changes made to an account could be useful for reference and documentation • To activate, select “Highlight Changes” under the “Track Changes” line on the “Tools” menu

10. Find All Feature • The “Find All” can be a useful alternative to the name box for finding accounts • To use, select “Find” under the “Edit” menu • Look for the exact number in the “Value” Column

11. Expense Allocation Methodology • Review previous year’s HAR documentation for allocation methods • If they are reasonable, use same methodology • Following the same process creates consistency and comparability. • Medicare Cost Report may provide insight • Talk with the MCR preparer • Review documentation on MCR, worksheet B

12. Outpatient ChargesSection 23 Understanding Where Specific Types of Charges are Reported

13. Outpatient Registrations Have Continued to Increase Registrations have increased over 70% from 1994 to 2004 As these numbers increase, so does their relative importance

14. Outpatient Registration Charges • Often certain types of charges vacillate between this account and Ancillary • Charges relating to physical therapy, rehabilitation, or treatments • Examples include: • Physical Therapy • Speech Pathology • Renal Dialysis • Cardiac Rehabilitation

15. Outpatient Surgery Charges • Simpler Category of Charges • Includes all charges relating to surgical procedures • Examples include: • Operating Room • Anesthesiology • Recovery Room

16. Outpatient Ancillary Charges • Includes all charges not directly involved in their condition or reason for visit • Examples include: • Diagnostic Radiology • Lab Charges • Supplies and Drugs • Easiest method of calculating is to subtract registration, surgery, and emergency from total outpatient charges

17. Final Notes on Outpatient Charges • Emergency Room Charges are usually easily identifiable on trial balance • If specific outpatient charges are difficult to determine on trial balance, MCR worksheet C may be of help • Make sure to exclude clinics, home health, and other institutions broken out on the Institution Section from section 23.

18. Primary Payer Charges and Adjustment Techniques and Suggestions on Accurate Payer Type Reporting

19. Important Notice for Payer Type Reporting Please make sure to report all Medicare Advantage Charges and Adjustments under “Medicare Managed Care”, accounts 742 and 842 on the HAR

20. Tips for Reporting Payer Information • Start from the largest categories and ensure their accuracy before calculating the next level of detail • The hospital’s AFS should provide Medicare and Medicaid charges or percentage in the Notes section • DHS may be able to verify the amount of charges and payments to the hospital for Medicaid

21. Verifying Accuracy of Payer Information • Compare Medicare and Medicaid numbers to AFS notes. • Analyze Medicare and Medicaid numbers against MCR and DHS figures. • Review specific payer to total account ratios against last year’s ratio. • Ensure charges vs. adjustments ratio for a given payer compares to previous year’s ratio.

22. Contact Information • MHA staff at (800) 462-5393 or (651) 641-1121 • Jonathan Peters, MHA (651) 659-1422 • Amy Camp, MDH (651) 201-3575 • Kristin Loncorich, MDH (651) 201-3573