1 / 13

Professional Fee Funds Flow

Professional Fee Funds Flow. May 19, 2005. PSA Report Principles. The Professional Service Agreement (PSA) defines the flow of funds to the department.

kalkin
Download Presentation

Professional Fee Funds Flow

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Professional Fee Funds Flow May 19, 2005

  2. PSA Report Principles • The Professional Service Agreement (PSA) defines the flow of funds to the department. • PSA departments are defined as a collection of cost centers and exist in the Accounting department. All Billing Areas associated with a PSA cost center are also PSA.

  3. PSA Report - Structure • Charges and Revenues are broken out by billing agent. • MGBS • Per-Se • “Cash Receipts” is actually “Net Revenue”.

  4. PSA – Revenue Adjustments • Start with Cash Receipts. • Less Refunds • Add Refund Reversal (787) • Less Check Returned (611) • Less Credit Balance Adj. (687) * • Less Escheat (90) * • Grand Total = Net Revenue * Included in Other Operating Revenue

  5. PSA Matching – Steps in DWH • Pull in the Post Month as columns. • Add PSA Department as a row. • Add Charges & Payments to row. • Add Refunds/CR Adj/DB Adj from Measures. • Add “787” as short drop to CR Adj. • Add “611, 687, 90” as short drop to DB Adj. • Add Group/Prov as a long drop.

  6. Research Billing The new Research Billing Bar Group #11 replaces the ZZ billing previously done in IDX. It is not managed by MGBS or Per-Se, but by the Medical Center. This new function started 07/01/04. The charges submitted are paid internally from the research grants at 100% of the Medicare Non-Facility fee schedule.

  7. SMS Guarantee The SMS Guarantee still exists in the new funds flow. To calculate it, however, you must first add the Cash SMS (Non-Gov’t) and the Cash SMS (Gov’t) lines together and compare those to the RBRVS-SMS line. If the RBRVS-SMS line exceeds the sum of the two lines above, the difference appears on the RBRVS Cash Diff-SMS line.

  8. Technical Offset and the Facilities Use Fee Cash SMS (Gov’t) is defined by the agreement as Medicare and MediCal revenues posted through the SMS system. This combined with the AB915 distribution create the Technical Offset used in the Facilities Use Fee calculation. It is intended to remove the cost of governmental patients from the department. JulAugSep AB-915 Revenue000 Cash SMS (Gov’t)000 Total Tech Offset000 Facilities Use Fee = (Total Direct Expense + Total Rent Expense) + Total Tech Offset

  9. AB 915 Distribution • The AB915 program is designed to reimburse the Medical Center for un-recouped costs from the MediCal program. • The clinic portion is allocated to the Medical Group as a whole. • Within the Medical Group, a methodology developed by ECG is used to facilitate our internal distribution. • The distribution is allocated to each department’s administrative cost center. When we attempted to allocate to the cost center level, re-allocations occurred because some cost centers generate revenue, but no expense. AB915 Allocation Method = (% MediCal Visits) * (Total Direct Expense) = MediCal Direct Expense The funds are distributed based on the % MediCal Direct Expense.

  10. Cancer Center Revenue The Cancer Center Adjustment line is used exclusively for quarterly Cancer Center distributions. • Cancer Center revenue is included in MGBS or Per-Se Cash Receipts. • There is no longer a monthly Cancer Center budgeted payment. • Cancer Center expenses and space are now included in the Facilities Use Fee. • Cost Center and Divisional reports reflect Cancer Center activity. • The quarterly Cancer Center Model still exists.

  11. Space Fee and Space Fee Credit • We are currently reconciling the July space allocations. These were generated from the Medical Center Facilities database. • Cancer Center and Leased Space were not initially entered in the July ledger. Cancer Center was added in August (x 2 months) and leases are being added continuously. • Other space may include space previously thought of a campus. The Medical Center has also included this space in their database for the purpose of State Reporting. • July and August did not have the space fee credit allocated separately. It is incorporated into the Space Fee. Once it is on it’s own line you can multiply the monthly dollar amount by 12 and divide by $38.20 to back out your square footage.

  12. Cash Control and Purchased IT Services • Cash Control is to reimburse the Medical Center for lockboxes, credit card machines, and accounts receivable personnel. • Purchased IT Services reimburses the Medical Center for IDX licenses, maintenance, personnel, and other costs directly related to the IDX billing function. • Other Medical Center services are covered by the Facilities Use Fee as indirect expenses. Both of these Purchased Services are allocated using the following methodology: 50% of the total amount is allocated based on a distribution of Invoice Counts 50% of the total amount is allocated based on a distribution of Total Revenue The distributions are recalculated monthly. Because of this they cannot be validated at the department level.

  13. PFF Payment To calculate the final payment: Total Revenue + Facilities Use Fee + Total Purchased Services This amount will be reflected in a ledger transaction available to the department via Weblinks reports.

More Related