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This worksheet provides for the reimbursement calculation specific to title XVIII, aimed at determining the interim all-inclusive rate of payment for RHC or FQHC services. It details the steps necessary
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How to fill out cms-2552-96

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How to fill out CMS-2552-96

01
Obtain the CMS-2552-96 form from the CMS website or your Medicare administrative contractor.
02
Fill in Section 1 with the identification details of your organization, including the provider number and name.
03
Complete Section 2 to report the cost report period and type of provider.
04
In Section 3, provide financial information including total costs, revenues, and other relevant data.
05
Fill out Section 4 to include any adjustments or allocations required for the reporting period.
06
Complete Section 5 to finalize the report, ensuring all calculations are accurate and consistent.
07
Review the form for completeness and accuracy before submission.
08
Submit the CMS-2552-96 form by the required deadline either electronically or via mail, as specified by CMS.

Who needs CMS-2552-96?

01
Healthcare providers that receive Medicare reimbursement for outpatient medical services.
02
Organizations seeking cost reporting for their Medicare services.
03
Facilities that qualify as rural health clinics or federally qualified health centers.
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CMS-2552-96 is the Medicare Cost Report used by healthcare providers to report costs and statistical data related to their services to the Centers for Medicare & Medicaid Services (CMS).
Healthcare providers that receive Medicare reimbursements, particularly those offering hospital services, are required to file CMS-2552-96.
To fill out CMS-2552-96, providers must carefully gather financial data regarding costs, patient statistics, and revenue, then complete the various sections of the form as specified in the CMS instructions, ensuring accuracy and compliance with reporting requirements.
The purpose of CMS-2552-96 is to establish a standardized method for healthcare providers to report their costs, which aids in determining the reimbursement rates and ensure proper allocation of Medicare funds.
Information required on CMS-2552-96 includes provider identification, financial data such as costs and expenses, statistical data about patient services, and revenue information to substantiate costs reported.
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