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This document outlines the worksheet A - reclassification and adjustment of trial balance of expenses, detailing the methods of determining costs payable under title XVIII, providing for recording

How to fill out cms 2552-96

How to fill out CMS 2552-96

1. Obtain a copy of the CMS 2552-96 form from the CMS website or a relevant source.
2. Identify the reporting period for which you are completing the form.
3. Fill out the provider identification section with relevant details such as name, address, and type of facility.
4. Complete the cost report sections, providing accurate financial data, including revenues, expenses, and costs associated with patient care.
5. Input any adjustments or corrections under the designated sections, ensuring documentation is available.
6. Review the instructions for specific line items to ensure all information is accurately captured.
7. Attach any required supporting documentation and schedules as specified in the instructions.
8. Sign and date the completed form and submit it to the appropriate Medicare Administrative Contractor by the deadline.

Who needs CMS 2552-96?

1. Healthcare providers that deliver services reimbursable under Medicare, including hospitals, skilled nursing facilities, and home health agencies.

For pdfFiller’s FAQs

What is CMS 2552-96?

CMS 2552-96 is a form used by Medicare providers to report their costs and the reimbursement they are seeking for services provided under the Medicare program.

Who is required to file CMS 2552-96?

Medicare certified providers of services, including hospitals and skilled nursing facilities, are required to file CMS 2552-96 to receive reimbursement for care provided to Medicare beneficiaries.

How to fill out CMS 2552-96?

To fill out CMS 2552-96, providers must gather financial data, accurately report costs on the form, include necessary supporting documentation, and ensure compliance with Medicare guidelines before submitting it to the appropriate fiscal intermediary.

What is the purpose of CMS 2552-96?

The purpose of CMS 2552-96 is to calculate and report the allowable costs incurred by Medicare providers for providing care to beneficiaries, facilitating the determination of reimbursement amounts.

What information must be reported on CMS 2552-96?

CMS 2552-96 requires reporting information such as facility costs, patient counts, etc. It includes sections for organizational structure, cost reporting, salaries, and additional financial data necessary for reimbursement calculations.