How To Complete Step 1: Initiate Reconciliation - Updated 03/25/2008
This document includes information about the following:
- What is the purpose of Step 1: Initiate Reconciliation?
- When can Plan Sponsors begin Step 1: Initiate Reconciliation?
- What is the Reconciliation Deadline?
- What is the deadline for Plan Sponsors wishing to only submit one payment request for a given application?
- Who is allowed to complete Step 1: Initiate Reconciliation?
- How can I tell if Step 1: Initiate Reconciliation has been completed?
- Can Step 1: Initiate Reconciliation be undone after it is completed?
- What happens after Step 1: Initiate Reconciliation is completed?
- What must be done if the Plan Sponsor is not ready to start reconciliation?
- How does completing Step 1: Initiate Reconciliation impact cost reporting?
- Can interim payments be requested after Step 1: Initiate Reconciliation is completed?
- How does a Plan Sponsor complete Step 1: Initiate Reconciliation?
What is the purpose of Step 1: Initiate Reconciliation?
The purpose of this step is for the Plan Sponsor to indicate to CMS' RDS Center that they are ready to submit their application for payment settlement. By choosing to complete this step the Authorized Representative or Account Manager is indicating that they are ready to finalize the qualifying covered retiree list and have completed all financial accounting for beneficiary costs and actual cost adjustments (e.g., discounts, chargebacks, rebates, and similar price concessions) for this application. This step can only be completed after an application's plan year has ended. After this step is complete CMS' RDS Center will no longer accept interim cost reports or interim payment requests. Mainframe final cost reports will not be accepted by CMS' RDS Center until Step 5 is completed. Data entry of final cost reports will not be permitted until Step 5 is completed. Mainframe submissions that are received after completing Step 1 and prior to completing Step 5 will display in the audit trail with an error status.
After reconciliation is initiated it may not be undone.
Note: Plan Sponsors that elected an annual RDS payment frequency, or otherwise did not receive any interim payments, and wish to receive a single subsidy payment must use the Reconciliation Checklist to submit the payment request for the application.
When can Plan Sponsors begin Step 1: Initiate Reconciliation?
A Plan Sponsor can begin reconciliation for an application when all of the following conditions are met:
- The application plan year has ended
- The reconciliation deadline has not passed
- The application is in an "Approved" or "Approved Appeal" status
- All prior interim payment requests have either been processed or canceled. Note: The maximum number of interim payment requests do not have to be used before initiating reconciliation
- At least fifteen calendar days have passed from the date of the last payment determination
For more information about what a Plan Sponsor should consider before initiating reconciliation, go to: Reconciliation: What Plan Sponsors Need to Know Before Getting Started and the: Reconciliation Job Aid.
What is the Reconciliation Deadline?
For information about the reconciliation deadline, go to: Important Reconciliation Deadline Information.
What is the deadline for Plan Sponsors wishing to only submit one payment request for a given application?
For information about this deadline, go to: Important Reconciliation Deadline Information.
Who is allowed to complete Step 1: Initiate Reconciliation?
Step 1 can only be completed by the Authorized Representative or the Account Manager. Designees with the Request Payment privilege will have View Only access to this step.
How can I tell if Step 1: Initiate Reconciliation has been completed?
The Reconciliation Checklist displays as follows:
- Step 1 is marked with a green check to indicate that the step is complete and Step 2 is marked with a blue arrow to indicate that it is the next step.
- The status of Step 1 will be marked "Complete" on the Reconciliation Checklist.
- The Last Updated Date and Last Updated By fields are updated accordingly.
- The status of the application will be changed to "Reconciliation Initiated."
Can Step 1: Initiate Reconciliation be undone after it is completed?
No. After Confirm is selected in Step 1, this step cannot be reversed. Therefore, CMS' RDS Center recommends that Plan Sponsors carefully prepare before completing Step 1. For more information about what a Plan Sponsor should consider before initiating reconciliation, go to: Reconciliation: What Plan Sponsors Need to Know Before Getting Started and the: Reconciliation Job Aid.
What happens after Step 1: Initiate Reconciliation is completed?
After Step 1 has been completed, the status of the application will be "Reconciliation Initiated" and Plan Sponsors will be allowed to complete Step 2. While all reconciliation steps can be viewed regardless of completion, the steps for reconciliation must be completed in numerical order.
After Step 1 has been completed, the Plan Sponsor may no longer submit interim cost reports, request interim payments, or appeal an interim payment request for the application.
What must be done if the Plan Sponsor is not ready to start reconciliation?
Plan Sponsors who are not ready to initiate reconciliation should continue to process retiree notification files, send updated retiree files as necessary, and submit interim cost reports and interim payment requests as appropriate. Plan Sponsors should also validate that individual retiree costs are being coordinated for all beneficiaries that have more than one subsidy period, or for whom more than one source is reporting cost data. For more information about the coordination of individual retiree costs, go to: How should coordinated individual retiree cost data be reported?
Plan Sponsors who have not yet initiated reconciliation will still be able to view each step in the Reconciliation Checklist, but will not be able to complete any subsequent steps until Step 1 has been completed.
For more information about what a Plan Sponsor should consider before initiating reconciliation, go to: Reconciliation: What Plan Sponsors Need to Know Before Getting Started and the: Reconciliation Job Aid.
Plan Sponsors should make sure that enough time is allocated to complete all 12 steps of the Reconciliation Checklist prior to the application reconciliation deadline.
How does completing Step 1: Initiate Reconciliation impact cost reporting?
After Step 1 is complete, CMS' RDS Center will no longer accept interim cost reports or interim payment requests. Previously reported interim cost data will be displayed in the audit trail accessible through the Final Costs action and Step 6: Manage Submission of Final Cost Reports. Final cost reports will not be accepted by CMS' RDS Center until Step 5 is completed. Data Entry Cost Reporters will no longer be able to access cost reporting functions within the RDS Secure Web Site until Step 5 is completed. Mainframe cost reports for this application that are submitted after Step 1 is completed will be rejected until Step 5 is completed. Rejected mainframe cost reports will display in the audit trail with an error status.
Can interim payments be requested after Step 1: Initiate Reconciliation is completed?
No. After Step 1 has been completed it cannot be reversed and interim payment requests will no longer be allowed.
How does a Plan Sponsor complete Step 1: Initiate Reconciliation?
- Log into the RDS Secure Web Site.
- The Plan Sponsor List With Application Summary page displays.
- Select the appropriate Plan Sponsor ID link. The Application List page displays.
- From the Application List page, find the Application Number to reconcile. To access reconciliation, select Reconciliation from the Actions dropdown and select Go.
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The Reconciliation Checklist displays.
- Select Step 1: Initiate Reconciliation. The Step 1: Initiate Reconciliation page displays.
- Review the warnings displayed at the top of the page to be sure that the reconciliation process should continue. To return to the Reconciliation Checklist without initiating reconciliation, select Cancel.
- To continue with reconciliation, click the checkbox to indicate that the warnings and instructions have been read.
- To initiate reconciliation, select Submit.
- The Step 1: Initiate Reconciliation Verification page displays. To initiate reconciliation, select Confirm or to return to the Initiate Reconciliation page without completing this step, select Cancel.
- The Step 1: Initiate Reconciliation Confirmation page displays. Reconciliation is successfully initiated. To proceed to the Reconciliation Checklist, select Continue.
- The Reconciliation Checklist displays. The status of Step 1: Initiate Reconciliation changes to "Complete" and the Last Updated Date and Last Updated By fields update accordingly. Step 1 is marked with a green check to indicate that it is complete and Step 2 is marked with a blue arrow to indicate that it is the next step. Additionally, the status of the application will be updated to "Reconciliation Initiated."
