How To Complete Step 12: Review And Submit Reconciliation Payment Request - UPDATED 12/19/08
This document includes information about the following:
- What is the purpose of Step 12: Review and Submit Reconciliation Payment Request?
- When can Plan Sponsors begin Step 12: Review and Submit Reconciliation Payment Request?
- Who is allowed to complete Step 12: Review and Submit Reconciliation Payment Request?
- How can I tell if Step 12: Review and Submit Reconciliation Payment Request has been completed?
- Can Step 12: Review and Submit Reconciliation Payment Request be undone after it has been completed?
- What happens after Step 12: Review and Submit Reconciliation Payment Request is completed?
- How long will it take for a payment to be made?
- What if the Authorized Representative does not agree with the cost summary?
- Must Step 12: Review and Submit Reconciliation Payment Request be completed all at once or can the Authorized Representative finish it later?
- What if the reconciliation payment request is negative?
- How does a Plan Sponsor complete Step 12: Review and Submit Reconciliation Payment Request?
What is the purpose of Step 12: Review and Submit Reconciliation Payment Request?
The purpose of this step is to allow the Authorized Representative to review and submit or reject the reconciliation final payment request as appropriate.
When can Plan Sponsors begin Step 12: Review and Submit Reconciliation Payment Request?
Step 12 cannot be started until Step 1 through Step 11 has been completed. Please keep in mind the Reconciliation Checklist Step 1 through Step 12 must all be completed before the application's reconciliation deadline.
Note: The Authorized Representative must have been verified and approved by CMS' RDS Center in order to complete Step 12. For more information on the verification process, go to: How To Submit An Authorized Representative Verification Form.
Who is allowed to complete Step 12: Review and Submit Reconciliation Payment Request?
Step 12 can ONLY be completed by the Authorized Representative. The Account Manager or Designee with the Request Payment privilege will have View Only access to this step.
How can I tell if Step 12: Review and Submit Reconciliation Payment Request has been completed?
The Reconciliation Checklist displays as follows:
- Step 12 is marked with a green check to indicate that the step is complete.
- The status of Step 12 is 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 Request Completed".
Can Step 12: Review and Submit Reconciliation Payment Request be undone after it has been completed?
No. Step 12 cannot be undone.
If you have not received your reconciliation determination e-mail after Step 12 is "Complete" and you need assistance, contact CMS' RDS Center Help Line.
If you have received your reconciliation determination e-mail, and you need more information regarding an appeal, go to: How To Request Informal Written Reconsideration.
What happens after Step 12: Review and Submit Reconciliation Payment Request is completed?
After the Authorized Representative completes Step 12, the application status will change to "Reconciliation Request Completed". When CMS' RDS Center completes the determination process, the Plan Sponsor will receive an e-mail indicating the status of the request.
How long will it take for a payment to be made?
For information regarding payment requests, go to: How quickly will CMS' RDS Center process reconciliation payments?
What if the Authorized Representative does not agree with the cost summary?
If the cost summary is incorrect, the Authorized Representative must reject the reconciliation payment request using Step 12. Rejecting the reconciliation payment request will require Step 9 through Step 11 to be completed again with any necessary changes. Any changes to the reconciliation payment request must be made by the Account Manager, Designees with the Request Payment privilege, and Cost Reporters.
Must Step 12: Review and Submit Reconciliation Payment Request be completed all at once or can the Authorized Representative finish it later?
To guarantee a correct reconciliation payment request, the Authorized Representative may revisit Step 12 as frequently as needed, before the step is completed, as long as the completion of this step occurs before the reconciliation deadline.
What if the reconciliation payment request is negative?
A negative reconciliation payment request is considered an overpayment. For more information about overpayments, go to: How To Satisfy An Overpayment.
How does a Plan Sponsor complete Step 12: Review and Submit Reconciliation Payment Request?
- 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.
- The Reconciliation Checklist displays. Select Step 12: Review and Submit Reconciliation Payment Request.
- The Step 12: Review and Submit Reconciliation Payment Request page displays. This page contains the Plan Year Application Summary and Benefit Option Summary tables. Please review this information carefully.
- Select View Reconciliation Agreement to view the Reconciliation Agreement in a new window.
- The actions that may be taken after viewing the Reconciliation Agreement are Approve, Reject, or Cancel.
For information about approving, go to: Approve instructions.
For information about rejecting, go to: Reject instructions.
Select Cancel to return to the Reconciliation Checklist without affecting the status of this step.
- Approve
- To approve, click the checkbox to indicate that the warnings and instructions have been read. Select Approve to submit the reconciliation payment request.
- The Step 12: Reconciliation Payment Request Verification page displays. Note: Please review the Reconciliation Agreement carefully.
- The electronic signature of the Plan Sponsor's Authorized Representative is required. Click the checkbox to indicate that you have read and agree to the reconciliation agreement. Select the Security Questions and provide answers. Select Confirm to confirm the reconciliation payment request. Select Cancel to return to the Step 12: Review and Submit Reconciliation Payment Request page.
- The Step 12: Reconciliation Payment Request Confirmation page displays. Note: Print this page for your records. The page includes the Plan Year Application Summary table and EFT Information. Select Continue to proceed to the Reconciliation Checklist.
- The Reconciliation Checklist displays. The status of all steps are marked "Complete" and the Last Updated Date and Last Updated By fields are updated accordingly. All steps are marked with a green check to indicate that the steps are complete.
- Reject
- To reject, click the checkbox on the Step 12: Review and Submit Reconciliation Payment Request page to indicate that the warnings and instructions have been read. Select Reject to reject the reconciliation payment request.
- The Step 12: Reject Prepared Reconciliation Payment Request page displays. Select Confirm to indicate that the reconciliation payment request is rejected. Select Cancel to return to the Step 12: Reconciliation Payment Request page.
Note: Rejecting the reconciliation payment request will require Step 9 through Step 11 to be completed again with any necessary changes. Any changes to the reconciliation payment request must be made by the Account Manager, Designees with the Request Payment privilege, and/or Cost Reporters.
- The Step 12: Reconciliation Reject Confirmation page displays. Select Continue to proceed to the Reconciliation Checklist.
- The status of Step 9 through Step 11 changes to "Incomplete" and the Last Updated Date and Last Updated By fields are updated accordingly. Step 9 is marked with a blue arrow to indicate that it is the next step.
