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Home » How To... » Reconciliation » Complete Step 7: Review Final Costs

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How To Complete Step 7: Review Final Costs - New 05/10/2007

The following document refers to reconciliation and provides questions and answers regarding Step 7.  This section contains information about who may complete the steps, when and how the steps should be completed and other information related to reconciliation. This document includes information about the following:

• What is the purpose of Step 7: Review Final Costs?
• When can Plan Sponsors begin Step 7: Review Final Costs?
• Who is allowed to complete Step 7: Review Final Costs?
• How can I tell if Step 7: Review Final Costs has been completed?
• Can Step 7: Review Final Costs be undone after it is completed?
• What happens after Step 7: Review Final Costs is completed?
• What if there are multiple cost reporting sources?
• What if I do not agree with the submitted cost reports?
• Can a cost report be rejected?
• Is there a way to undo the rejection of a cost report?
• What if Step 7: Review Final Costs was previously completed and new cost data is received?
• Must the Plan Sponsor complete the review of all benefit options in one session?
• How does a Plan Sponsor complete Step 7: Review Final Costs?
• Is there a quick way to complete Step 7: Review Final Costs if the Review Final Costs summaries match the expected summary report figures?
• How is detailed cost data for a benefit option examined?
• How are final costs rejected and how is the rejection undone if only one reporting source has submitted final costs for the benefit option?
• How are final costs rejected and how is the rejection undone if multiple reporting sources submitted final costs for the benefit option?

What is the purpose of Step 7: Review Final Costs?

The purpose of this step is to allow the Account Manager or Designees with the Request Payment privilege to review and confirm all final cost reports for the application. Users may indicate acceptance of all costs at the benefit option level or choose to reject individual cost reports.  Users may also save their cost review and return at a later time to complete Step 7. Users must indicate when their review of costs for a benefit option is complete. Step 7 may be completed only when final cost reports for all benefit options have been marked as "Review Complete."

When can Plan Sponsors begin Step 7: Review Final Costs?

Step 7 cannot be started until Step 1 through Step 6 has been completed. Step 7 must be marked "Complete" on the Reconciliation Checklist to proceed to the remaining steps.

Who is allowed to complete Step 7: Review Final Costs?

Step 7 can only be completed by the Account Manager or the Designee with the Request Payment privilege.  The Authorized Representative will have View Only access to this step.

How can I tell if Step 7: Review Final Costs has been completed?

The Reconciliation Checklist displays as follows:

• Step 7 is marked with a green check to indicate that the step is complete and Step 8is marked with a blue arrow to indicate that it is the next step.
• The status of Step 7 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 remain "Reconciliation Cost Reporting Closed."

Can Step 7: Review Final Costs be undone after it is completed?

Yes. Step 7 can be revisited until Step 12 is completed.  Step 8 through Step 11 will be marked "Incomplete" as a result of changing Step 7, even if they were previously marked "Complete."

What happens after Step 7: Review Final Costs is completed?

After Step 7 has been completed, the Account Manager or the Designee with the Request Payment privilege may proceed to Step 8.  The application status remains "Reconciliation Cost Reporting Closed."

What if there are multiple cost reporting sources?

The Review Final Costs page shows the total of the cost data received at the application and benefit option level.  Cost reports from all sources are included in those totals.  The user must select View Costs in order to view cost reports, reject cost reports or undo rejected cost reports. 

What if I do not agree with the submitted cost reports?

The final cost reports may be rejected or replaced.  For more information about how to reject the submitted cost reports, go to: Can a cost report be rejected?  For more information about how to replace the submitted final cost reports, go to: How To Complete Step 6: Manage Submission of Final Cost Reports.

Can a cost report be rejected?

Yes. A cost report from a specific source within a benefit option may be rejected by selecting the Review Costs link on the Review Final Costs page.  The Account Manager or Designee with the Request Payment privilege, by selecting Allow Cost Reporting in Step 6, may then allow Cost Reporters to submit corrected costs.  For detailed instructions about rejecting cost reports go to:  How are final costs rejected and how is the rejection undone if only one reporting source has submitted final costs for the benefit option? and:  How are final costs rejected and how is the rejection undone if multiple reporting sources submitted final costs for the benefit option?

Is there a way to undo the rejection of a cost report?

Yes.  For detailed instructions about undoing the rejection of a cost report, go to: How are final costs rejected and how is the rejection undone if only one reporting source has submitted final costs for the benefit option? and:  How are final costs rejected and how is the rejection undone if multiple reporting sources submitted final costs for the benefit option?

What if Step 7: Review Final Costs was previously completed and new cost data is received?

New cost data may be received that replace the previously reported final cost data if Allow Reporting in Step 6 is selected.  If Step 7 was previously completed, there will be an attention icon (red exclamation point) next to the benefit options for which there are new cost data. 

Must the Plan Sponsor complete the review of all benefit options in one session?

No.  The Review Complete indicator may be saved and changed until Step 7 is complete. The Plan Sponsor may revisit Step 7 as often as necessary to validate the final cost data.  Please note that Step 7 and all subsequent steps must be completed before the application's reconciliation deadline.

How does a Plan Sponsor complete Step 7: Review Final Costs?

1. Log into the RDS Secure Web Site.

   

2. The Plan Sponsor List With Application Summary page displays.
3. Select the appropriate Plan Sponsor ID link.  The Application List page displays. 

   

4. From the Application List page, find the Application Number to reconcile. To access reconciliation, select Reconciliation from the Actions dropdown and select Go.

   

5. The Reconciliation Checklist displays. Select Step 7: Review Final Costs.

   

6. The Step 7: Review Final Costs page displays. 

   

7. Two tables are displayed on this page.  The Plan Year Application Summary table displays the total current, old, and net costs reports for the entire application.  The Benefit Option Summary table displays the current, old, and net subsidy dollars for each benefit option included in the application.  For more detailed cost data for each benefit option, select the Review Cost action.

   

1. The Benefit Option Cost Review page displays.

   

2. There are three tables on the Benefit Option Cost Review page. The Benefit Option Cost Report List shows status, last action date, cost report last submitted, and current allowable retiree costs for each source reporting costs for the selected benefit option. The Plan Year Benefit Option Summary table displays the current, old, and net cost data and subsidy dollars for the selected benefit option for the entire plan year. The Monthly Benefit Option Summary table displays the current, old, and net cost data and subsidy dollars for the selected benefit option by month.
3. If there are multiple cost reports for the benefit option, choose the Review/Reject Costs action from the Benefit Option Cost Report List to view the specific cost report details and to initiate the reject and undo reject cost report actions for a specific cost report.

   

1. The Benefit Option Final Cost Report page displays.  Review the Cost Report and select either Reject or Return to Benefit Option Cost Review.

   

2. The Benefit Option Cost Review page displays.  If Reject was selected, the status in the Benefit Option Cost Report List table is "Rejected."

   

4. When there is only one benefit option, select either Reject, Complete Benefit Option Review, or Return to Review Final Costs.
8. Review the cost data for each benefit option. Check the Review Complete column for each benefit option to indicate that the review is complete.  The Check All or Uncheck All buttons are available for convenience.  Save the benefit options that have been checked if returning to this page at a later date is necessary.

   

9. After the review is complete for all benefit options, select Complete Review.  To return to the Reconciliation Checklist without saving changes, select Cancel.

   

10. The Step 7: Review Final Cost Complete Review Verification page displays.  Select Confirm to indicate that the review of final costs is complete.  Select Cancel to return to the Step 7: Review Final Costs page.

    

11. The Step 7: Review Final Cost Complete Review Confirmation page displays.  Select Continue to proceed to the Reconciliation Checklist.

    

12. The Reconciliation Checklist displays.  The status of Step 7: Review Final Costs changes to "Complete" and the Last Updated Date and Last Updated By fields are updated accordingly. Step 7 is marked with a green check to indicate that the step is complete and Step 8 is marked with a blue arrow to indicate that it is the next step.

    

Is there a quick way to complete Step 7: Review Final Costs if the Review Final Costs summaries match the expected summary report figures?

Yes.  It is expected that the Plan Sponsor will have internal supporting drug cost details and summarized data that validates all final costs being reported.  Furthermore, it is expected that the Plan Sponsor will compare the summarized data with the final cost reports that have been submitted to ensure that the final costs that could be included in the reconciliation payment request are accurate.  If the figures in the summary tables on the initial screen match the figures on the Plan Sponsor's summarized data, a detailed review of all final cost reports is not necessary to complete Step 7. 

To complete Step 7 in instances where a detailed review of all final cost reports is not necessary:

1. Select Step 7: Review Final Costs from the Reconciliation Checklist. (For directions on how to log into the RDS Secure Web Site and navigate to the Reconciliation Checklist, go to: How does a Plan Sponsor complete Step 7: Review Final Costs?)

   

2. The Step 7: Review Final Costs page displays. The Review Complete checkbox will display unchecked for each benefit option. After confirming the accuracy of the final cost data, select Check All to indicate that the final cost review is complete for all benefit options. 

   

3. The Review Complete checkbox will appear checked for all benefit options and the Complete Review button will become enabled. Select Complete Review to proceed with completing Step 7.

   

4. The Step 7: Review Final Cost Complete Review Verification page will display. Select Confirm to complete the review of final costs for the application and complete Step 7.  Note:  Negative amounts are indicated in parentheses with red font. 

   

5. The Step 7: Review Final Cost Complete Review Confirmation page will display. Select Continue to return to the Reconciliation Checklist.

   

6. The Reconciliation Checklist displays.  The status of Step 7: Review Final Costs changes to "Complete" and the Last Updated Date and Last Updated By fields are updated accordingly. Step 7 is marked with a green check to indicate that the step is complete and Step 8 is marked with a blue arrow to indicate that it is the next step.

   

How is detailed cost data for a benefit option examined?

1. Select Step 7: Review Final Costs from the Reconciliation Checklist. (For directions on how to log into the RDS Secure Web Site and navigate to the Reconciliation Checklist, go to: How does a Plan Sponsor complete Step 7: Review Final Costs?)

   

2. Step 7: Review Final Costs page displays. Two tables are displayed on this page.  The Plan Year Application Summary table displays the total current, old, and net cost reports for the entire application.  The Benefit Option Summary table displays the current, old, and net subsidy dollars for each benefit option included in the application.  Select the Review Costs action to examine detailed cost data reported for a benefit option.

   

3. The Benefit Option Cost Review page displays.
1. There are three tables on the Benefit Option Cost Review page.  The Benefit Option Cost Report List shows status, last action date, cost report last submitted, and current allowable retiree costs for each source reporting costs for the selected benefit option. The Plan Year Benefit Option Summary table displays the current, old, and net cost data and subsidy dollars for the selected benefit option for the entire plan year. The Monthly Benefit Option Summary table displays the current, old, and net cost data and subsidy dollars for the selected benefit option by month.   
2. In this example, only one reporting source (the Plan Sponsor) has submitted final costs for the benefit option. The tables on the Benefit Option Cost Review page contain only the final costs figures submitted by the one reporting source. Selecting the View Costs action in the Benefit Option Cost Report List will display the last submitted final cost report reflected as current costs on the Benefit Option Cost Review page.

   

4. If satisfied with the final cost report figures, select Complete Benefit Option Review to indicate that review of final costs is complete for the benefit option. The Step 7: Review Final Costs page will display and the Review Complete checkbox will appear checked for the benefit option.

   Note: The Complete Review button will not become enabled until all benefit options are marked as reviewed.

   

How are final costs rejected and how is the rejection undone if only one reporting source has submitted final costs for the benefit option?

1. Select Step 7: Review Final Costs from the Reconciliation Checklist. (For directions on how to log into the RDS Secure Web Site and navigate to the Reconciliation Checklist, go to: How does a Plan Sponsor complete Step 7: Review Final Costs?)

   

2. The Step 7: Review Final Costs page displays. Two tables are displayed on this page.  The Plan Year Application Summary table displays the total current, old, and net cost reports for the entire application.  The Benefit Option Summary table displays the current, old, and net subsidy dollars for each benefit option included in the application.  The status of all benefit options will display "As Reported." Select the Review Costs action to examine detailed cost data reported for a benefit option.

   

3. The Benefit Option Cost Review page displays. Select Reject to reject the final cost report. Note: The reject button will not appear on the Benefit Option Cost Review page if multiple sources are reporting final costs for the benefit option.

   

4. Alternatively, the cost report may be rejected from the Benefit Option Final Cost Report page. Select View Costs from the Benefit Option Cost Report List to display this page. Next, select Reject to reject the final cost report.

   

5. The Benefit Option Cost Review page will display. The status of the benefit option will appear as "All Reports Rejected." The status of the cost report in the Benefit Option Cost Report List will display "Rejected." Current will display zero amounts. Net will display negative cost figures and negative subsidy amounts if submitted costs for the benefit option were included in an interim payment request.

   Select Complete Benefit Option Review to indicate that the final review of costs is complete for the benefit option and return to the Step 7: Review Final Costs page. Select Return to Review Costs to return to Step 7: Review Final Costs page without marking the Benefit Option Review as "Complete."

   

6. The Step 7: Review Final Costs page will display. The status of the benefit option will display "All Reports Rejected." The Current Subsidy Amount for the benefit option will display a zero amount. Net Subsidy Amount will display a negative amount if subsidy was requested for the benefit option in an interim payment request.

   

   Note: To allow the Cost Reporter to submit additional final cost reports for the application, please return to Step 6 and select Allow Reporting. After reporting is allowed, all Cost Reporters for the application will be once again permitted to submit final costs. 

7. If the cost report was mistakenly rejected, the reject action may be undone. Select the Review Costs action in the Benefit Option Summary table.

   

8. The Benefit Option Cost Review page displays. Select Undo Reject to again include the costs for the benefit option in the final reconciliation request. Note: The Undo Reject button will not appear on the Benefit Option Cost Review page if multiple sources are reporting final costs for the benefit option.

   

9. Alternatively, the reject action may be undone from the Benefit Option Final Cost Report page. To access Benefit Option Final Cost Report page select View Costs from the Benefit Option Cost Summary table. Next, select Undo Reject.

   

10. The Benefit Option Cost Review page will display. The status of the benefit option and the cost report will once again display "As Reported." Current figures will once again display the last submitted final cost data reported for the benefit option. Net figures will display the difference between Current and Old.

    

How are final costs rejected and how is the rejection undone if multiple reporting sources submitted final costs for the benefit option?

1. Select Step 7: Review Final Costs from the Reconciliation Checklist.  (For directions on how to log into the RDS Secure Web Site and navigate to the Reconciliation Checklist, go to: How does a Plan Sponsor complete Step 7: Review Final Costs?)

   

2. The Step 7: Review Final Costs page displays. Two tables are displayed on this page.  The Plan Year Application Summary table displays the total current, old, and net costs reports for the entire application.  The Benefit Option Summary table displays the current, old, and net subsidy dollars for each benefit option included in the application.  The status of all benefit options will display "As Reported." Select the Review Costs action to examine detailed cost data reported for a benefit option.

   

3. The Benefit Option Cost Review page displays. Note: the reject button will not appear on the Benefit Option Cost Review page since multiple sources are reporting final costs for the benefit option. Select Review/Reject Costs from the Benefit Option Cost Report List to display the final cost report submitted by the reporting source.

   

4. The Benefit Option Final Cost Report page displays. Select Reject to reject the final cost report.

   

5. The Benefit Option Cost Review page displays. The status of the cost report will display "Rejected" in the Benefit Option Cost Report List. The status of the Benefit Option will display as "Some Reports Rejected." Current costs will have been recalculated to exclude the rejected cost report. Net will have been recalculated to display the difference between Current and Old. Net may reflect negative costs and a negative subsidy amount if Old Costs exceeds recalculated Current costs.

   Select Complete Benefit Option Review to indicate that the final review of costs is complete for the benefit option and return to the Step 7: Review Final Costs page. Select Return to Review Costs to return to Step 7: Review Final Costs page without marking the Benefit Option Review "Complete."

   

6. The Step 7: Review Final Costs page will display. The status of the benefit option will display "Some Reports Rejected." The Current Subsidy Amount for the benefit option will exclude the rejected report. Net Subsidy Amount may display a negative amount if the Old Subsidy amount exceeds the Current Subsidy Amount.

   

   Note: To allow the Cost Reporter to submit additional final cost reports for the application, please return to Step 6: Manage Submission of Final Cost Reports and select Allow Reporting. After reporting is allowed, all Cost Reporters for the application will be permitted to submit final costs. 

7. If the cost report was mistakenly rejected, the reject action may be undone. Again, select the Review Costs action in the Benefit Option Summary table.

   

8. The Benefit Option Cost Review page displays. Note: the Undo reject button will not appear on the Benefit Option Cost Review page since multiple sources are reporting final costs for the benefit option. Select Review/Reject costs from the Benefit Option Cost Report List to display the final cost report submitted by the reporting source.

   

9. The Benefit Option Final Cost Report page displays. Select Undo Reject to again include the costs for the benefit option in the final reconciliation request.

   

10. The Benefit Option Cost Review page displays. The status of the cost report will once again display "As Reported." Current figures will once again display the last submitted final costs reported for the benefit option. Net figures will display the difference between Current and Old.