How To Complete Step 8: Enter Revisions To Final Costs - Updated 04/08/2008
This document includes information about the following:
- What is the purpose of Step 8: Enter Revisions to Final Costs?
- When can Plan Sponsors begin Step 8: Enter Revisions to Final Costs?
- Who is allowed to complete Step 8: Enter Revisions to Final Costs?
- How can I tell if Step 8: Enter Revisions to Final Costs has been completed?
- Can Step 8: Enter Revisions to Final Costs be undone after it is completed?
- What happens after Step 8: Enter Revisions to Final Costs is completed?
- Should Plan Sponsors wait until Step 8: Enter Revisions to Final Costs, is fully operational, before they start reconciliation?
- What if I have revisions and the feature is not available yet within Step 8: Enter Revisions to Final Costs?
- How should a Plan Sponsor complete Step 8 when the Plan Sponsor has already used Step 6 to coordinate individual retiree cost data and/or account for rebates and price concessions directly from a drug manufacturer?
- What are acceptable reasons to revise final costs?
- How should an individual retiree's cost data be coordinated?
- How does a Plan Sponsor complete Step 8: Enter Revisions to Final Costs?
What is the purpose of Step 8: Enter Revisions to Final Costs?
The purpose of this step, if and when it becomes fully operational, will be for the Account Manager or Designee with the Request Payment privilege to enter any necessary revisions on behalf of the Plan Sponsor, to the summarized final cost data as a result of the coordination of individual retiree cost data, and account for rebates or other price concessions directly from a drug manufacturer (that the Cost Reporter was not aware of).
Although the step must be completed, the ability to enter cost revisions through Step 8 is not available at this time. Therefore, coordinating individual beneficiaries' threshold and limit reductions must be reported through Step 6: Manage Submission of Final Cost Reports, as must rebates and other price concessions directly from a drug manufacturer to the Plan Sponsor. For more information on how to use Step 6 for this purpose, go to: What if I have revisions and the feature is not available yet within Step 8: Enter Revisions to Final Costs?
To report direct rebates or coordinate individual retiree costs, Plan Sponsors may have their plans and/or vendors incorporate the coordinated data into their final cost reports. If there is coordination of individual retiree cost data, or direct rebates or other price concessions not reflected in the final cost reports, Plan Sponsors may submit alternative final cost reports that reflect the corrected values.
An alternative to reporting coordinated individual retiree costs is for the Plan Sponsors to submit a separate cost report to the RDS Center for those retirees requiring individual coordination. Cost data for those specific retirees must be removed from all other cost reports, and those retirees coordinated cost data (not adjusted data) would be reported separately using a "new" cost report.
Please Note:
- Aggregated cost data for reconciliation is reported by benefit option by month incurred. Plan Sponsors are reminded that allowable retiree costs are determined at the retiree level, and records need to be retained showing how data submitted in the cost reporting process is determined.
- When reporting final cost data from different sources, cost data will be added together.
- Previously submitted final cost reports may need to be zeroed out for the affected benefit options.
For more information on submitting final cost reports, go to: How to Submit Final Cost Data.
When can Plan Sponsors begin Step 8: Enter Revisions to Final Costs?
Step 8 cannot be started until Step 1 through Step 7 has been completed. Although Step 8 is not fully functional, Step 8 must be marked "Complete" on the Reconciliation Checklist to proceed to the remaining steps.
Who is allowed to complete Step 8: Enter Revisions to Final Costs?
Step 8 can only be completed by the Account Manager or Designees with the Request Payment privilege. The Authorized Representative will have View Only access to this step.
How can I tell if Step 8: Enter Revisions to Final Costs has been completed?
The Reconciliation Checklist displays as follows:
- Step 8 is marked with a green check to indicate that the step is complete and Step 9 is marked with a blue arrow to indicate that it is the next step.
- The status of Step 8 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 8: Enter Revisions to Final Costs be undone after it is completed?
Yes. However, the question asked within Step 8, "Do you have revisions to make?" should be answered "No" because revisions to final costs must and can be accounted for in Step 6. If the answer is changed from "No" to "Yes," then Step 9 through Step 11 will be marked "Incomplete" as a result of this change, even if these steps were previously marked "Complete." In such cases, the EFT information already entered in Step 10 will remain, but will have to be verified if correct, or changed if incorrect.
What happens after Step 8: Enter Revisions to Final Costs is completed?
The remaining steps may be completed if Step 8 is complete by indicating that no revisions are required. The status of the application will remain "Reconciliation Cost Reporting Closed."
Should Plan Sponsors wait until Step 8: Enter Revisions to Final Costs, is fully operational, before they start reconciliation?
No. Unless and until Step 8 becomes fully operational, Plan Sponsors with final cost revisions must address these revisions by adjusting and resubmitting final cost reports. Please keep in mind that the application status must be "Reconciliation Cost Reporting Opened" to enable Cost Reporters to access the Final Costs action for data entry and for final mainframe cost data to be accepted. Revising cost data in this manner eliminates the need to revise cost data using Step 8. For instructions on how to revise cost data in this manner, go to: What if I have revisions and the feature is not available yet within Step 8: Enter Revisions to Final Costs?
What if I have revisions and the feature is not available yet within Step 8: Enter Revisions to Final Costs?
If there is coordination of individual retiree cost data, or direct rebates or other price concessions are not reflected in the final cost reports, Plan Sponsors must resubmit cost reports to reflect the changed values. To enable Cost Reporters to submit or resubmit cost reports select Allow Reporting using Step 6. Next, if necessary, update Payment Setup using Step 2 to add Report Costs privileges to the Account Manager or Designee. Finally, use the Final Cost action on the Application List page to add the adjusted cost report that reflects the net effect of the changes made to the previously rejected cost reports.
How should a Plan Sponsor complete Step 8 when the Plan Sponsor has already used Step 6 to coordinate individual retiree cost data and/or account for rebates and price concessions directly from a drug manufacturer?
Plan Sponsors may complete the step by selecting No, then selecting Submit.
What are acceptable reasons to revise final costs?
Revising cost data by returning to Step 6: Manage Submission of Final Cost Reports, is necessary only if one or more of the following conditions apply:
- Multiple sources are reporting cost data for a single benefit option within the same application, and the final cost reports do not already coordinate cost data among the different sources for individual retirees.
- Individual retirees are enrolled in more than one benefit option during the same time period within the same application, and the final cost reports do not already coordinate cost data among the different benefit options for individual retirees.
- Individual retirees are enrolled in more than one benefit option within the same application, the time periods do not overlap, and final cost reports do not already coordinate cost data among the different benefit options for individual retirees.
- Individual retirees are enrolled in one benefit option within the same application for two or more separate subsidy periods and final cost reports do not already coordinate cost data for the different subsidy periods for individual retirees.
- A Plan Sponsor who has not accounted for, in final cost reports, direct rebates or other price concessions from one or more drug manufacturers.
The ability to enter revisions to final cost data by using Step 8 is currently unavailable; revisions must be accommodated by using final cost reporting. For more information, go to: What if I have revisions and the feature is not available yet within Step 8: Enter Revisions to Final Costs?
How should an individual retiree's cost data be coordinated?
The cost threshold and cost limit are applied to each retiree's cost data at the application level. If multiple sources are reporting cost data for a single retiree or a retiree has more than one subsidy period within an application, then the retiree's cost data MUST be coordinated across all sources or benefit options within the application. For more information about the coordination of retiree cost data, go to: How should coordination of individual retiree cost data be handled?
Plan Sponsors must account for rebates or other price concessions directly from one or more drug manufacturers by revising the final cost reports if the final cost reports do not already incorporate these cost adjustments.
How does a Plan Sponsor complete Step 8: Enter Revisions to Final Costs?
- 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 8: Enter Revisions to Final Costs.
- The Step 8: Enter Revisions to Final Costs page displays. This page contains the Plan Year Application Summary table.
- Select No and select Submit. To return to the Reconciliation Checklist without affecting the status of this step, select Cancel.
