2005 HAR Education and Information Session

Amy Camp, MDHKristin Loncorich,

MDH

Joe Schindler, MHAJonathan Peters, MHA

Updates and Changes for FY 2005

Contract Staffing Section changed to FTE’s and Contract Amounts

Self-Pay Adjustments line added to Section 20 of HAR

Cover Page fields become Auto-Fill

Medicare Advantage to be placed under Medicare Managed Care line in HAR

Stricter auditing of mental health information

Important Conditional Comments included in HAR

Lines that are Auto-Fill

Areas that are highlighted in yellow are now auto-filled

Please ensure that the information that is automatically filled in is accurate.

New Contract Staffing Section

This section was added due to the difficulties hospital preparers reported in collecting contracted staff headcounts.

Numbers and amounts reported in the staffing sections should be hospital only.

New Data Transmission Method Available

Hospitals now can set up an SFTP login with MHA to submit their HAR and other electronic documents Transmission encrypted and secure Both MHA and sender receive confirmation of

delivery More safe and secure than postal mail or e-mail

This new method is highly recommended by MDH and MHA for data transmission

Please contact MHA to setup a login and password

Preparation for Starting the HAR

Records and Reports Prior Year’s HAR Audited Financial Statement Medicare Cost Report Internal Financial Statements PS & R Payroll Records

Divide and Conquer Divide the workload among hospital departments Complete a section a time, not large portions all

at once Spread the work over an extended time frame Don’t procrastinate

Excel Tips and Tools View the HAR as pages instead of as a

spreadsheet “Page Break Preview” option under the view menu “Normal View” will revert it back to the spreadsheet view

Track Changes made to HAR Lines “Track Changes” option under the “Highlight Changes”

option on the “Tools” menu Knowing what numbers were previously entered can be

useful

Find All Feature Alternative to using the Name Box Will display all occurrences in formset at once Select the one that has the EXACT line number listed

Page Break Preview

Using the “Page Break Preview” option can make finding accounts easier

Option is located under “View” on the Menu Bar

To switch back, select “Normal”

Tracking Changes Tracking changes

made to an account could be useful for reference and documentation

To activate, select “Highlight Changes” under the “Track Changes” line on the “Tools” menu

Find All Feature The “Find

All” can be a useful alternative to the name box for finding accounts

To use, select “Find” under the “Edit” menu

Look for the exact number in the “Value” Column

Expense Allocation Methodology

Review previous year’s HAR documentation for allocation methods If they are reasonable, use same methodology Following the same process creates

consistency and comparability.

Medicare Cost Report may provide insight Talk with the MCR preparer Review documentation on MCR, worksheet B

Outpatient ChargesSection 23

Understanding Where Specific Types of Charges are

Reported

Outpatient Registrations Have Continued to Increase

Registrations have increased over 70% from 1994 to 2004

As these numbers increase, so does their relative importance

Outpatient Registration Charges

Often certain types of charges vacillate between this account and Ancillary

Charges relating to physical therapy, rehabilitation, or treatments

Examples include: Physical Therapy Speech Pathology Renal Dialysis Cardiac Rehabilitation

Outpatient Surgery Charges

Simpler Category of Charges

Includes all charges relating to surgical procedures

Examples include: Operating Room Anesthesiology Recovery Room

Outpatient Ancillary Charges

Includes all charges not directly involved in their condition or reason for visit

Examples include: Diagnostic Radiology Lab Charges Supplies and Drugs

Easiest method of calculating is to subtract registration, surgery, and emergency from total outpatient charges

Final Notes on Outpatient Charges

Emergency Room Charges are usually easily identifiable on trial balance

If specific outpatient charges are difficult to determine on trial balance, MCR worksheet C may be of help

Make sure to exclude clinics, home health, and other institutions broken out on the Institution Section from section 23.

Primary Payer Charges and Adjustment

Techniques and Suggestions on Accurate Payer Type

Reporting

Important Notice for Payer Type Reporting

Please make sure to report all Medicare Advantage Charges and

Adjustments under “Medicare Managed Care”, accounts 742

and 842 on the HAR

Tips for Reporting Payer Information

Start from the largest categories and ensure their accuracy before calculating the next level of detail

The hospital’s AFS should provide Medicare and Medicaid charges or percentage in the Notes section

DHS may be able to verify the amount of charges and payments to the hospital for Medicaid

Verifying Accuracy of Payer Information

1. Compare Medicare and Medicaid numbers to AFS notes.

2. Analyze Medicare and Medicaid numbers against MCR and DHS figures.

3. Review specific payer to total account ratios against last year’s ratio.

4. Ensure charges vs. adjustments ratio for a given payer compares to previous year’s ratio.

Contact Information

• MHA staff at (800) 462-5393 or (651) 641-1121

• Jonathan Peters, MHA (651) 659-1422

• Amy Camp, MDH (651) 201-3575

• Kristin Loncorich, MDH (651) 201-3573