4/25/00 Instructions for completing the 1999 RHCF report.
April 25, 2000
Dear Client,
As part of our continuing service, we are enclosing procedures to assist you
in completing the N.Y. State RHCF-IV, annual cost report.
Except as noted otherwise, all reports are produced by program PMGEN.
Instructions are based on the latest version of Part I - Statistical Data.
Print out the census report for each of the 12 months of 1999 before running
the enclosed reports.
Sincerely,
Reliable Health Systems, Inc.
encl.
Page 11, Part 1-3, Lines 10-11(Scr: 1-2-2)
Number of Days of Care
Total Medicaid Days - (Not)/Eligible Part B
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Enter ARGEN2 [AR, 5, 10] from any menu and press ENTER.
Run the report as shown. Items that need adjusting are underlined
Verify (Y/N): N
All Billing Types Level of Care: Budget Ancillary
X Medicaid Medicare Pvt VA Other
=============== ================ ==================
MEDICAID MA MEDICARE MC PRIVATE PVT
===========================================================================
Report on Billing/ Cash Receipt/Outstanding (B/C/O): B
Residents: A - ZZ
Processing Order: S Report Type: G Report Order By: 1
(P)-By Posting Date P- Pat.total R- Regular 1- Resident 2- Date
(S)-By Service Date S- Subtotal G- Grand Ttl 3- Denial# 4- Bill
DATES --- Ancillaries ---
Posted : 01/01/01 12/31/00 Billed/Not Billed: YY No. 9999999
Service: 01/01/99 12/31/99 User ID: ZZZ Bill types:
Logon : 01/01/01 12/31/00 Amounts: -99999.99 99999.99 Ancl.Class:
Billed : 01/01/01 12/31/00 Source (credit) : ZZ Attend Dr.: ZZZ
Record Types : YNYY YY Rec.Type YYYY (Reg./X/V/A) Diag.:
Reg/Coin/Elg/NonElg Bh/Thr Denial No.: 99999 Receiv.From:
Room Category : Z Set to Bill Z Pending: Z
Type : Z Subtype(Mc: 9999
Resident Participation Include in Open Items
Print Only Part. : Credits :
Bill Types(credit): - 99 Overpayment:
Report Header: Print Option: S
The breakdown of days appear on the last line of the report:
GRAND TOTALS 281
ELIG.B DAYS 185
NON ELIG.B DAYS(INCL BH) 96
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Page 11, Part 1-3, Lines 18-21 (scr: 1-2-3)
Bed Reservations established and days
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PATIENT RANGE : A-ZZ
FROM DATE : 01/01/99
TO DATE : 12/31/99
ACTIVITY MASTER : A
ACTIVE A/O : LEAVE BLANK
PRINT OPTION : P
FIELD FROM RANGE TO RANGE SORT
----- ---------- -------- ----
1) 46
2) 47
3) 46 11 20
4) 47 11 20
ALL/ANY : ANY
--------------------------------------------------------------------------
Report Generator
ID PATIENT NAME HOSP BH THER BH HOSP BH THER BH
----- ------------ ------------- ------------ -------------- -------
30888 AGARS,GEORGE HOSP.BH - 09 THER.BH - 02 HOSP.BH - 09
HOSP.BH - 24 HOSP.BH - 24
30004 DOE,SAM HOSP.BH - 07
31005 BETH,SARAH HOSP.BH - 02 HOSP.BH - 02
----- ------------ ------------- ------------ -------------- -------
00003 4 42 1 2 3 35 0
PATIENTS ON MORE THAN ONE BH IN COL.01 1
PATIENTS ON MORE THAN ONE BH IN COL.03 1
The above report provides the answers to the following:
8 ) Bed Reservations: Total = 5 8a) Days = 44 (Hospital + Therapeutic)
8b) Medicaid Bedhold: Total = 35 8c) Days = 0 (Therapeutic)
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Page 13, Part 1-5, Lines 3-10 (Scr: 1-3-1)
Admissions during reporting period
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PATIENT RANGE : A-ZZ
FROM DATE : 01/01/99
TO DATE : 12/31/99
ACTIVITY MASTER : A
ACTIVE A/O : LEAVE BLANK
PRINT OPTION : P
FIELD FROM RANGE TO RANGE SORT
----- ---------- -------- ----
1) 85 1 skip at break - Y
- -----------------
2) 52
ALL/ANY : ALL
---
--------------------------------------------------------------------------
Report Generator
ID PATIENT NAME HOSP TYPE ADMISSION ACTIVITY-DATE
----- ----------------- --------- ------------------ -------------
10234 BEICHLE,E. 01 HOPKIN 04/10/95 04/10/96
10213 BIRUM,STAN 01 HOME 05/01/95 05/01/96
10243 BREWSTER,F 01 HOPKIN 04/03/95 04/03/96
10244 BREWSTER,S 01 HOPKIN 01/24/95 01/24/96
[ 4 ]
10006 BACCHIERI,FAUSTINA 02 JOHN JAY 10/17/95 10/17/96
10009 BEASLEY,RUTH 02 JOHN JAY 10/30/95 10/30/96
10010 BENTLEY,MARY 02 JOHN JAY 11/28/95 11/28/96
[ 3 ]
----- ---------------- --------- ------------------ -----------
00007 7 7 7.00
---------------------------------------------------------------------------
Note : Hosp. Types (01) HOME = 04
(02) HOSPITAL = 3
(03) SNF = 0
(04) HRF = 0
(05) OTHER = 0
(00) FACILITY NOT ENTERED IN HOSPITAL TABLE
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Page 13, Part 1-5, Lines 14-21 (Scr: 1-3-2)
Discharges during reporting period
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PATIENT RANGE : A-ZZ
FROM DATE : 01/01/99
TO DATE : 12/31/99
ACTIVITY MASTER : A
ACTIVE A/O : LEAVE BLANK
PRINT OPTION : P
FIELD FROM RANGE TO RANGE SORT
----- ---------- -------- ----
1) 85 1 skip at break - Y
- -----------------
2) 86
ALL/ANY : ALL
---
---------------------------------------------------------------------------
Report Generator
ID PATIENT NAME HOSP TYPE FINAL DISCH DATE
----- -------------------- --------- -------------------- --------
10008 BALDI,MARIE 00 EXPIRED-HOME2641 08/01/96
[ 1 ]
10011 BERG,ANNA 01 EXPIRED-OUT 559 01/10/96
10213 DIRNDAUM,EVA 01 NO BEDHOLD 93 08/01/96
[ 2 ]
10007 BAKTAY,EMERY 02 BH-RELEASE 5513 11/20/96
[ 1 ]
----- -------------------- --------- -------------------- --------
00004 4 4 4.00
DAYS ON BH PRIOR TO RELEASE FOR COL.02 28
Note : Hosp. Types (01) HOME = 2
(02) HOSPITAL = 1
(03) SNF = 0
(04) HRF = 0
(05) OTHER = 0
(00) FACILITY NOT ENTERED IN HOSPITAL TABLE = 1
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Page 14, Part 1-6, Lines 1-11 (Scr: 1-4-1)
Ages of Patients
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PATIENT RANGE : A-ZZ
FROM DATE : 01/01/99
TO DATE : 12/31/99
ACTIVITY MASTER : M
ACTIVE A/O : 12/31/99 - 12/31/99
PRINT OPTION : P
FIELD FROM TO SORT
----- ---- -- ----
1) 18 M MZ
2) 139 16 20
3) 139 21 54
4) 139 55 64
5) 139 65 69
6) 139 70 74
7) 139 75 79
8) 139 80 84
9) 139 85 89
10) 139 90
ALL/ANY : ANY
MUST INCLUDE FIELD: 1
--------------------------------------------------------------------------
Rerun the same report for females changing the first range to :
FIELD FROM TO SORT
----- ---- -- ----
1) 18 F FZ
--------------------------------------------------------------------------
Note: If there are any resident in your facility in the age
range of 0 - 15 you will need to rerun this report
another 2 times as follows:
FIELD FROM TO SORT
----- ---- -- ----
1) 18 M MZ
2) 139 0 15
FIELD FROM TO SORT
----- ---- -- ----
1) 18 F FZ
2) 139 0 15
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Page 15, Part 1-7, Line 19 (Scr: 1-4-3)
Patients Previously Private
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PATIENT RANGE : A-ZZ
FROM DATE : 01/01/70
TO DATE : 12/31/99
ACTIVITY MASTER : M
ACTIVE A/O : 12/31/99 - 12/31/99
Latest Bill Code : 11
PRINT OPTION : P
FIELD FROM RANGE TO RANGE SORT
----- ---------- -------- ----
1) 53 31
ALL/ANY : ANY
Line 2H = total private patients (line 12) - totals from this report
Totals for other bill types can be found on the December census
Note: If you have multiple Medicaid bill types other than type '11' you
should run this report as follows (and remove the '11' from
Latest Bill Code above):
1) 53 31
2) 120 1 1
ALL/ANY : ALL
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Page 16, Part 1-8, Lines 20-25 (Scr: 1-4-5)
New Admissions Payors
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PATIENT RANGE : A-ZZ
FROM DATE : 01/01/99
TO DATE : 12/31/99
ACTIVITY MASTER : A
ACTIVE A/O : LEAVE BLANK
PRINT OPTION : P
FIELD FROM RANGE TO RANGE SORT
----- ---------- -------- ----
1) 53 11 20
2) 53 * 21 30
3) 53 31 40
4) 53 41
*Facilities that have different codes for MC/Medicaid & MC/Pvt
may add another line to separate them.
ALL/ANY : ANY
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Page 17, Part 1-9, Lines 26-50 (Scr: 1-5-1)
Length of Stay
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From the Patient Information screen enter 10. (length of Stay)
Enter 01/01/99-12/31/99 for the range of dates.
The following is a sample printout.
------------------------------------------------------------------------------
LENGTH OF STAY
ID PATIENT NAME HOSP.TYPE DAYS DISCHARGE INFO.
------ --------------------- --------- ---- ------------------
31029 FOX,SALLY 06 31 EXPIRED-HOME
[ 1 FOR 01 + MONTHS ]
31030 GREENE,TIMOTHY 01 121 NO BEDHOLD
[ 1 FOR 04 + MONTHS ]
------ --------------------- --------- ---- ------------------
2
-------------------------------------------------------------------------------
Note : Each Category is separated by Length of stay and facility
[ 1 FOR 01 + MONTHS ] = 1 patient for the 1+ Month category
[ 1 FOR 04 + MONTHS ] = 1 patient for the 4+ Month category
Hosp Types : 06 - Expired in facility
See (scr: 1-3-1) for other codes
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Page 19, Part 1-10, Lines 1-41 (Scr: 1-6-1)
Patient origin by county
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PATIENT RANGE : A-ZZ
FROM DATE : 12/31/99
TO DATE : 12/31/99
ACTIVITY MASTER : M
ACTIVE A/O : 12/31/99-12/31/99
PRINT OPTION : P
FIELD FROM RANGE TO RANGE SORT
----- ---------- -------- ----
1) 42 1 Skip at Break Y
2) 13 2
3) 10
ALL/ANY : ANY
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