60RRBH21R0011 Attachment J.32 Cash Collections Worksheet.xlsx

XLSX spreadsheet 51 KB Posted

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Solicitation 60RRBH21R0011 - RRB Specialty MAC
Solicitation number
60RRBH21R0011
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60RRBH21R0011 Attachment J.1.C Performance Requirements Summary -Revised.docx DOCX document
60RRBH21R0011 Amendment 0002.pdf PDF
60RRBH21R0011 Attachment J.13 CLIN 0004 Cost Proposal Template Option Year Two- Revised.xlsx XLSX spreadsheet
60RRBH21R0011 Attachment J.16 CLIN 0007 Cost Proposal Template Option Year Five- Revised.xlsx XLSX spreadsheet
60RRBH21R0011 RRB SMAC Services- Amendment 0001 Q and A and other changes SF 30.pdf PDF
60RRBH21R0011 Attachment J.7 Basis of Estimate- Revised.xlsx XLSX spreadsheet
60RRBH21R0011 Attachment J.1.C Performance Requirements Summary.docx DOCX document
60RRBH21R0011 Attachment J.14 CLIN 0005 Cost Proposal Template Option Year Three- Revised.xlsx XLSX spreadsheet
60RRBH21R0011 Attachment J.18 CLIN 0009 Cost Proposal Template Option Year Seven- Revised.xlsx XLSX spreadsheet
60RRBH21R0011 Attachment J.15 CLIN 0006 Cost Proposal Template Option Year Four- Revised.xlsx XLSX spreadsheet
60RRBH21R0011 Attachment J.11 CLIN 0002 Cost Proposal Template Base Year- Revised.xlsx XLSX spreadsheet
60RRBH21R0011 Attachment J.33 RRB SMAC Providers by State.xlsx XLSX spreadsheet
60RRBH21R0011 Attachment J.20 CLIN 0011 Cost Proposal Template Option Year Nine- Revised.xlsx XLSX spreadsheet
60RRBH21R0011 Attachment J.12 CLIN 0003 Cost Proposal Template Option Year One- Revised.xlsx XLSX spreadsheet
60RRBH21R0011 Attachment J.17 CLIN 0008 Cost Proposal Template Option Year Six- Revised.xlsx XLSX spreadsheet
60RRBH21R0011 Attachment J.34 RRB Responses to Offeror Questions.xlsx XLSX spreadsheet
60RRBH21R0011 Attachment J.19 CLIN 0010 Cost Proposal Template Option Year Eight- Revised.xlsx XLSX spreadsheet
60RRBH21R0011 Attachment J.1 RRB SMAC SOW- Revised.docx DOCX document
60RRBH21R0011 Attachment J.14 CLIN 0005 Cost Proposal Template Opt Year 3.xlsx XLSX spreadsheet
60RRBH21R0011 Attachment J.17 CLIN 0008 Cost Proposal Template Opt Year 6.xlsx XLSX spreadsheet
60RRBH21R0011 Attachment J.18 CLIN 0009 Cost Proposal Template Opt Year 7.xlsx XLSX spreadsheet
60RRBH21R0011 Attachment J.10 CLIN 0001 Cost Proposal Template- Implementation Services for RRB SMAC.xlsx XLSX spreadsheet
60RRBH21R0011 Attachment J.21 CLIN 0012 Cost Proposal Template Closeout.xlsx XLSX spreadsheet
60RRBH21R0011 Attachment J.16 CLIN 0007 Cost Proposal Template Opt Year 5.xlsx XLSX spreadsheet
60RRBH21R0011 Attachment J.13 CLIN 0004 Cost Proposal Template Opt Year2.xlsx XLSX spreadsheet
60RRBH21R0011 Attachment J.15 CLIN 0006 Cost Proposal Template Opt Year 4.xlsx XLSX spreadsheet
60RRBH21R0011 Attachment J.20 CLIN 0011 Cost Proposal Template Opt Year 9.xlsx XLSX spreadsheet
60RRBH21R0011 Attachment J.19 CLIN 0010 Cost Proposal Template Opt Year 8.xlsx XLSX spreadsheet
60RRBH21R0011 Attachment J.3 Small Business Subcontracting Plan.docx DOCX document
60RRBH21R0011 Attachment J.8 Past Performance Questionnaire.doc DOC document
60RRBH21R0011 Attachment J.27 Compliance Attestation.docx DOCX document
60RRBH21R0011 Attachment J.23 Non-Disclosure Statement.docx DOCX document
60RRBH21R0011 Attachment J.11 CLIN 0002 Cost Proposal Template Base Year.xlsx XLSX spreadsheet
60RRBH21R0011 Attachment J.29 Contractor Furnished Property.docx DOCX document
60RRBH21R0011 Attachment J.2 RRB SMAC Deliverable Schedule.docx DOCX document
60RRBH21R0011 Attachment J.25 Information Security Attestation.docx DOCX document
60RRBH21R0011 Attachment J.1.A Fee-For-Service Shared System Base Functions.docx DOCX document
60RRBH21R0011 Attachment J.4 Billing Instructions.docx DOCX document
60RRBH21R0011 Attachment J.6 Award Fee Plan Template.docx DOCX document
60RRBH21R0011 Attachment J.30 CMS Sec and Priv Language for Info Tech Procurements.docx DOCX document
60RRBH21R0011 Attachment J.28 HHS Contracting Guide for Contract of Government Property.docx DOCX document
60RRBH21R0011 Attachment J.1.B SOW Appendices.docx DOCX document
60RRBH21R0011 Attachment J.12 CLIN 0003 Cost Proposal Template Opt Year1.xlsx XLSX spreadsheet
60RRBH21R0011 Attachment J.24 Proposal Assumptions Template.xlsx XLSX spreadsheet
60RRBH21R0011 Attachment J.10A Cost Template Summary Sheet RRB SMAC.xlsx XLSX spreadsheet
60RRBH21R0011 Attachment J.31 Systems of Records.docx DOCX document
60RRBH21R0011 Attachment J.10B CLIN 0001 Cost Proposal Template- Implementation Services for RRB SMAC.xlsx XLSX spreadsheet
60RRBH21R0011-Sections B-M.docx DOCX document
60RRBH21R0011 Attachment J.26 Corporate Experience Attestation.docx DOCX document
60RRBH21R0011 Attachment J.7 Basis of Estimate.xlsx XLSX spreadsheet
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Allowance

Contractor Name:LEGENDExhibit 1
Warning: There could be an issue but there may not be.
Period Ending:Issue: There is an issue such as missing data that needs to be resolved.
This cell requires manual input
Allowance for Uncollectible Accounts Matrix
NONFEDERAL-HI-MSP-CM-Registers-TOTALNONFEDERAL-HI-NONMSP-CM-Registers-TOTALNONFEDERAL-SMI-MSP-CM-Registers-TOTALNONFEDERAL-SMI-NONMSP-CM-Registers-TOTALNONFEDERAL-GEN-MSP-CM-Registers-TOTALNONFEDERAL-GEN-NONMSP-CM-Registers-TOTALNONFEDERAL-NA-NA-CM-TROR-TOTAL
Col ECol FCol GCol HCol ICol J
HI PrincipalHI PrincipalSMI PrincipalSMI PrincipalGeneral FundGeneral FundFundTROR
Note: Amounts are from the TROR Supporting ReportsMSPNON-MSPMSPNON-MSPMSPNON-MSPTotalReportCheck
TROR Line ItemHIGLAS Detail Activity Report/Register Line
A(1) Beginning FY BalanceCMS Beginning Balance Report / (1) Beginning FY Balance00717,471,68039156,9497,628,7397,628,7381
(2) New Receivables (+)CMS Transaction Register / LINE 2 NEW RECEIVABLES00012,715,5710012,715,57112,715,5710
(3) Accruals (+) (New Interest Receivables)2180,186180,188180,1880
Transaction Register (support line 3)CMS Transaction Register / LINE 3 ADJUSTMENT056,23556,235
CMS Adjustment Register (support line 3)CMS Adjustment Register / LINE 3 MSP/NONMSP ADJUSTMENT2123,951123,953
(5) Adjustments00263.000(189,677)12118,428(170,865)(170,865)0
(A) Reclassified/Adjusted Amounts (+ or -)CMS AR Adjustments Register / LINE 5A MSP/NONMSP ADJUSTMENT000(538,772)0(612)0(539,384)(539,383)-1
(B) Adjustments Due to Sale of Assets (+ or -)CMS AR Adjustments Register / LINE 5B MSP/NONMSP ADJUSTMENT0000000000
(C) Consolidations (+ or -)CMS AR Adjustments Register / LINE 5C MSP/NONMSP ADJUSTMENT0000000000
(D) Forcloser Adjustments (+ or -)CMS AR Adjustments Register / LINE 5D MSP/NONMSP ADJUSTMENT000000000
(E) Written-Off Debts Reinstated for Collections (+)CMS AR Adjustments Register / LINE 5E MSP/NONMSP ADJUSTMENT00263.000349,09512119,040368,519368,5181
(6) Amounts Written-Off (-)000(1,036,986)0(71,781)(1,108,767)(1,108,767)0
(A) Currently Not Collectible (-)CNC - CMS Adjustment Register / LINE 6A MSP/NONMSP ADJUSTMENT000(833,953)0(71,117)0(905,070)(905,070)0
(B) Written-Off and Closed Out (-)CMS AR Adjustments Register / LINE 5E MSP/NONMSP ADJUSTMENT000(203,033)0(664)0(203,697)(203,697)0

Receivable Available to Be Collected 0 0 334.000 18,960,588 162 283,782 19,244,866 19,244,865 1

B(4) Collections on Receivables (-)CMS AR Applied Collections00263.00010,786,07412170,61110,857,06910,857,0690
(A) At Agency000(10,606,769)0(43,429)(10,650,198)(10,650,198)0
(B) At Third Party000000000
(C) Asset Sales000000000
(D) Collections by Treasury through Offset and Cross-Servicing (-)00(263)(179,305)(121)(27,182)(206,871)(206,870)-1
(E) Collections by Sales After Foreclosure (-)000000000
(F) Collections by Department of Justice (-)000000000
(G) Other - must footnote (-)000000000

Collection Percentage n/a n/a 78.74% 56.89% 74.69% 24.88% 56.42% 56.42%

C Allowance Percentage (1-collection %) n/a n/a 21.26% 43.11% 25.31% 75.12% 43.58% 43.58%

DAverage of Allowance (current instruction require Medicare contractors to use five year historical allowance rate
Averagen/an/a16.31%20.03%25.31%75.12%
Current Period: Dec 31, 2010n/an/a21.26%43.11%
Sep 30, 20100.00%0.00%20.00%15.00%
Sep 30, 20090.00%0.00%10.00%12.00%
Sep 30, 20080.00%0.00%14.00%10.00%
Sep 30, 2007n/an/an/an/a
E(7) Ending Balance (TROR/Activity Registers)CMS AR Overpayments Report0008,174,5140213,16908,387,6838,387,795112
Cost Report Settlements000000000
Claims Accounts Receivable000000000
Credit Balances000000000
Other (if cost reports issues included with cost reports)000000000
Physician/Supplier0008,129,9310213,1698,343,1008,343,1000
Beneficiary00044,5830044,58344,5830
PIP Accrual000000000
GHP (Data/non-Data Match)000000000
MSP Prov/Phys/Supp/Bene000000000
MSP Beneficiary (Liability)000000000
Other MSP (Liability)000000000
Check00(71)0-41(2)-114-1-113

(X1) Allowance Amount (Collection Percentage) n/a n/a 0 1,637,216 0 160,128 1,797,344

(X2) Individual Account Analysis-Not Applicable for Carriers (Part B) *************************************** CMS has granted a Waiver for Carriers **************************************

(X3)Delinquencies Exceeding 180 DaysCMS AR Overpayment Report where parameter "Allowance Calc(Over 180 Days Delinquent))"=Y0002,750,3140165,4362,915,7502,915,7491
Cost Report Settlements[180]00000000- 0
Claims Accounts Receivable[180]00000000- 0
Credit Balances[180]00000000- 0
Other (if cost reports issues included with cost reports)[180]00000000- 0
Physician/Supplier[180]0002,749,7900165,4362,915,2262,915,2251
Beneficiary[180]00052400524524- 0
PIP Accrual[180]00000000- 0
GHP (Data/non-Data Match)[180]00000000- 0
MSP Prov/Phys/Supp/Bene[180]00000000- 0
MSP Beneficiary (Liability)[180]00000000- 0
Other MSP (Liability)[180]00000000- 0

F Estimated Allowance Amount ALLOWANCE USING THE MOST CONSERVATIVE AMOUNT 0 0 0 2,750,314 0 165,436 2,915,750

Amount Reported on Trial Balance per Allowance Matrix (Using the conservative amount):
Amount
HI MSP Allowance Amount0
HI NON-MSP Allowance Amount0
HI Total Allowance0

Fund Acct# 05961 SGL#131901 SGL# 131901 - Allow For Loss on REC-PRINC - 0

SMI MSP Allowance Amount0
SMI NON-MSP Allowance Amount(2,750,314)
SMI Total Allowance(2,750,314)

Fund Acct# 05960 SGL#131901 SGL# 131901 - Allow For Loss on REC-PRINC (2,750,314.00)

General Fund MSP Allowance0
General Fund NON -MSP Allowance(165,436)
General Fund Total Allowance(165,436)

Fund Acct# 050720 SGL#134901 SGL# 134901 - Allow For Loss on REC-INT (165,436.00)

Note: HIGLAS Interest is not split between HI/SMI but MSP/non-MSP. Therefore, contractors shall compare the current interest collection percentage vs. the over 180 days delinquent amounts.

NOTES:

(*) The above amounts are the allowance estimates for loss on receivable for the period-to-date.
(**) Therefore, the estimated amounts are the calculated ending balances to be reported on the Summary 2 Trial Balance by SGL account by fund (Ending Balance Column).
(***) When Line A1, Receivables Available to be Collected by component is less then or equal to zero (0) the component estimated allowance amount must equal zero (0).
(****) When the estimated allowance is greater than the Line 7, Ending Balance (Line E - above by Fund), the reported allowance amount must equal the Line 7, Ending Balance (Line E - above by Fund).

&"Arial,Bold"RFP # 75FCMC21R0002 &"Arial,Bold"&F Allowance

&A &D

Matrix-B MAC

Contractor Name:Exhibit 3
Contractor Number:
Period Ending :
400.14 - Exhibit 14 - Protocol for Estimating Allowance for Uncollectible Accounts
Carrier - Group 2
Allowance for Uncollectible Accounts Matrix
Part B (SMI)
Col. ACol. BCol. CCol. DCol. E
Sub-Group1 (Non-MSP) Claims A/R, Credit Balance & Other Accounts ReceivableHistorical Collection % TotalIndividual Account AnalysisDelinquencies Exceeding 180 days totalEstimated Allowance for Uncollectible A/REstimated Allowance for Uncollectible A/R (Interest Only)Justification for amount recorded on Summary 2 Trial Balance
NONMSP$ 1,637,216$ - 0$ 2,750,314$ 2,750,314$ 165,436

Morgan: CMS:

This Cell(F12) in the old version referenced to the Delinquencies Exceeding 180 Days in the Allowance Tab (cell I69). This was changed to reference cell I83, because the estimated allowance amount could potentially be determined based on the Collection percentage. Row I83 applies the comparison between the available methods and should therefore flow to the Matrix.

Total $ 1,637,216 $ - 0 $ 2,750,314 $ 2,750,314 $ 165,436

Sub-Group 2 (MSP) Group Health Plan (Data-Match & Non-Data Match), LiabilityHistorical Collection % TotalIndividual Account AnalysisDelinquencies Exceeding 180 days totalEstimated Allowance for Uncollectible A/REstimated Allowance for Uncollectible A/R (Interest Only)Justification for amount recorded on Summary 2 Trial Balance
MSP$ - 0$ - 0$ - 0$ - 0$ - 0

Total $ - 0 $ - 0 $ - 0 $ - 0 $ - 0

Historical Collection % TotalIndividual Account AnalysisDelinquencies Exceeding 180 days totalEstimated Allowance for Uncollectible A/REstimated Allowance for Uncollectible A/R (Interest Only)Justification for amount recorded on Summary 2 Trial Balance
Sub-Group 1 (Non-MSP) Claims A/R, Credit Balance & Other Accounts Receivable$ 1,637,216$ - 0$ 2,750,314$ 2,750,314

Morgan: CMS:

This cell(E22) was mapped to D22 in old version, but changed to E12 in the new version to be consistant with Matrix-FI tab.$ 165,436
Sub-Group 2 (MSP) Group Health Plan (Data-Match & Non-Data Match), Liability$ - 0$ - 0$ - 0$ - 0

Morgan: CMS:

This Cell(E23) was mapped to D23 in old version but changed to E17 in new version to be consistant with Matrix-FI tab. $ - 0

Total Part B (SMI) $ 1,637,216 $ - 0 $ 2,750,314 $ 2,750,314 $ 165,436

&"Arial,Bold"RFP 60RRBH21R0011 &"Arial,Bold"Attachment J.32 Cash Collections Worksheet Matrix-B MAC

Data

TROR_LineNONFEDERAL-GEN-MSP-CM-Registers-TOTALNONFEDERAL-GEN-NONMSP-CM-Registers-TOTALNONFEDERAL-NA-NA-CM-Registers-TOTALNONFEDERAL-NA-NA-CM-TROR-COUNTNONFEDERAL-NA-NA-CM-TROR-TOTALNONFEDERAL-SMI-MSP-CM-Registers-TOTALNONFEDERAL-SMI-NONMSP-CM-Registers-TOTAL
(1) Beginning FY Balance39156949309997628738717471680
(2) New Receivables (+)1426331271557112715571
(3) Accruals (+) (New Interest Receivables)180188
(4) Collections on Receivables (-)-10857069
(5) Adjustments5489-170865
(6) Amounts Written-Off (-)27374-1108768
(7) Ending Balance (TROR/Activity Registers)423028387795
(A) At Agency-43429-10650198-10606769
(A) Currently Not Collectible (-)-71117573-905070-833953
(A) Reclassified/Adjusted Amounts (+ or -)-612-539383-538772
(B) Written-Off and Closed Out (-)-66426801-203697-203033
(D) Collections by Treasury through Offset and Cross-Servicing (-)-121-27182-206870-263-179305
(E) Written-Off Debts Reinstated for Collections (+)12119040368518263349095
Beneficiary4458344583
Beneficiary[180]524524
CMS Adjustment Register (support line 3)2123951
GHP(Data/non-Data Match)4111271
GHP(Data/non-Data Match)[180]4111271
Physician/Supplier21316983431008129931
Physician/Supplier[180]16543629152252749790
Transaction Register (support line 3)56235

Changes to calcs

TabCell ChangedChanged FromChanged toChange Rationale
Matrix-CarrierF22D22E12"Estimated Allowance for Uncollectible A/R" should be most conservative estimate of "Delinquencies Exceeding 180 days total" or "Historical Collection % Total".
Matrix-CarrierE23D23E17"Estimated Allowance for Uncollectible A/R" should be most conservative estimate of "Delinquencies Exceeding 180 days total" or "Historical Collection % Total".
Matrix-CarrierF12Allowance!I69Allowance!I83Cell F12 - Estimated Allowance for Uncollectible A/R (Interest Only) – this is referenced to the Delinquencies Exceeding 180 Days in the Allowance Tab (cell I69). This should be referenced into cell I83, because the estimated allowance amount could potentially be determined based on the Collection percentage. Row 83 applies the comparison between the available methods and should therefore flow to the Matrix.
Matrix-FIE22D22E12"Estimated Allowance for Uncollectible A/R" should be most conservative estimate of "Delinquencies Exceeding 180 days total", "Individual Account Analysis" or "Historical Collection % Total".
Matrix-FIE23D22E17"Estimated Allowance for Uncollectible A/R" should be most conservative estimate of "Delinquencies Exceeding 180 days total", "Individual Account Analysis" or "Historical Collection % Total".
Matrix-FIE41D41E31"Estimated Allowance for Uncollectible A/R" should be most conservative estimate of "Delinquencies Exceeding 180 days total", "Individual Account Analysis" or "Historical Collection % Total".
Matrix-FIE42D42E36"Estimated Allowance for Uncollectible A/R" should be most conservative estimate of "Delinquencies Exceeding 180 days total", "Individual Account Analysis" or "Historical Collection % Total".
Matrix-CarrierF12Allowance!I69Allowance!I83Cell F12 - Estimated Allowance for Uncollectible A/R (Interest Only) – this is referenced to the Delinquencies Exceeding 180 Days in the Allowance Tab (cell I69). This should be referenced into cell I83, because the estimated allowance amount could potentially be determined based on the Collection percentage. Row 83 applies the comparison between the available methods and should therefore flow to the Matrix.

&"Arial,Bold"RFP 60RRBH21R0011 &"Arial,Bold"Attachment J.32 Cash Collections Worksheet Changes to calcs

Request_IDs

Original WorkloadCust_ClassReport12/31/2010
99998NONFEDERALAdjLn3rpt11337101
99998NONFEDERALAdjLn5_6rpt11359879
99998NONFEDERALAppCollrpt11337102
99998NONFEDERALAROvrrpt11337104
99998NONFEDERALAROvrrpt[180]11324610
99998NONFEDERALBBrpt11337098
99998NONFEDERALHIGLAS_TROR11341019
99998NONFEDERALTALn2rpt11337099
99998NONFEDERALTALn3rpt11337100

&"Arial,Bold"RFP 60RRBH21R0011 &"Arial,Bold"Attachment J.32 Cash Collections Worksheet Request_IDs

Lookup_Values

CategoryORG NAME
CM12/31/2010
ORGPart B
PartB
PM11/30/2010
PQ9/30/2010
PY12/31/2009
WL99998

HISTORICAL_ALLOWANCES

HISTORICAL_YEARNONFEDERAL-HI-MSP-CM-Registers-TOTALNONFEDERAL-HI-NONMSP-CM-Registers-TOTALNONFEDERAL-SMI-MSP-CM-Registers-TOTALNONFEDERAL-SMI-NONMSP-CM-Registers-TOTAL
20100.20.15
20090.10.12
20080.140.1

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