Identification, Utilization, Statistical Data
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Worksheet Section | Description | Reference |
---|---|---|
Wkst. S, Parts II | Analysis of Renal Dialysis Department Costs | 3650 |
Wkst. S-2 | Direct and Indirect Renal Dialysis Cost Allocation - Statistical Basis | 3650 |
Wkst. S-3, Parts II-III | Analysis of Renal Dialysis Department Costs | 3650 |
Wkst. S-4 | Direct and Indirect Renal Dialysis Cost Allocation - Statistical Basis | 3650 |
Wkst. S-5 | Reasonable Cost Determination for Therapy Service Furnished after April 10, 1998 by | 3650 |
Wkst. S-6 | Direct and Indirect Renal Dialysis Cost Allocation - Statistical Basis | 3650 |
Reclassification And Adjustment Of Trial Balance Of Expenses
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Worksheet Section | Description | Reference |
---|---|---|
Wkst. S, Parts II | Analysis of Renal Dialysis Department Costs | 3650 |
Wkst. S-2 | Direct and Indirect Renal Dialysis Cost Allocation - Statistical Basis | 3650 |
Wkst. S-3, Parts II-III | Analysis of Renal Dialysis Department Costs | 3650 |
Wkst. S-4 | Direct and Indirect Renal Dialysis Cost Allocation - Statistical Basis | 3650 |
Wkst. S-5 | Reasonable Cost Determination for Therapy Service Furnished after April 10, 1998 by | 3650 |
Wkst. S-6 | Direct and Indirect Renal Dialysis Cost Allocation - Statistical Basis | 3650 |
Cost and Cost Allocation
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Worksheet Section | Description | Reference |
---|---|---|
Wkst. I | Analysis of Renal Dialysis Department Costs | 3650 |
Wkst. I | Direct and Indirect Renal Dialysis Cost Allocation - Statistical Basis | 3650 |
Wkst. I | Analysis of Renal Dialysis Department Costs | 3650 |
Wkst. I | Direct and Indirect Renal Dialysis Cost Allocation - Statistical Basis | 3650 |
Wkst. I | Reasonable Cost Determination for Therapy Service Furnished after April 10, 1998 by Outside | 3650 |
Wkst. I | Direct and Indirect Renal Dialysis Cost Allocation - Statistical Basis | 3650 |
Computation of Ratio of Costs to Charges
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Worksheet Section | Description | Reference |
---|---|---|
Wkst. I | Analysis of Renal Dialysis Department Costs | 3650 |
Wkst. I | Direct and Indirect Renal Dialysis Cost Allocation - Statistical Basis | 3650 |
Wkst. I | Analysis of Renal Dialysis Department Costs | 3650 |
Wkst. I | Direct and Indirect Renal Dialysis Cost Allocation - Statistical Basis | 3650 |
Wkst. I | Reasonable Cost Determination for Therapy Service Furnished after April 10, 1998 by Outside | 3650 |
Wkst. I | Direct and Indirect Renal Dialysis Cost Allocation - Statistical Basis | 3650 |
Apportionment of Inpatient Cost (Routine, Ancillary, Capital), Computation of Operating Cost
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Worksheet Section | Description | Reference |
---|---|---|
Wkst. I | Analysis of Renal Dialysis Department Costs | 3650 |
Wkst. I | Direct and Indirect Renal Dialysis Cost Allocation - Statistical Basis | 3650 |
Wkst. I | Analysis of Renal Dialysis Department Costs | 3650 |
Wkst. I | Direct and Indirect Renal Dialysis Cost Allocation - Statistical Basis | 3650 |
Wkst. I | Reasonable Cost Determination for Therapy Service Furnished after April 10, 1998 by Outside | 3650 |
Wkst. I | Direct and Indirect Renal Dialysis Cost Allocation - Statistical Basis | 3650 |
Calculation of Reimbursement Settlement
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Worksheet Section | Description | Reference |
---|---|---|
Wkst. I | Analysis of Renal Dialysis Department Costs | 3650 |
Wkst. I | Direct and Indirect Renal Dialysis Cost Allocation - Statistical Basis | 3650 |
Wkst. I | Analysis of Renal Dialysis Department Costs | 3650 |
Wkst. I | Direct and Indirect Renal Dialysis Cost Allocation - Statistical Basis | 3650 |
Wkst. I | Reasonable Cost Determination for Therapy Service Furnished after April 10, 1998 by Outside | 3650 |
Wkst. I | Direct and Indirect Renal Dialysis Cost Allocation - Statistical Basis | 3650 |
Financial Statements
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Worksheet Section | Description | Reference |
---|---|---|
Wkst. I | Analysis of Renal Dialysis Department Costs | 3650 |
Wkst. I | Direct and Indirect Renal Dialysis Cost Allocation - Statistical Basis | 3650 |
Wkst. I | Analysis of Renal Dialysis Department Costs | 3650 |
Wkst. I | Direct and Indirect Renal Dialysis Cost Allocation - Statistical Basis | 3650 |
Wkst. I | Reasonable Cost Determination for Therapy Service Furnished after April 10, 1998 by Outside | 3650 |
Wkst. I | Direct and Indirect Renal Dialysis Cost Allocation - Statistical Basis | 3650 |
Provider Based Home Health Agency
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Worksheet Section | Description | Reference |
---|---|---|
Wkst. I | Analysis of Renal Dialysis Department Costs | 3650 |
Wkst. I | Direct and Indirect Renal Dialysis Cost Allocation - Statistical Basis | 3650 |
Wkst. I | Analysis of Renal Dialysis Department Costs | 3650 |
Wkst. I | Direct and Indirect Renal Dialysis Cost Allocation - Statistical Basis | 3650 |
Wkst. I | Reasonable Cost Determination for Therapy Service Furnished after April 10, 1998 by Outside | 3650 |
Wkst. I | Direct and Indirect Renal Dialysis Cost Allocation - Statistical Basis | 3650 |
Provider Based Renal Dialysis
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Worksheet Section | Description | Reference |
---|---|---|
Wkst. I | Analysis of Renal Dialysis Department Costs | 3650 |
Wkst. I | Direct and Indirect Renal Dialysis Cost Allocation - Statistical Basis | 3650 |
Wkst. I | Analysis of Renal Dialysis Department Costs | 3650 |
Wkst. I | Direct and Indirect Renal Dialysis Cost Allocation - Statistical Basis | 3650 |
Wkst. I | Reasonable Cost Determination for Therapy Service Furnished after April 10, 1998 by Outside | 3650 |
Wkst. I | Direct and Indirect Renal Dialysis Cost Allocation - Statistical Basis | 3650 |
Provider Based CORF
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Worksheet Section | Description | Reference |
---|---|---|
Wkst. I | Analysis of Renal Dialysis Department Costs | 3650 |
Wkst. I | Direct and Indirect Renal Dialysis Cost Allocation - Statistical Basis | 3650 |
Wkst. I | Analysis of Renal Dialysis Department Costs | 3650 |
Wkst. I | Direct and Indirect Renal Dialysis Cost Allocation - Statistical Basis | 3650 |
Wkst. I | Reasonable Cost Determination for Therapy Service Furnished after April 10, 1998 by Outside | 3650 |
Wkst. I | Direct and Indirect Renal Dialysis Cost Allocation - Statistical Basis | 3650 |
Provider Based Hospice
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Worksheet Section | Description | Reference |
---|---|---|
Wkst. I | Analysis of Renal Dialysis Department Costs | 3650 |
Wkst. I | Direct and Indirect Renal Dialysis Cost Allocation - Statistical Basis | 3650 |
Wkst. I | Analysis of Renal Dialysis Department Costs | 3650 |
Wkst. I | Direct and Indirect Renal Dialysis Cost Allocation - Statistical Basis | 3650 |
Wkst. I | Reasonable Cost Determination for Therapy Service Furnished after April 10, 1998 by Outside | 3650 |
Wkst. I | Direct and Indirect Renal Dialysis Cost Allocation - Statistical Basis | 3650 |
Computation of Medicare Capital Payment
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Worksheet Section | Description | Reference |
---|---|---|
Wkst. I | Analysis of Renal Dialysis Department Costs | 3650 |
Wkst. I | Direct and Indirect Renal Dialysis Cost Allocation - Statistical Basis | 3650 |
Wkst. I | Analysis of Renal Dialysis Department Costs | 3650 |
Wkst. I | Direct and Indirect Renal Dialysis Cost Allocation - Statistical Basis | 3650 |
Wkst. I | Reasonable Cost Determination for Therapy Service Furnished after April 10, 1998 by Outside | 3650 |
Wkst. I | Direct and Indirect Renal Dialysis Cost Allocation - Statistical Basis | 3650 |
Computation of Medicare RHC/FQHC Medicare Payment
Download Worksheet Documentation 
Worksheet Section | Description | Reference |
---|---|---|
Wkst. I | Analysis of Renal Dialysis Department Costs | 3650 |
Wkst. I | Direct and Indirect Renal Dialysis Cost Allocation - Statistical Basis | 3650 |
Wkst. I | Analysis of Renal Dialysis Department Costs | 3650 |
Wkst. I | Direct and Indirect Renal Dialysis Cost Allocation - Statistical Basis | 3650 |
Wkst. I | Reasonable Cost Determination for Therapy Service Furnished after April 10, 1998 by Outside | 3650 |
Wkst. I | Direct and Indirect Renal Dialysis Cost Allocation - Statistical Basis | 3650 |