Cost Report Setup - Cal-PM

Dictionary Update form

Each Financial Class data element (Payor file - data element 1000) must be associated with cost reporting. Link the Financial Classes defined within the system to the applicable value using the Cost Report Class (data element 1005) extended attribute.

There are three selections:

• Commercial
• Non-Recoverable
• Self Pay

Define the following Service Function Primary Codes for the Service Codes form:

• Mode of Service 45
• Mode of Service 55
• Mode of Service 60
• Service Function (CSI - Mode 5)
• Service Function (CSI - Mode 10)
• Service Function (CSI - Mode 15)

Also, populate the Service Function - DMH in order to define the specific Service Function Code associated with the service.

Program Maintenance form

1. Import the applicable Provider and Legal Entity Files into myAvatar Cal-PM.
2. Link every program to the correct Provider Number and Legal Entity.

Define the following fields:

• Program Code (S/D Medi-Cal) field - Select the Medi-Cal program.
• Provider Code (S/D Medi-Cal) field - Enter the Medi-Cal program code number.

Service Codes form

1. Confirm that all service codes have the appropriate value selected in one of the six fields where Service Function Primary Codes can be selected.
2. Confirm that there are no values in any of the six fields where Service Function Primary Codes can be selected that do not apply to the service code being defined. If it has been determined that a value has been selected in error, then remove the value by selecting the field and pressing the "F5" key.
3. Review the configuration of your service codes to assure that:
   • If the Service Code is to be considered Mode 05, 10, or 15 for Cost Reporting purposes, only populate the Mode of Service field.
   • If the Service Code is to be considered Mode 45 for Cost Reporting purposes, only populate the Mode of Service 45 - Outreach field.
   • If the Service Code is to be considered Mode 55 for Cost Reporting purposes, only populate the Mode of Service 55 - Medi-Cal Administration field.
   • If the Service Code is to be considered Mode 60 for Cost Reporting purposes, only populate the Mode of Service 60 - Support Services field.
4. If, upon review, you find that values have already been assigned to the services codes, these values can be removed by activating the field and then pressing the "F5" button.
   Since, for Cost Reporting purposes, these values are only referenced when the cost report data is compile, any changes that are made will be incorporated in the next cost report compile.

Cost Report Data Compile form

Select Report field:

• Reports are imported into myAvatar Cal-PM through the Import Report For Command Button Launch form (RADplus Utilities).
• The selections in the Select Report field are set up in the Dictionary Update form (Other Tabled Files - data element 70263).

Note: In order for the report to work properly: the report description used when importing the report should match the dictionary code that is created for the report.

Service transfer calculation

• The original service fee will be used as the gross charge for service transfers.