CSHCN 2008 >6.1.3.3 Financial Transactions

6.1.3.3 Financial Transactions

All accounts receivables, IRS levies, payouts, refunds, reissues, and voids appear in this section of the R&S report. The financial transactions section does not use the R&S report form column headings. Additional subheadings are printed to identify the financial transactions. References to fiscal year end (FYE) represent the provider's FYE based on cost report information and does not apply to all providers. The following are descriptions of the six types of financial transactions.

Accounts Receivable

Accounts receivable identifies money that was subtracted from the provider's current payment because it owed to TMHP. Specific claim data is not given on the R&S report unless the accounts receivable setup is claim-specific. An accounts receivable control number is provided that should be referenced when corresponding with TMHP. If the withholding amount is related to a specific claim and not an EOB 00601 previously described, a separate letter with this information is sent to the provider. Accounts receivable appears on the R&S report in the following format:


Row Heading/Section	Explanation
Control number	A control number that should be referenced when corresponding with TMHP.
Recoupment rate	The percentage of the provider's payment withheld each week unless the provider elects to have a specific amount withheld each week.
Maximum periodic recoupment amount	The amount to be withheld each week or month. This field is blank if the provider elects to have a percentage withheld each week or month.
Original date	The date the financial transaction was originally processed.
Original amount	The total amount owed TMHP.
Prior date	The date the last transaction on the accounts receivable occurred.
Prior balance	The amount owed from a previous R&S report.
Applied amount	The amount subtracted from the current R&S report.
FYE	The fiscal year end for cost reports.
EOB	The EOB code that corresponds to the reason code for the accounts receivable.
Patient name	If the accounts receivable is claim specific, the name of the patient on the claim.
Claim number	If the accounts receivable is claim specific, the ICN of the original claim.

IRS Levies

The payments withheld from a provider's check as a result of a notice from the IRS of a levy against the provider are IRS levies. These are displayed in the IRS Levies section of the R&S report. Payments are withheld until the levy is satisfied or released. Although the current payment amount is lowered by the amount of the levy payment, the provider's 1099 earnings are not lowered. IRS levies are reported in the following format:


Row Heading/Section	Explanation
Control number	Control number to reference when corresponding with TMHP.
Maximum recoupment rate	The percentage of the provider's payment withheld each week unless the provider elects to have a specific amount withheld each week.
Maximum recoupment amount	The amount to be withheld on a periodic basis. This field is blank if the provider elects to have a percentage withheld each week.
Original date	The date the levy was originally set up.
Original amount	The total amount owed TMHP.
Prior balance	The amount owed from a previous R&S report.
Prior update	The date the last transaction on the levy occurred.
Current amount	The amount subtracted from the current R&S report.
Remaining balance	The amount still owed on the levy (this amount becomes the previous balance on the next R&S report).

Payouts

Payouts are dollar amounts TMHP owes to the provider. TMHP processes two types of payouts: system payouts that increase the weekly check amount and manual payouts/refunds that result in the issuance of a separate check sent to the provider. Specific claim data is not given on the R&S report for payouts. If the payout is claim-related, a separate letter with this information is sent to the provider. A control number is given that should be referenced when corresponding with TMHP.

Payouts appear on the R&S report in the following format:


Row Heading/Section	Explanation
Payout control number	Control number to reference when corresponding with TMHP.
Payout amount	Amount of the payout.
FYE	The fiscal year for which this refund is applicable.
EOB	The EOB code that corresponds to the reason code assigned.
Refund check number	The number of the refund check issued by TMHP.
Refund check amount	The amount of the refund check mailed to the provider.
Patient name	The name of the patient (if available).
PCN	The CSHCN Services Program number of the patient/client (if available).
DOS	The date of service (if available).

Claim Reissues

Claim reissues are identified by EOB 00122, "This claim is a reissue of a previous claim." For example, EOB 00122 is used if a check is lost in the mail and must be reissued to the provider. The message follows each claim reissued. Every claim paid on the original check is reprinted in the financial section. The claims appear on the R&S report in the following format:


Row Heading/Section	Explanation
Check number	The number of the original check.
Check amount	The amount of the original check.
R&S number	The number of the original R&S report.
R&S date	The date of the original R&S report.

Claim Voids

Claim voids are identified by EOB 00134, "Voided claims-this amount has been credited to your net IRS liability." This occurs when the TMHP check is returned and voided. Claims originally paid on the check are listed and the amounts credited to the provider's 1099. Claim voids print in the same format as claim reissues.

Claim Refunds

Claim refunds are identified by EOB 00124, "Thank you for your refund; your 1099 liability has been credited." This message verifies that dollars refunded to TMHP for incorrect payments were received and posted. The provider's check number and the date of the check are printed on the R&S report. Claim refunds appear on the R&S report in the following format:


Row Heading/Section	Explanation
ICN	The claim number of the claim to which the refund was applied this cycle.
Patient name	The patient's/client's first name, middle initial, and last name on the applicable claim.
CSHCN number	The patient's CSHCN Services Program number.
Date of service	The format MMDDYYYY (month, day, year) in From date of service.
Total billed	The total billed amount of the refunded claim.
Amount applied this cycle	The refund amount applied to the claim.
EOB	The EOB code that corresponds to the reason code assigned.