CCRS Cost Report Specialist study plan

Diagram the Medicare cost report worksheet sequence from the certification/signature page through the settlement worksheets, labeling the purpose of each worksheet family.

Trace how charge, cost, and reimbursement data flow from the trial balance into the settlement calculation.

Assemble a filing checklist covering signature requirements, due dates, extension requests, amended reports, and electronic submission rules.

Compare as-filed, amended, and final-settled reports and list what changes at each stage and who bears the reimbursement risk.

Map a provider's chart of accounts to standard cost center lines and worksheet reporting locations.

Reconcile a sample trial balance to a completed trial balance worksheet.

Classify at least 12 cost items as allowable or nonallowable and cite the governing principle for each.

Compute a simple departmental cost-to-charge ratio and state what it is used for downstream.

Execute a multi-round step-down allocation across six cost centers and verify the allocation order closes to zero residual.

Compute adjusted costs and apportionment statistics for a cost center with mixed direct and indirect costs.

Decide allowability in 15 scenario items covering related-party charges, advertising, lobbying, provider taxes, and physician compensation arrangements.

Recalculate a cost-to-charge ratio after a charge increase and explain the settlement consequence.

Trace an inpatient claim from MS-DRG assignment through the IPPS operating and capital payment computation, including wage index and indirect medical education adjustment placement.

Recompute an outlier payment and a transfer-adjusted per-discharge payment for two fact patterns.

Recompute an OPPS payment covering APC group assignment, packaging, multiple-procedure discounting, and the 2x wage index rule for a non-excepted clinic.

Explain how tentative versus final settlement works and how payment-limit lines on the cost report reconcile to actual payments.

Compute the DSH patient percentage from Medicare SSI days and total Medicaid days using the statutory formula and dual-eligible rules.

Calculate the IME resident-to-bed ratio, apply the rolling-average and cap concepts, and compute the IME adjustment factor.

Build the three-factor uncompensated care payment from UCC proxy, DSH factor, and the applicable Medicare/Medicaid fractions.

Identify documentation weaknesses that would cause a MAC to reject SSI/Medicaid day counts or resident counts.

Distinguish bad debt from charity care and compute reimbursable bad debt at the correct percentage with the Medicare utilization applied.

Apply the 120-day filing window and reasonable collection effort documentation standards to at least 10 claim scenarios and rule each in or out.

Evaluate provider-based or departmental status against the seven statutory requirements and determine which costs move to the provider-based worksheets.

Reclassify mislabeled charity care and bad debt in a sample worksheet and show the reimbursement effect of each reclassification.

Identify audit red flags in a cost report such as cost-to-charge outliers, related-party charges, unsupported DSH day counts, and reclassifications lacking support.

Draft a response plan for a MAC additional documentation request, sequencing which worksheets and ledgers to pull first.

Quantify the reimbursement impact of three findings and rank them by dollar exposure.

Re-derive two step-down allocations and one cost-to-charge ratio to confirm the reviewed numbers reproduce.

Rebuild the formula sheet from memory: step-down apportionment, cost-to-charge, DSH patient percentage, IME adjustment, UCC payment, and bad debt percentage.

Complete a full-length timed mock exam across all six domains and log every missed item by domain and root cause.

Re-study the two weakest domains using corrected notes and re-attempt the missed items without notes.

Summarize the ten highest-impact cost report filing and compliance controls in a personal pre-exam one-pager.