Specialized Healthcare Reporting Services
Comprehensive Medicare and Medicaid cost report solutions that maximize reimbursement, ensure federal compliance, and strengthen financial sustainability for FQHCs, CHCs, and evolving healthcare practices
Maximize Reimbursement with Expert Medicare and Medicaid Cost Report Services
Medicare and Medicaid cost reports are essential tools for Federally Qualified Health Centers (FQHCs), FQHC Look-Alikes (LALs), and Tribal health entities. These reports are foundational to ensuring accurate reimbursement from Medicare and Medicaid programs. For FQHCs, cost reports help support the Medicare Prospective Payment System (PPS) rate and Medicaid PPS and wraparound payments, which are vital for covering the full cost of care.
Cost reports provide valuable financial transparency with detailed breakdowns of costs by service line—medical, dental, behavioral health, and enabling services. This allows organizations to better understand their cost structure and make informed decisions about budgeting and operations. For Tribal and LAL entities, these reports support funding justifications for Indian Health Service (IHS) and HRSA grants, and they align with Uniform Data System (UDS) reporting requirements.
FQHC cost reports solve several operational and financial challenges by helping identify underpayments through comparing actual costs to reimbursement rates. They clarify how resources are allocated across departments, which is especially important for organizations offering a wide range of services. Cost reports also provide the data needed to negotiate or justify rate adjustments with state Medicaid agencies and Primary Care Organizations.
Without proper reporting support, healthcare organizations face serious consequences. Without timely and accurate cost reports, FQHCs risk losing reimbursement, facing payment recoupments, or triggering audits that may result in penalties or disallowances. Most critically, noncompliance with reporting requirements can jeopardize an organization's Medicare certification or FQHC status, threatening its ability to serve its community.
How Healthcare Reporting Transforms Your Financial Performance
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Enhanced Accuracy and Financial Transparency
The trained experts at Community Link Consulting will meticulously review every detail of cost report schedules, ensuring all expenses and encounters are accurately documented to reflect the true financial state of your healthcare organization. This involves detailed data analysis of financial data, patient records, and service utilization to identify and correct any discrepancies. Robust verification processes cross-check information and ensure consistency across all reports.
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Regulatory Compliance and Risk Mitigation
Our specialized consultants ensure your FQHC remains compliant with complex and evolving regulations set by federal and state agencies, particularly HRSA, CMS and state Medicaid authorities. We guide organizations through Medicare and Medicaid cost reporting, UDS submissions, Federal Financial Reports (FFRs), Cost-Based Fee Schedules (CBFS), and grant performance reporting. Our expertise helps avoid costly compliance errors, ensures all required documentation is accurate and submitted on time, and maintains your organization's eligibility for federal funding programs including HRSA grants and Medicare/Medicaid participation.
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Optimized Reimbursement and Revenue Enhancement
Accurate and detailed reporting significantly impacts reimbursement rates by ensuring all eligible costs are captured and reported, maximizing reimbursement potential. Our strategic reporting approach utilizes proven methodologies to highlight areas that qualify for higher reimbursement rates. Recent clients achieved average Medicaid rate increases ranging from 23% to 87% across multiple states.
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Operational Efficiency and Time Savings
Outsourcing report preparation to our specialized experts saves valuable time for healthcare administrative staff, allowing internal teams to focus on critical operational management and patient care. Our consultants complete reports more efficiently due to specialized knowledge and experience, reducing administrative burden while ensuring all federal reporting deadlines are met.
Comprehensive Healthcare Reporting Services Tailored for Your Organization
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Medicare Cost Report Preparation
Federally Qualified Health Centers must submit annual Medicare cost reports using the CMS-224-14 form to determine payment rates and reconcile interim payments. Our comprehensive service includes revenue, expense, and encounter data preparation, with reimbursement calculations for graduate medical education adjustments, Medicare bad debt, and administration of Medicare vaccines including flu, hepatitis B, COVID-19, and pneumococcal shots. We analyze data reports directly from your financial systems without requiring you to complete cost report worksheets, develop custom workbooks that mirror CMS formats, and provide submission support from initial data validation to final electronic submission to Medicare Administrative Contractors within the required five-month deadline.
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Medicaid Cost Report and Rate Setting
FQHCs must submit Medicaid cost reports to document expenses and services provided to Medicaid patients, crucial for determining reimbursement rates under the Medicaid Prospective Payment System (PPS). These state-specific reports include facility characteristics, utilization data, cost and charges by cost center, Medicare settlement data, and financial statement data. Payment methodologies vary significantly between states, with different rate calculations, timing requirements, and managed care supplemental payment structures. CLC has worked directly with state Medicaid agencies and Primary Care Associations to help develop cost reporting processes for states without defined procedures, ensuring both compliance and practical implementation.
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Specialty State Reports
Specialty reporting for FQHCs varies by state and is shaped by both federal guidelines and state-specific Medicaid policies. Factors that impact state reporting include Alternative Payment Methodology structures, Quality Assurance Reporting Requirements, and wraparound payment reconciliations, as well as reporting specific to telehealth, behavioral health, and pharmacy reimbursement. Our state-specific expertise navigates these complex variations, with particular depth in Washington, Oregon, and California, where we've supported health centers through evolving regulatory landscapes and detailed reporting processes.
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UDS Report Preparation
The Uniform Data System (UDS) report is an annual HRSA requirement providing detailed information on health center operations and performance. Key components include patient characteristics (demographics, age, income, insurance status), services provided (medical, dental, mental health, enabling services), clinical processes and outcomes (quality measures, health outcomes, preventive services), utilization data, staffing details, and comprehensive financial data including costs, revenues, and funding sources. We provide specialized support for financial sections focusing on Tables 8A, 9D, 9E, and Full-Time Equivalent calculations in Table 5, with direct data entry into Electronic Handbooks (EHBs) and assistance with demographic and clinical tables upon request.
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Cost-Based Fee Schedule Development
FQHCs operate under cost-based fee schedules designed to ensure reimbursement for actual service delivery costs through the Prospective Payment System (PPS). Our comprehensive analysis includes current fee schedules, CPT frequency reports, and Medicare cost reports benchmarked against regional fee data and highest-paying insurer reimbursement schedules. We identify CPT codes that, if adjusted, could yield higher reimbursement while ensuring Medicare G-codes align with both the Medicare PPS rate and your organization's average billed charges. Fee schedules are updated annually to reflect cost changes and inflation, with ongoing policy updates affecting telehealth flexibilities and preventive vaccine billing.
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Federal Grant Reporting and Performance Reports
FQHCs must adhere to specific grant reporting requirements to maintain compliance and secure funding. This includes Federal Financial Reports (FFRs) using SF-425 forms submitted annually through Payment Management System (PMS), covering cash receipts and disbursements, federal funds authorized and expenditures, recipient share requirements, and program income. Grant performance reports provide semi-annual or annual updates on project goals, activities, outcomes, and challenges. We also support Operational Site Visit (OSV) preparation, typically conducted every three years, covering staffing, quality measures, sliding fee discount schedules, community characteristics, services provided, and financial performance.
Our Proven Healthcare Reporting Process
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We begin by identifying all necessary data required to complete each specific cost report type:
Creating customized data request lists reflecting your unique cost centers, sites and services
Identifying trial balance, detailed payroll records, full CPT report, and GL detail requirements
Establishing clear instructions and deadlines for efficient data submission
Tailoring requirements to your organization's specific reporting obligations
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Once data is received, it undergoes thorough review for completeness and accuracy:
Reconciling trial balance to audited financial statements for verification
Identifying cost centers based on FQHC-specific services (medical, dental, behavioral health, enabling services, pharmacy)
Analyzing statistical data including unduplicated patient counts, visits by payer, and provider FTEs
Ensuring consistency with prior years and operational expectations
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Financial and statistical data is coded into appropriate reporting forms using proven methodologies:
Mapping data to CMS cost report forms such as CMS-224-14 for FQHCs
Coding general ledger accounts to correct lines on Worksheets A (costs), B (visits), B-1 (vaccines), E (reimbursement), and F (revenue)
Utilizing HRSA's official systems including Payment Management System (PMS) for FFRs
Completing UDS and federal grant reporting requirements in Electronic Handbooks (EHBs)
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Throughout the process, we maintain regular communication to ensure transparency and accuracy:
Clarifying any discrepancies in data and requesting missing information
Explaining adjustments made during coding and allocation processes
Sharing draft versions of cost reports for client review and feedback
Ensuring clients understand data representation and reimbursement impact
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A thorough internal review ensures accuracy and integrity of all reports:
Cross-checking totals across worksheets for mathematical accuracy
Verifying that allocations are reasonable and well-documented
Ensuring compliance with CMS and HRSA instructions specific to FQHCs and Tribal providers
Investigating and resolving any anomalies or outliers before finalization
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Once reports are finalized, we handle all technical submission requirements:
Entering reports into appropriate software and generating necessary files
Providing detailed submission instructions and signature pages to clients
Supporting submission to Medicare Administrative Contractors (MACs), state agencies, or federal systems
Archiving all supporting documentation for audit readiness and future reference
Why Choose Community Link Consulting for Healthcare Reporting
With over 25 years of experience, Community Link Consulting has been a trusted partner to Federally Qualified Health Centers (FQHCs), FQHC Look-Alikes (LALs), and other healthcare providers across the country. We specialize in the preparation and submission of Medicare and Medicaid Cost Reports, delivering expert support that ensures accuracy, compliance, and peace of mind. Each year, we prepare Medicare cost reports for more than 60 health centers, including those with multiple sites and complex reporting requirements.
Our comprehensive expertise includes working closely with clients to gather and interpret critical financial and operational data. We analyze data reports directly from client financial systems without requiring organizations to complete cost report worksheets. Our custom workbooks mirror CMS cost report formats, streamlining the review and audit process. We understand that Medicaid cost reporting requirements vary significantly from state to state, and we've developed deep expertise in navigating these complexities through decades of experience supporting health centers through evolving regulatory landscapes.
CLC has worked directly with state Medicaid agencies and Primary Care Associations to help develop and refine cost reporting processes, ensuring they are both compliant and practical for health centers. Our approach goes beyond compliance to focus on strategic reimbursement optimization, identifying opportunities within cost structures to enhance financial sustainability for FQHCs and safety-net providers.
Cost Report Success Story:
Between April 2024 and March 2025, CLC prepared and submitted 40 Medicaid rate-setting cost reports, achieving transformative results for our clients across multiple states. Our strategic approach to cost presentation and comprehensive analysis delivered exceptional outcomes that significantly enhanced organizational sustainability.
In Alabama, we secured an average increase of 87% for 15 health centers, with individual increases ranging from 6% to a remarkable 227%. Our Oregon clients achieved an average increase of 37%, with results ranging from 17% to 60% for 7 health centers. In Washington, we delivered an average increase of 23% across 10 health centers, with individual increases ranging from 2% to 68%.
These results represent millions of dollars in additional annual reimbursement that directly support expanded patient services, improved care quality, and enhanced organizational financial stability. Our success stems from deep understanding of state-specific requirements and our focus on identifying opportunities within cost structures to enhance financial sustainability.
Frequently Asked Questions About Healthcare Reporting Services
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Medicare cost reports are federally required and submitted to CMS to determine reimbursement rates like the PPS rate for FQHCs using the standardized CMS-224-14 form. Medicaid cost reports are state-specific and used to calculate wraparound or supplemental payments, with each state having different formats, timing requirements, and rules.
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Medicare cost reports are due 5 months after the end of your fiscal year. Medicaid cost reports have different timing requirements based on the state, with wide variations in submission deadlines and eligibility requirements. Understanding state-specific requirements in advance is essential for timely and compliant submission.
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We thoroughly analyze current fee schedules, CPT frequency reports, and the latest Medicare cost report, benchmarking against regional fee data and highest-paying insurer reimbursement schedules. This analysis identifies CPT codes that, if adjusted, could yield higher reimbursement while ensuring Medicare G-codes align with both the Medicare PPS rate and your organization's average billed charges.
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We provide specialized support for financial sections of UDS reports, focusing on Tables 8A, 9D, 9E, and the Full-Time Equivalent (FTE) section of Table 5. We send detailed client request lists outlining specific data and documentation needed, conduct thorough analysis to validate accuracy and identify discrepancies, and enter data directly into the Electronic Handbooks (EHBs) system. We can also assist with data entry for demographic and clinical tables upon request, offering comprehensive UDS reporting support that reduces administrative burden while ensuring HRSA requirements are met with confidence and accuracy.
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To submit an FFR in PMS, log into pms.psc.gov and navigate to Federal Financial Reporting to select your grant and reporting period. Complete the SF-425 form including general information, federal cash tracking (receipts, disbursements, cash on hand), federal expenditures and unobligated balance, and indirect expenses if applicable. The Certification section must be completed by an authorized official before submission, and confirmation receipts should be saved with all supporting documentation for compliance purposes.
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Yes! Our Medicaid cost report specialists engage in strategic planning discussions to help determine optimal timing for report preparation and submission to maximize reimbursement, especially when future expansion is anticipated. Our approach focuses on identifying opportunities within your cost structure to enhance financial sustainability and position your organization for successful rate negotiations.
Maximize Your Healthcare Organization's Reimbursement Potential
Don't leave money on the table due to suboptimal reporting or compliance gaps. Our specialized healthcare reporting services help organizations optimize reimbursement, ensure federal compliance, and build sustainable financial practices that support quality patient care.
With Community Link Consulting as your partner, you can focus on your healthcare mission while we ensure your reporting maximizes every available dollar for your community