Financial Data Submission Tools
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Hospital Data and Reporting

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Financial Data Submission Tools

Annual Filing Model Outputs consist of CDEFHPV and REV5PDA worksheets, which are part of the Annual Filings. See the Annual Report of Revenue, Expenses and Volume for more information. (September, 2016)

Case Mix Reconciliation​ form is used to reconcile hospital financial data by payer (All-Payer, Medicare FFS, Medicare HMO) and patient residency with the case mix patient-level charges.
                          Memorandum: New Reconciliation Templates (October, 2014)
                          Webinar Recording and Webinar Slides (October, 2014) 

Community Benefits Data Collection Tool is designed to collect information on the types and scope of community benefits services provided by Maryland nonprofit hospitals. Due Date: December 15

DCFA Annual Schedule is used to collect data for the Debt Collection ⁄ Financial Assistance Report.

Denied Admission Data Collection Tool (Denied Admissions Instructions (October, 2012) ) is designed to automate the collection of the Admissions Denied for lack of medical necessity included in the Case Mix data as prescribed in the staff recommendation approved at the August 5, 2009 Commission Meeting. (Updated July, 2015)

Intern and Resident Survey (IRS) Schedule Template contains a worksheet with instructions. In 2012, based on hospital feedback, HSCRC staff added to the Schedule IRS template a column (Col 11 Percent of Rotation) in which hospitals may report a percentage of the rotation period for which a resident worked on patient care activities at the hospital. *Note that a hospital's IRS Schedule must reconcile with the hospital's IRIS (Intern and Resident Information System) Report submitted to the Medicare fiscal intermediary. If the reports do not reconcile, the hospital must submit a supplementary worksheet to HSCRC staff explaining the reasons for the differences between the reports.

MD Hospital Data Repository Data Collection System Revenue and Volumes Report is mandated reporting of hospitals billed charges and related volumes by rate center. This report is also submitted monthly, 30 days after the end of each month and is used to ensure hospital charging compliance with approved rates. For questions regarding the Data Collection System, please contact Amanda Vaughan.

Outpatient Services Survey​ ​lists all outpatient services at regulated hospitals that are:

  • Owned (more than 50%) by the hospital regardless of whether it is a regulated or unregulated service, no matter where the services are located, or
  • Not owned by the hospital but located in the principal hospital buildings or in other buildings in which regulated hospital services are provided.

Special Audit Case Mix Audit Record Layout is used by the Commission's Auditing Vendor to audit hospital diagnostic coding as it relates to case mix.​

The Hospital Patient Information Sheet According to Health-General §19-214.1(e), Maryland’s acute care hospitals must provide a patient information sheet to patients being discharged from the hospital. The HSCRC has developed Guidelines for the Patient Information Sheet and answers to Frequently Asked Questions in order to assist hospitals in developing/editing their own patient information sheets. For more information, please contact Amanda Vaughan at 410-764-2605.


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