Cost reporting principles
All allowable costs are properly identified, classified, and allocated in accordance with Medicare cost accounting standards.
The most rigorous cost report filing a provider can submit.
Medicare Cost Report Engine assembles a documentation-complete, reimbursement-optimized, audit-defensible annual cost report — every worksheet populated, statistics tied out, reimbursement positions captured, and filed before the statutory 5-month deadline — checked against the letter of 42 CFR Part 413 and the CMS Provider Reimbursement Manual before a specialist releases it.
Every subsection of 42 CFR §413.20, §413.24All CMS-2552-10 / CMS-2540-10 worksheets populatedTrial balance mapping · statistic extraction · prior-year roll-forwardSpecialist release on every filing5-business-day SLA
Why filings fail
A single missing worksheet or misallocated cost can trigger payment suspension.
Every Medicare-certified institutional provider must file an annual cost report within five months of fiscal-year end. Failure to file an acceptable report by the due date results in payment suspension and up to 100% of interim payments withheld until the report is accepted.
The cost report is not just compliance — it sets final settlement, wage index, DSH uncompensated-care factor (Worksheet S-10), bad-debt reimbursement, GME/IME, and cost-based reimbursement for CAHs and FQHCs. Small and rural providers with limited in-house expertise often overpay national accounting firms or rely on retiring specialists.
Medicare Cost Report Engine exists to close that gap with a single, exhaustive standard applied identically to every filing.
100%
of interim payments withheld if no acceptable report is filed by the due date
The benchmark
Measured against the letter of the regulation — subsection by subsection.
We do not summarize the law and hope. Every filing is scored against a versioned rule pack tied to the exact text of 42 CFR §413.20, §413.24 and the CMS Provider Reimbursement Manual. These are the provisions each filing is held to.
Cost finding and apportionment
Cost centers are accurately defined, statistics are tied out, and allocation bases are selected and applied per the Provider Reimbursement Manual.
Uncompensated care data
Charity-care and bad-debt amounts are computed using the provider's established methodology, with full audit trail for DSH uncompensated-care pool claims.
Officer certification
The provider's authorized officer certifies the report under penalty of law; we provide the certification package and supporting documentation.
Worksheet-by-worksheet instructions
Every line of every worksheet is populated per the Provider Reimbursement Manual instructions, with exceptions noted and justified.
Timely filing requirement
The report is filed before the 5-month deadline; the filing date is verified deterministically and tracked against the MAC's electronic submission system (MCReF).
How a filing is built
Intake to specialist release, with deterministic gates the AI cannot overrule.
AI extracts and drafts. Deterministic rules — running as code, outside the model — decide what is complete. A human specialist signs every release. That order is never reversed.
01
Gap Scan
Upload the trial balance, prior-year report, and supporting schedules. We return a free completeness read: which worksheets, statistics, and schedules you already have, and which are missing.
02
Evidence & data extraction
As your authorized clerical agent, we map the trial balance to CMS cost centers, extract statistics from payroll and patient-day data, and roll forward prior-year positions.
03
Grounded drafting
All worksheets are populated from validated data and the CMS rule pack into field-locked templates — no legal opinions, no invented facts.
04
Deterministic completeness gates
Trial balance ties to general ledger; statistics reconcile to source; prior-year amounts roll forward correctly; all required worksheets are present. Any failure blocks release.
05
Specialist release
A reimbursement specialist reviews judgment calls (cost-center reclassifications, allocation bases, S-10 methodology) and signs the release. High-value or complex filings route to attorney review first.
06
Delivery
You receive the complete, reconciled cost report package — every worksheet populated, certification package, audit trail, and MCReF submission-ready files — for the provider's officer to certify and submit.
The bar we hold
Rigor you can measure.
100%
Specialist-released
No filing ships without a human signature.
5 days
Standard SLA
From complete intake to released filing.
<1%
Critical-defect target
Tracked against a gold-standard filing library.
4
Reconciliation sources
Trial balance · payroll · statistics · prior-year report, every applicable file.
Why Medicare Cost Report Engine
Built to be the most thorough option a provider has.
Documentation-complete, by design
The deliverable is completeness itself — every worksheet and line accounted for or explicitly exception-coded. Nothing is left implicit.
Deterministic, not vibes
The gates that decide completeness are code, not a model's opinion. A drafting error cannot slip past a regulatory requirement.
In its lane, on purpose
We prepare documentation and run searches as your clerical agent. We never give legal advice, certify the report, or submit on your behalf without your officer's signature.
Engagement
Flat fee, per released filing. No contingency, ever.
Simple, predictable, and aligned with a documentation standard — not a cut of any recovery.
- A free Gap Scan before you commit — see exactly what is missing.
- One flat fee per released cost report filing; disclosed pass-through search fees.
- Optional fixed-fee attorney review for complex or high-value filings.
- Optional Recovery Share Add-on for reimbursement optimization (e.g., S-10 methodology, wage index reclassification).
FAQ
Questions, answered precisely.
Is Medicare Cost Report Engine a law firm?
No. Medicare Cost Report Engine, a service of Your Deputy, Obuke LLC, provides documentation-completeness services. It is not a law firm, does not provide legal advice, and does not represent you in any legal matter. Attorney review is available and recommended for complex or high-value filings.
Do you certify the cost report or submit it to the MAC?
No. The provider's authorized officer certifies the report under penalty of law (42 CFR §413.24(f)(4)(iv)). We prepare the documentation and provide the submission-ready package; the provider submits through MCReF or its designated system.
What makes a filing 'complete'?
Completeness is defined by the regulations: all required worksheets populated, trial balance tied, statistics reconciled, prior-year amounts rolled forward, officer certification package included, and all MAC acceptance edits resolved. Deterministic gates enforce each one before release.
How fast is it?
The standard SLA is five business days from complete intake to a specialist-released filing. The free Gap Scan is returned much sooner and tells you exactly what is still needed.
How are you priced?
A flat fee per released filing, plus disclosed pass-through costs. No contingency and no percentage of any recovered amount or settlement. Optional recovery-share add-on for reimbursement optimization.
See what's missing before it costs you a payment suspension.
Start with a free Gap Scan. Send your trial balance, prior-year report, and supporting schedules and we'll return a completeness read against every subsection of 42 CFR §413.20 and §413.24.
Documentation-completeness service · not legal advice · the provider certifies and submits every filing.