Cost Reporting and Review
Dear Hospital Licensee:
Arizona Administrative Code, Title 9, Chapter 11, specifies the requirements for financial reporting, and are available on the Arizona Secretary of State's web site.
All reports must be submitted to the Department's Cost Reporting Program at firstname.lastname@example.org as e-mail attachments.
There are three types of hospital financial reports required by the Department.
- A Copy of the Hospital's Annual Audited Financial Statement (AFS): The AFS is due 120 days after the hospital’s fiscal year end. A 30-day extension may be requested from our office (see contact information below). An electronic copy of the AFS in PDF format is preferred.
- The AFS must be from an independent certified public accountant.
- If a hospital is part of a group, a combined AFS will be acceptable IF the AFS contains a financial statement specific to the hospital.
- The Hospital Uniform Accounting Report (UAR): The UAR is due 150 days after the hospital’s fiscal year end.
The Hospital UAR (see forms and instructions below) will be posted on a schedule based on the facility's fiscal year end date. Reports will be posted in March, June, and December. If a facility's report is not received by the time of posting, there will be a blank space where the facility's report should be posted.
The Accuracy of Your Data Counts: Since the UAR rules include requirements for reporting hospital vacancy and turnover rates for many healthcare professions, your data may be used to inform hospital and healthcare providers and policy makers about the severity of the workforce shortage in Arizona.
A complete Hospital UAR consists of:
- A Hospital Uniform Accounting Report Form (Updated 09/19/14) filled out with hospital-specific data.
- A copy of the Hospital’s Medicare Cost Report - An e-mail copy of the report in PDF format is required.
- A Statement of Cash Flow, unless submitted as part of the annual Audited Financial Statement.
- Attestation of Completeness and Accuracy (updated 02/11/14) completed by the hospital’s administrator.
- Hospital Chargemaster and the Rates & Charges Overview Form
All hospitals are required to keep their existing schedule of rates and charges on file with the Department.
- The Charge Description Master (CDM), or chargemaster, is a comprehensive listing of items that could be billed to a patient, payer, or healthcare provider.
- If a facility submits changes to its CDM that affect the Rates & Charges Overview Form, the facility must also submit an updated Rates & Charges Overview Form.
The Office policy will be to receive a complete current chargemaster, including CPT Codes, a new Rates & Charges Overview Form, and a completed Attestation of Completeness and Accuracy from each hospital at the beginning of each calendar quarter.
Hospital Uniform Accounting Reports
- 2013 UAR
- 2013 UAR by Counties(updated 09/19/14)
- 2012 UAR (updated 10/14/14)
- 2012 UAR by Counties (updated 10/14/14)
- 2011 UAR (updated 12/19/12)
Cost Comparison Report
- Hospital Rates and Charges - Alphabetical Order (updated 02/04/14)
- If your procedure cannot be found in the document above, we can assist you in finding estimated costs for your procedure, upon request. Pease email email@example.com and include the following:
- Your name, phone number, email address
- The Hospital Charge Code (HCPCS) for the procedure you are inquiring about
- Example: EEG – 7400609
- This information can be obtained from the doctor ordering the procedure
- The names of the hospitals in Arizona you would like to compare