FQHC Cost Report Preparation Checklist

This checklist covers the data collection work that happens before an FQHC Medicare cost report is prepared, including visit counts, revenue support, payroll records, expense allocations, and supporting schedules. It is meant to help the DRI confirm that the source documents are complete and ready for CMS-222-17 preparation. It does not replace the cost report itself or the final review by your finance or reimbursement team.

Use it annually as part of your year-end close and cost report prep cycle. Many FQHCs also run a lighter version quarterly or monthly to reduce the year-end scramble and catch missing support earlier. If your organization has multiple sites or a complex revenue cycle, a recurring cadence can make the annual filing much easier to assemble.

The DRI is usually someone in finance, reimbursement, or revenue cycle who can coordinate across payroll, billing, operations, and clinic leadership. The checklist can be assigned as a simple task to one owner, with checklist items delegated to the people who hold the source records. If your cost report is prepared by an outside consultant, the internal DRI should still own the data-gathering step.

Yes, it is designed around the documentation needed to support an FQHC Medicare cost report, including CMS-222-17 preparation. It helps organize the records that typically back up allowable costs, visit counts, and revenue reconciliation. You should still confirm the final reporting approach with your reimbursement advisor or auditor, especially if your organization has unusual service lines or ownership changes.

The most common issues are missing visit totals, incomplete payroll support, uncategorized expenses, and source documents that do not reconcile to the general ledger. Another frequent problem is waiting until the filing deadline to ask clinic managers for records, which creates blocking work and delays. This checklist makes each item independently verifiable so gaps are visible before the report is assembled.

Yes, you should customize it for your chart of accounts, service mix, sites, and any grants or contract arrangements that affect reporting. You can add checklist items for specific departments, wraparound services, or local documentation requirements. Keep the items atomic so each one has a clear yes, no, or N/A answer.

An ad-hoc email thread usually creates scattered attachments, unclear ownership, and no easy way to see what is still blocking the report. This checklist turns the request into a repeatable task with a defined DRI, priority, and verification step for each source document. That makes it easier to track completion and reduces back-and-forth during filing season.

Yes, it works well alongside accounting, payroll, billing, and document storage tools because each checklist item can point to a source file or report. Many teams link the checklist to the general ledger, payroll exports, visit reports, and shared folders for supporting schedules. The key is to store the verification evidence where reviewers can find it quickly during prep and audit support.