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pdfCenters for Medicare & Medicaid Services
CMS eXpedited Life Cycle (XLC)
Incurred But Not Reported Survey (IBNRS)
System
User Manual
Version 1.7 FINAL
3/21/2014
Document Number: CMS.IBNRS.UserManual.1.7FINAL
Contact Number: HHSM-500-2007-00029I / HHSM-500-T0006
CMS XLC
Table of Contents
Table of Contents
1. Introduction .............................................................................................................. 7
1.1
1.2
General Description/Purpose .......................................................................... 7
System Requirements ..................................................................................... 7
2. Overview ................................................................................................................... 8
2.1
2.2
Conventions .................................................................................................... 8
Cautions and Warnings ................................................................................... 8
3. Getting Started ......................................................................................................... 9
3.1
3.2
3.3
3.4
3.5
Set-up Considerations ..................................................................................... 9
User Access Considerations ........................................................................... 9
Accessing IBNRS ............................................................................................ 9
System Organization and Navigation ............................................................ 11
3.4.1
Navigation Bar ................................................................................. 12
3.4.2
Common User Links ........................................................................ 12
3.4.3
Common Controls ............................................................................ 16
Exiting the System ........................................................................................ 20
4. Using the System ................................................................................................... 21
4.1
4.2
4.3
4.4
4.5
Main .............................................................................................................. 21
Medicaid (Form CMS R-199) ........................................................................ 22
4.2.1
Add Form ......................................................................................... 23
4.2.2
Browse Form ................................................................................... 26
4.2.3
Edit Form ......................................................................................... 27
4.2.4
Certify Form ..................................................................................... 28
4.2.5
Audit Form ....................................................................................... 32
4.2.6
Reports ............................................................................................ 33
CHIP (Form CMS-10180) .............................................................................. 33
4.3.1
Add Form ......................................................................................... 33
4.3.2
Browse Form ................................................................................... 37
4.3.3
Edit Form ......................................................................................... 38
4.3.4
Certify Form ..................................................................................... 39
4.3.5
Audit Form ....................................................................................... 43
4.3.6
Reports ............................................................................................ 44
Regional Office.............................................................................................. 44
4.4.1
Browse Form ................................................................................... 45
4.4.2
Certify Form ..................................................................................... 46
Central Office ................................................................................................ 49
4.5.1
Browse Form ................................................................................... 50
4.5.2
Certify Form ..................................................................................... 51
4.5.3
Uncertify Form ................................................................................. 52
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4.6
4.7
4.8
Table of Contents
4.5.4
Reports ............................................................................................ 53
Administrative Functions ............................................................................... 53
4.6.1
User Maintenance ............................................................................ 54
4.6.2
System Messages ........................................................................... 59
4.6.3
Email ................................................................................................ 63
4.6.4
System Email Messages.................................................................. 64
4.6.5
User Audit ........................................................................................ 66
4.6.6
Open Periods ................................................................................... 66
Reports.......................................................................................................... 69
Report History ............................................................................................... 73
5. Troubleshooting & Support .................................................................................. 74
5.1
5.2
5.3
5.4
Error Messages ............................................................................................. 74
5.1.1
IBNRS Session Expiration Pending Alert ......................................... 74
5.1.2
Error/Warning Message Pop-ups..................................................... 74
5.1.3
Error Information Screens ................................................................ 75
Resolving Password Issues .......................................................................... 76
5.2.1
Forgotten Password ......................................................................... 76
5.2.2
Forgotten User ID ............................................................................ 77
Special Considerations ................................................................................. 77
Support.......................................................................................................... 78
Acronyms ..................................................................................................................... 79
Glossary ....................................................................................................................... 80
Referenced Documents .............................................................................................. 81
Record of Changes ..................................................................................................... 82
Approvals ..................................................................................................................... 83
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List of Figures
List of Figures
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CMS Warning Page ..................................................................................... 8
IBNRS System Login Screen ....................................................................... 9
Change Your Password Dialog .................................................................. 10
Change Password Complete Confirmation ................................................ 10
IBNRS Welcome Screen ............................................................................ 11
IBNRS Screen – Major Components ......................................................... 11
Navigation Bar ........................................................................................... 12
My User Profile Screen .............................................................................. 13
Change Email Address, Step 1 .................................................................. 13
Change Email Address, Step 2 .................................................................. 14
Change Password Dialog........................................................................... 15
IBNRS Welcome Screen ............................................................................ 21
IBNRS Message Alert Window .................................................................. 22
Medicaid R-199 Forms Screen .................................................................. 23
Add CMS R-199 Medicaid IBNRS Screen ................................................. 23
R-199 Form ................................................................................................ 24
Define Line Window ................................................................................... 25
Browse Form R-199 Screen....................................................................... 26
Edit Form R-199 Screen ............................................................................ 27
Already State Certified Message................................................................ 28
Form R-199 Questionnaire, Filled out ........................................................ 29
Form R-199 Questionnaire......................................................................... 30
State Certify Form R-199 ........................................................................... 31
Certification Complete Window .................................................................. 31
Form R-199 Print State Certification Screen .............................................. 32
System Audit Screen ................................................................................. 32
CHIP CMS-10180 Forms Screen ............................................................... 33
Add CMS-10180 CHIP IBNRS Screen ....................................................... 34
CMS-10180 Form ...................................................................................... 35
Define Line Window ................................................................................... 36
Browse Form CMS-10180 Screen ............................................................. 37
Edit Form CMS-10180 Screen ................................................................... 38
Already State Certified Message................................................................ 39
Form CMS-10180 Questionnaire, Filled out ............................................... 40
Form CMS-10180 Questionnaire ............................................................... 41
State Certify Form CMS-10180 .................................................................. 42
Certification Complete Window .................................................................. 42
Form CMS-10180 Print State Certification Screen ..................................... 43
System Audit for Form CMS-10180 ........................................................... 43
RO Forms Screen ...................................................................................... 44
Change Submission Date Screen .............................................................. 45
Already Regional Office Certified Message................................................ 46
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List of Figures
Regional Office Certify Screen ................................................................... 46
Certification Complete Window .................................................................. 47
Print Regional Office Certification Screen .................................................. 48
CO Forms Screen ...................................................................................... 49
Change Submission Date Screen .............................................................. 50
Already Central Office Certified Message .................................................. 51
Central Office Certify Screen ..................................................................... 51
Certification Complete Window .................................................................. 52
Print Central Office Certification Screen .................................................... 52
Uncertify Screen ........................................................................................ 53
Uncertify Complete window........................................................................ 53
Admin Screen ............................................................................................ 54
Manage User Accounts Screen ................................................................. 54
Step 1: Enter User Base Information Screen ............................................. 55
Modify User Information Screen, User Information Tab ............................. 56
Modify User Information Screen, State Access Tab ................................... 56
Modify State Access .................................................................................. 57
Modify User Information Screen, Function Access Tab ............................. 58
System Messages Choose Function Screen ............................................. 59
Update Bcast News Screen ....................................................................... 60
Billboard Screen......................................................................................... 60
Add Message Screen ................................................................................. 61
Edit Message Screen ................................................................................. 62
Email Screen.............................................................................................. 63
System Email Messages Screen ............................................................... 65
Audit User Accounts Screen ...................................................................... 66
Open Periods Screen ................................................................................. 67
Add Open Period ....................................................................................... 67
Modify Open Period Screen ....................................................................... 68
Report Options Screen .............................................................................. 69
Report Options Screen, Type = CO ........................................................... 70
Report Options Screen, Multiple States ..................................................... 71
Report Complete Screen............................................................................ 72
Report History Screen ................................................................................ 73
Report History Calendar Drop-down .......................................................... 73
Pending Session Expiration Alert ............................................................... 74
Session Expired Alert ................................................................................. 74
Error Message Example ............................................................................ 75
Sample Configuration Error Screen ........................................................... 76
Forgot User ID or Password Dialog ........................................................... 76
Password Reset Message ......................................................................... 77
User ID Sent Confirmation ......................................................................... 77
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List of Tables
List of Tables
Table 1:
Table 2:
Table 3:
Table 4:
Table 5:
Table 6:
Table 7:
Table 8:
Table 9:
Icons .......................................................................................................... 16
Navigation Bar Buttons .............................................................................. 16
Screen and Form Buttons .......................................................................... 17
Text Links................................................................................................... 19
Support Points of Contact .......................................................................... 78
Acronyms ................................................................................................... 79
Glossary ..................................................................................................... 80
Referenced Documents ............................................................................. 81
Record of Changes .................................................................................... 82
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Introduction
1. Introduction
This user manual provides the information necessary to use the Incurred But Not
Reported Survey (IBNRS) system.
1.1
General Description/Purpose
The IBNRS system is a web-based application used by the Centers for Medicare and
Medicaid Services (CMS). It is used biannually prior to 2008, and annually since 2008
to report estimated expenditures for the Medicaid Program and the Children’s Health
Insurance Program (CHIP) and to report estimated expenditures for both programs.
CMS will be preparing its fiscal year (FY) Annual Financial Report as required by the
Public Law 103-356, (the Government Management Reform Act of 1994), section 3515.
Because CMS fulfills its mission through the contractors and States, these entities are
the primary source of information for the financial statements. There are three basic
categories of data: expenses, payables, and receivables. The Medicaid and CHIP
IBNRS are used to collect Medicaid and CHIP payable and receivable accounting data
from the states. CMS must accrue:
An accounts payable for the services rendered by Medicaid and CHIP providers
as of the end of the fiscal year
An accounts receivable for all amounts due to the States from various sources,
excluding the Federal Government.
The Medicaid and CHIP IBNRS have been available as an Internet system beginning
with the FY 2006 survey. Since then, the Medicaid IBNRS have no longer been mailed
out to each State and Territory. The automated system expanded CMS’ existing
information technology architecture to allow for a more effective and efficient solution in
completing, reviewing, and transmitting the Medicaid and CHIP IBNRS. This enabled
the States and Territories to fill out and submit their surveys electronically beginning FY
2006.
IBNRS has been upgraded to the 3-zone CMS Technical Reference Architecture (TRA).
The functionality of the system is the same as prior to the upgrade. However, the layout
of the screens has changed.
1.2
System Requirements
To use the IBNRS system, you must meet the following requirements:
You must have a connection to the Internet.
You must have an Enterprise User Administration (EUA) account.
You must be using Internet Explorer 8.0 or higher.
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Overview
2. Overview
2.1
Conventions
This document provides the user with screen step-by-step procedures to use the IBNRS
system. The following conventions apply:
2.2
The term “user” and “you” are used throughout this document to refer to any
person who requires and/or has acquired access to IBNRS.
Whenever possible, the screen capture graphics used in this document are
enlarged and/or cropped to emphasize the important areas of the screen.
The Section 508-compliant alternative text within the graphics often identifies
specific areas on screens, forms, reports, or tables that are described as “shown
in box” or “shown in circle”.
Unless otherwise indicated, any text reference to a “text link” used in the system
is the same as a hyperlink.
Cautions and Warnings
The CMS Warning Page (Figure 1) appears as part of each login session on the
system. Read the warning before logging in.
Figure 1:
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Getting Started
3. Getting Started
3.1
Set-up Considerations
CMS screens can best be viewed at a screen resolution of 1024 x 768 or higher. To
optimize your access to IBNRS:
3.2
Disable pop-up blockers.
Use Internet Explorer, version 8.0 or higher.
User Access Considerations
The step-by-step procedures in this document assume that the user has already been
given prior authorization to access the IBNRS system through EUA.
3.3
Accessing IBNRS
To log in to IBNRS:
1. Open the Internet Explorer browser.
2. Use the Uniform Resource Locator (URL) provided when granted access to the
system:
https://65.220.21.9/ibnrs
The CMS Warning Page (Figure 1) appears.
3. Read the warning.
4. Click on the Click Here To Log In link. The IBNRS System Login screen (Figure
2) appears.
Figure 2:
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IBNRS System Login Screen
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Getting Started
5. Enter your 4-character CMS-issued User ID in the User ID field.
6. Enter your password in the Password field.
7. If you forgot your password or User ID, click on the Forgot Password link. Refer
to Section 5.2, Resolving Password Issues, for details.
8. Click on the Log In button. If your password has expired, the Change Your
Password dialog (Figure 3) appears.
Figure 3:
Change Your Password Dialog
9. If you are required to change your password:
a. Click on the this document link in the Change Your Password dialog if
you want to review the Password Requirements for IBNRS.
b. Enter your current password in the Password field.
c. Enter your new password in the New Password field.
d. Enter your new password in the Confirm New Password field.
e. Click on the Change Password button. The Change Password Complete
confirmation (Figure 4) appears.
Figure 4:
Change Password Complete Confirmation
f. Click on the Continue button.
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10. The IBNRS Welcome screen (Figure 5) appears. This screen is the starting point
to most procedures in this document.
Figure 5:
3.4
IBNRS Welcome Screen
System Organization and Navigation
Figure 6 identifies the major components of the majority of the IBNRS screens.
Figure 6:
IBNRS Screen – Major Components
This section describes the organization of the system and how to navigate it.
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3.4.1 Navigation Bar
The Navigation Bar (Figure 7) appears at the top of the IBNRS screens.
Figure 7:
Navigation Bar
The Navigation Bar provides access to the various program areas and forms within
IBNRS:
Main – IBNRS Welcome Screen
Medicaid – Medicaid Form CMS-R199
CHIP – CHIP Form CMS-10180
Regional Office – Regional Office utilities
Central Office – Central Office utilities
Admin – Administrative functions
Report History – previously requested reports
The selections available on your Navigation Bar correspond to the functional access
you have been granted.
3.4.2 Common User Links
The following common user links (see Figure 6) are available to IBNRS system users on
the IBNRS screens:
Log Out
Profile
Help
Refresh
A+ and A- font-size links
These links are located in and directly above the Navigation Bar and are further
described in the following paragraphs.
3.4.2.1
Log Out Link
To log out of IBNRS, click on the Log Out common user link in the upper right corner of
the screen.
3.4.2.2
Profile Link
The Profile common user link presents your profile and allows you to change the
password, theme, and email address. The profile includes the following items:
User ID
Name
Email Address
State Access (U.S. states and territories to which you have access/permissions)
Theme (background color)
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Getting Started
To access your user profile:
1. Click on the Profile link. The My User Profile screen (Figure 8) appears.
Figure 8:
My User Profile Screen
2. Review your permissions to verify that all of the information is correct.
3. If necessary, make changes to the background color and your email address as
shown in the following sections. For any other changes to your profile, see the
contacts listed in Section 5.4 and on the IBNRS Welcome screen (Figure 5).
3.4.2.2.1
Select Background Color
To choose one of the four available background colors for your IBNRS screens, select it
from the Theme drop-down on the My User Profile screen (Figure 8). The color is
changed instantly.
A selection of None presents a white background.
3.4.2.2.2
Change Email Address
Perform the following steps if you wish to change your email address:
1. Click on the Change E-Mail Address link located next to your present e-mail
address in the My User Profile screen (Figure 8). The Change Email Address,
Step 1 screen (Figure 9) appears.
Figure 9:
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Change Email Address, Step 1
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Getting Started
2. Enter your new email address in the New Email Address textbox.
3. If you are not sure you want to change your email address, click on the Cancel
button. You are returned to the My User Profile screen (Figure 8).
4. If you are sure you want to change your email address, click on the
Submit Change button. The Change Email Address, Step 2 screen (Figure 10)
appears.
Figure 10: Change Email Address, Step 2
5. Copy the code that was sent to your new email address.
6. Paste the code into the Code field.
7. Click on the Complete Change button. A confirmation appears.
8. Click on the Continue link. You are returned to the My User Profile screen
(Figure 8).
3.4.2.2.3
Change Password
You cannot change your password if you have changed it less than 24 hours ago.
Perform the following steps if you wish to change your password:
1. Click on the Change Password button. The Change Password dialog (Figure
11) appears:
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Getting Started
Figure 11: Change Password Dialog
2. Click on the this document link in the Change Password dialog if you want to
review the Password Requirements for IBNRS.
3. Enter your present password in the Password field.
4. Enter your new password in the New Password field.
5. Enter your new password in the Confirm New Password field.
6. If you change your mind about changing your password, click on the Cancel
button. You are returned to the My User Profile screen (Figure 8).
7. If you want to change your password, click on the Change Password button.
The Change Password Complete confirmation appears.
8. Click on the Continue button on the Change Password Complete confirmation.
You are returned to the IBNRS Welcome screen (Figure 5).
3.4.2.3
Help Link
Click on the Help link to access the IBNRS System Help. For further questions that
cannot be answered by System Help, contact any of the individuals listed in Section 5.4
and on the IBNRS Welcome screen (Figure 5).
3.4.2.4
Refresh Link
Click on the Refresh link to refresh the screen.
3.4.2.5
Font Size Links
You can increase or decrease the font size on the IBNRS screens:
Click on the A+ link to increase the font size of all text on the screen.
Click on the A- link to decrease the font size of all text on the screen.
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3.4.3 Common Controls
IBNRS has screen controls in the form of icons, buttons, and links. Some of the screen
controls are found in the screen displays and dialogs, while others are found in pop-up
messages. These functions are accessed by clicking the various buttons, symbol icons,
or text links that are listed and described in detail in the following tables:
Table 1:
Table 2:
Table 3:
Table 4:
Icons
Navigation Bar Buttons
Screen and Form Buttons
Text Links
Table 1:
Function / Action
Icons
Description
Audit
Enables you to audit a CMS form.
Browse
Enables you to browse a CMS form.
Calendar Date
Enables you to select a calendar date for
insertion in textbox.
Certify
Enables you to certify a CMS form.
Delete
Enables you to delete an item, such as a file
associated with a system message.
Edit
Enables you to make changes on a CMS
form.
Next Submission
Enables you to move forward to the next
submission year.
Previous Submission
Enables you to move back to the previous
submission year.
Uncertify
Enables you to uncertify a CMS form
Table 2:
Function /
Action
Main
Icon
Navigation Bar Buttons
Description
Button
Provides access to the IBNRS Welcome Screen
(Figure 5).
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Function /
Action
Description
Medicaid
Provides access to Medicaid form CMS-R199.
CHIP
Provides access to CHIP form CMS-10180.
Regional Office
Provides access to Regional Office functions.
Central Office
Provides access to Central Office functions.
Admin
Provides access to administrative functions.
Report History
Provides access to Report History.
Table 3:
Function /
Action
Screen and Form Buttons
Description
Add
Enables you to add newly entered data to a
form.
Add Form
Enables you to add a CMS form to the
CMS forms list.
Add New User
Enables you to add a new user.
Browse
Enables you to navigate to a file.
Cancel
Enables you to cancel out of a form without
saving changes.
Change
Enables you to change the submission
year.
Clear
Enables you to clear entries.
Click to Review
Enables you to review a submission prior to
certifying it.
Complete
Change
Enables you to complete your change of
email address.
Continue
Allows you to continue after reading a
confirmation.
Define Line #
Enables you to provide a definition for a
line item on a form. Line number can vary.
Done
Enables you to return to the previous
screen.
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Button
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Getting Started
Function /
Action
Description
Excel
Creates the form in Excel format on your
screen.
I Accept
Enables you to accept CMS Terms and
Conditions for accessing IBNRS.
I Decline
Enables you to decline CMS Terms and
Conditions for accessing IBNRS.
Log In
Enables you to log in to the IBNRS system.
Modify
Enables you to modify an item.
Modify User
Information
Enables you to modify user information.
Print
Creates the form in Excel format as an
email attachment.
Report
Enables you to generate a report.
Reset
Enables you to clear one or more fields on
a screen.
Return
Enables you to return to the previous
screen.
Return to User
List
Enables you to return to the User List.
Run Report
Enables you to run a report.
Save
Enables you to save information on a form.
Save Function
Access
Enables you to save functional access for a
user.
Search
Enables you to search for a user.
Select
Enables you to select an item from a list.
Select All
Enables you to select all items.
Submit Change
Enables you to submit a change, such as
one made to your email address.
Unselect All
Enables you to unselect all items.
Update
Enables you to update an item such as a
system message.
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Button
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Function /
Action
Description
Update BCast
News
Enables you to update the Broadcast
News.
Update State
Access
Enables you to update a user’s State
Access.
Table 4:
Function / Action
Button
Text Links
Description
Link Graphic
“Back” link
Returns view to previous screen.
Back
Change E-Mail
Address link
Links to a Change Email Address
dialog for submitting email
address change.
Change E-Mail Address
Continue link
Allows you to continue after
reading a confirmation.
Current Submission
date format link
Allows you to change Submission
Year for Medicaid or CHIP forms.
“Decrease font size”
common user link
Allows you to decrease text font
size.
Delete link
Allows deleting of user.
“Forgot Password”
link
Enables you to reset password to
a CMS-issued, temporary
password.
Continue
2012
(sample format)
ADelete
Internet Users
MDCN Users
CMS Internal Users
“Help” common user
link
Provides access to the online
Help.
Help
“here” link
Links to completed report in Excel
format. May be saved and/or
printed.
here
“Increase font size”
common user link
Allows you to increase text font
size.
A+
“Log Out” common
user link.
Allows you to log out of current
session.
Log Out
Open Report link
Links to a printable report from
the Report History screen.
Open Report
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Function / Action
Description
Link Graphic
“Profile” common
user link
Provides access to the My User
Profile screen.
Profile
“Refresh” common
user link.
Allows you to refresh the screen.
Refresh
Select link
Links to access details for a
specific user.
View System
Messages
Provides access to the system
messages.
3.5
Select
View System Messages
Exiting the System
To exit the IBNRS system click on the Log Out link in the top, right corner of the
window. You are returned to the CMS Warning Page (Figure 1).
Note: Please be sure to use the Log Out link in the application. After closing the
browser without logging out, you will be required to wait 20 minutes before you will be
able to log in again.
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Using the System
4. Using the System
This section provides detailed, step-by-step instructions on how to use the various
functions of IBNRS, accessible from the Navigation Bar:
4.1
Main – IBNRS Welcome Screen
Medicaid – Medicaid Form CMS-R199
CHIP – CHIP Form CMS-10180
Regional Office – Regional Office utilities
Central Office – Central Office utilities
Admin – Administrative functions
Report History – previously requested reports
Main
After clicking on the Main button in the Navigation Bar, the IBNRS Welcome Screen
(Figure 12) appears. This screen shows the date, a welcome message, the list of
contacts, and a link to the system messages.
Figure 12: IBNRS Welcome Screen
To view the system messages:
1. Click on the View System Messages link. The IBNRS Message Alert window
(Figure 13) pops up.
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Figure 13: IBNRS Message Alert Window
2. Read the messages. Some messages contain a hyperlink for additional
information.
3. Click on the Close button. The IBNRS Message Alert window disappears.
4.2
Medicaid (Form CMS R-199)
To access the Medicaid R-199 Forms screen (Figure 14):
1. Click on the Medicaid button on the Navigation Bar.
2. Select the state for which you want to access the forms from the drop-down.
This screen allows you to perform the following tasks:
Adding a form
Browsing a form
Editing a form
Certifying a form
Auditing a form
Generating reports
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Figure 14: Medicaid R-199 Forms Screen
4.2.1 Add Form
When the current date is within an Open Period for the CMS R-199 forms, you can add
a form by performing the following steps:
1. In the Medicaid R-199 Forms screen (Figure 14), select the state from the dropdown.
2. Click on the Add Form button. The Add CMS R-199 Medicaid IBNRS screen
(Figure 15) appears.
Figure 15: Add CMS R-199 Medicaid IBNRS Screen
This screen shows for which state, form, and year you are about to add a form.
3. If you are not sure you want to add a form, click on the Cancel button. You are
returned to the Medicaid R-199 Forms screen (Figure 14).
4. If you are sure you want to add a form, click on the Add button. The R-199 form
for the chosen state and year appears. Figure 16 shows an example for the
state of Wyoming for 2012.
The form contains a number of lines, each with a field for the Total and Federal
Financial Participation (FFP) amount for the year. For comparison, the line also
contains the Total and FFP amount entered in the previous year.
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Figure 16: R-199 Form
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5. Enter the Latest CAFR as of date, if necessary using the Calendar icon.
6. Enter the appropriate amounts in whole dollars in the Total and FFP fields.
7. For all fields that have a Define Line # button:
a. Click on the button. The Define Line window appears. The example
shown in Figure 17 is for line 3.
Figure 17: Define Line Window
b. Enter an explanation for the line.
c. Click on the Continue button. You are returned to the R-199 form you
were filling out.
8. Enter a brief description in the large text box near the bottom of the form.
9. Enter the average number of business days that elapse from when a service is
provided to a Medicaid beneficiary until the state reimburses the provider for the
claim in the Days field near the bottom of the form.
10. If you are not sure that you want to save the information you entered, click on the
Cancel button. You are returned to the Medicaid R-199 Forms screen (Figure
14).
11. If you are sure that you want to save the information you entered, click on the
Save button. Your entry is added to the Medicaid R-199 Forms screen (Figure
14).
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4.2.2 Browse Form
To browse any of the forms previously added for the state:
1. In the Medicaid R-199 Forms screen (Figure 14), select the state from the dropdown.
2. Click on the Browse icon for the form you want to browse. The Browse Form R199 screen (Figure 18) appears.
Figure 18: Browse Form R-199 Screen
3. If you want to download the form in Excel format, click on the Excel button and
follow your browser’s instructions.
4. If you want to return to the Medicaid R-199 Forms screen (Figure 14), click on
the Return button.
5. If you want IBNRS to generate a report of the form and email it to you, click on
the Print button. The form is sent to you in an email attachment. The Report
History appears. See Section 4.8 for details.
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4.2.3 Edit Form
To edit a form that is not state certified:
1. In the Medicaid R-199 Forms screen (Figure 14), select the state from the dropdown.
2. Click on the Edit icon for the form you want to edit. The Edit Form R-199 screen
(Figure 19) appears.
Figure 19: Edit Form R-199 Screen
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3. Make any changes you need to make:
a. Update the Latest CAFR as of date, if necessary using the Calendar icon.
b. Update the appropriate amounts in whole dollars in the Total and FFP
fields.
c. For all fields that have a Define Line # button:
i. Click on the button. The Define Line window appears. The
example shown in Figure 17 is for line 3.
ii. Update the explanation for the line.
iii. Click on the Continue button. You are returned to the R-199 form
you were filling out.
d. Update the brief description in the large text box near the bottom of the
form.
e. Update the average number of business days that elapse from when a
service is provided to a Medicaid beneficiary until the state reimburses the
provider for the claim in the Days field near the bottom of the form.
4. If you are not sure that you want to save the information you updated, click on
the Cancel button. You are returned to the Medicaid R-199 Forms screen
(Figure 14).
5. If you are sure that you want to save the information you updated, click on the
Save button. Your entry is updated in the Medicaid R-199 Forms screen (Figure
14).
4.2.4 Certify Form
To perform state certification on a form:
1. In the Medicaid R-199 Forms screen (Figure 14), select the state from the dropdown.
2. Click on the Certify icon for the form you want to certify.
a. If the selected form for the state is already certified, an Already State
Certified Message (Figure 20) appears.
Figure 20: Already State Certified Message
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i. Click on the OK button. The Form R-199 Questionnaire, Filled out
(Figure 21) appears.
Figure 21: Form R-199 Questionnaire, Filled out
ii. Click on the Continue button. The Form R-199 Print State
Certification screen (Figure 25) appears.
iii. Continue as described in Step 3.
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b. If the selected form for the state was not certified, the Form R-199
Questionnaire (Figure 22) appears.
Figure 22: Form R-199 Questionnaire
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i. Answer all questions.
ii. Click on the Continue button. The State Certify Form R-199
screen appears. The example shown in Figure 23 is for Form R199 for the state of Florida for 2012.
Figure 23: State Certify Form R-199
iii. Read the certification statement.
iv. Enter your name in the Signature field.
v. Enter your title in the Title field.
vi. If necessary, add footnotes in the Footnotes field.
vii. If you are not sure you want to state certify this form, click on the
Cancel button. You are returned to the Medicaid R-199 Forms
screen (Figure 14).
viii. If you are sure you want to state certify this form, click on the Save
button. The Certification Complete window (Figure 24) pops up.
Figure 24: Certification Complete Window
ix. Click on the OK button. The Form R-199 Print State Certification
screen (Figure 25) appears.
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Figure 25: Form R-199 Print State Certification Screen
3. If you want to print the certification, click on the Print button. The Report
History appears. See Section 4.8 for instructions how to use the Report History.
4. If you do not want to print the certification, click on the OK or Cancel button.
You are returned to the Medicaid R-199 Forms screen (Figure 14).
4.2.5 Audit Form
To perform an audit on a form, allowing you to find out who made what changes to the
form:
1. In the Medicaid R-199 Forms screen (Figure 14), select the state from the dropdown.
2. Click on the Audit icon for the form you want to audit. The System Audit screen
(Figure 26) appears.
Figure 26: System Audit Screen
3. Select an Audit Type from the drop-down. The screen is updated with the audit
information.
4. Repeat the previous step as often as needed.
5. Click on the Return button. You are returned to the IBNRS Welcome screen
(Figure 12).
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4.2.6 Reports
To generate a report, click on the Reports button. See Section 4.7, Reports, for details.
4.3
CHIP (Form CMS-10180)
To access the CHIP CMS-10180 Forms screen (Figure 27):
1. Click on the CHIP button on the Navigation Bar.
2. Select the state for which you want to access the forms from the drop-down.
This screen allows you to perform the following tasks:
Adding a form
Browsing a form
Editing a form
Certifying a form
Auditing a form
Generating reports
Figure 27: CHIP CMS-10180 Forms Screen
4.3.1 Add Form
When the current date is within an Open Period for the CMS-10180 forms, you can add
a form by performing the following steps:
1. In the CHIP CMS-10180 Forms screen (Figure 27), select the state from the
drop-down.
2. Click on the Add Form button. The Add CMS-10180 CHIP IBNRS screen (Figure
28) appears.
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Figure 28: Add CMS-10180 CHIP IBNRS Screen
This screen shows for which state, form, and year you are about to add a form.
3. If you are not sure you want to add a form, click on the Cancel button. You are
returned to the CHIP CMS-10180 Forms screen (Figure 27).
4. If you are sure you want to add a form, click on the Add button. The CMS-10180
form for the chosen state and year appears. Figure 29 shows an example for the
state of Florida for 2012.
The form contains a number of lines, each with a field for the Total and Federal
Financial Participation (FFP) amount for the year. For comparison, the line also
contains the Total and FFP amount entered in the previous year.
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Figure 29: CMS-10180 Form
5. Enter the Latest CAFR as of date, if necessary using the Calendar icon.
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6. Enter the appropriate amounts in whole dollars in the Total and FFP fields.
7. For all fields that have a Define Line # button:
a. Click on the button. The Define Line window appears. The example
shown in Figure 30 is for line 3.
Figure 30: Define Line Window
b. Enter an explanation for the line.
c. Click on the Continue button. You are returned to the CMS-10180 form
you were filling out.
8. Enter a brief description in the large text box near the bottom of the form.
9. Enter the average number of business days that elapse from when a service is
provided to a Medicaid beneficiary until the state reimburses the provider for the
claim in the Days field near the bottom of the form.
10. If you are not sure that you want to save the information you entered, click on the
Cancel button. You are returned to the CHIP CMS-10180 Forms screen (Figure
27).
11. If you are sure that you want to save the information you entered, click on the
Save button. Your entry is added to the CHIP CMS-10180 Forms screen (Figure
27).
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4.3.2 Browse Form
To browse any of the forms previously added for the state:
1. In the CHIP CMS-10180 Forms screen (Figure 27), select the state from the
drop-down.
2. Click on the Browse icon for the form you want to browse. The Browse Form
CMS-10180 screen (Figure 31) appears.
Figure 31: Browse Form CMS-10180 Screen
3. If you want to download the form in Excel format, click on the Excel button and
follow your browser’s instructions.
4. If you want to return to the CHIP CMS-10180 Forms screen (Figure 27), click on
the Return button.
5. If you want IBNRS to generate a report of the form and email it to you, click on
the Print button. The form is sent to you in an email attachment. The Report
History appears. See Section 4.8 for details.
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4.3.3 Edit Form
To edit a form that is not state certified:
1. In the CHIP CMS-10180 Forms screen (Figure 27), select the state from the
drop-down.
2. Click on the Edit icon for the form you want to edit. The Edit Form CMS-10180
screen (Figure 32) appears.
Figure 32: Edit Form CMS-10180 Screen
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3. Make any changes you need to make:
a. Update the Latest CAFR as of date, if necessary using the Calendar icon.
b. Update the appropriate amounts in whole dollars in the Total and FFP
fields.
c. For all fields that have a Define Line # button:
i. Click on the button. The Define Line window appears. The
example shown in Figure 30 is for line 3.
ii. Update the explanation for the line.
iii. Click on the Continue button. You are returned to the CMS-10180
form you were filling out.
d. Update the brief description in the large text box near the bottom of the
form.
e. Update the average number of business days that elapse from when a
service is provided to a Medicaid beneficiary until the state reimburses the
provider for the claim in the Days field near the bottom of the form.
4. If you are not sure that you want to save the information you updated, click on
the Cancel button. You are returned to the CHIP CMS-10180 Forms screen
(Figure 27).
5. If you are sure that you want to save the information you updated, click on the
Save button. Your entry is updated in the CHIP CMS-10180 Forms screen
(Figure 27).
4.3.4 Certify Form
To perform state certification on a form:
1. In the CHIP CMS-10180 Forms screen (Figure 27), select the state from the
drop-down.
2. Click on the Certify icon for the form you want to certify.
a. If the selected form for the state is already certified, an Already State
Certified Message (Figure 33) appears.
Figure 33: Already State Certified Message
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i. Click on the OK button. The Form CMS-10180 Questionnaire,
Filled out (Figure 34) appears.
Figure 34: Form CMS-10180 Questionnaire, Filled out
ii. Click on the Continue button. The Form CMS-10180 Print State
Certification screen (Figure 38) appears.
iii. Continue as described in Step 3.
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b. If the selected form for the state was not certified, the Form CMS-10180
Questionnaire (Figure 35) appears.
Figure 35: Form CMS-10180 Questionnaire
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i. Answer all questions.
ii. Click on the Continue button. The State Certify Form CMS-10180
screen appears. The example shown in Figure 36 is for Form
CMS-10180 for the state of Florida for 2012.
Figure 36: State Certify Form CMS-10180
iii. Read the certification statement.
iv. Enter your name in the Signature field.
v. Enter your title in the Title field.
vi. If necessary, add footnotes in the Footnotes field.
vii. If you are not sure you want to state certify this form, click on the
Cancel button. You are returned to the CHIP CMS-10180 Forms
screen (Figure 27).
viii. If you are sure you want to state certify this form, click on the Save
button. The Certification Complete window (Figure 37) pops up.
Figure 37: Certification Complete Window
ix. Click on the OK button. The Form CMS-10180 Print State
Certification screen (Figure 38) appears.
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Figure 38: Form CMS-10180 Print State Certification Screen
3. If you want to print the certification, click on the Print button. The Report
History appears. See Section 4.8 for instructions how to use the Report History.
4. If you do not want to print the certification, click on the OK button. You are
returned to the CHIP CMS-10180 Forms screen (Figure 27).
4.3.5 Audit Form
To perform an audit on a form, allowing you to find out who made what changes to the
form:
1. In the CHIP CMS-10180 Forms screen (Figure 27), select the state from the
drop-down.
2. Click on the Audit icon for the form you want to audit. The System Audit for
Form CMS-10180 screen (Figure 39) appears.
Figure 39: System Audit for Form CMS-10180
3. Select an Audit Type from the drop-down. The screen is updated with the audit
information.
4. Repeat the previous step as often as needed.
5. Click on the Return button. You are returned to the IBNRS Welcome screen
(Figure 12).
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4.3.6 Reports
To generate a report, click on the Reports button. See Section 4.7, Reports, for details.
4.4
Regional Office
The Regional Office (RO) utilities allow you to perform RO certification of Medicaid
Form R-199 and CHIP Form CMS-10180. To access this functionality:
1. Click on the Regional Office button in the Navigation Bar. The RO Forms screen
(Figure 40) appears.
Figure 40: RO Forms Screen
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2. Select a form type from the Form drop-down.
3. Select the year using one of two methods:
a. Click on the Previous Year or Next Year icons until the year shown is the
year for which you want to certify forms.
b. Use the Change Submission Date screen (Figure 41):
i. Click on the year link in the RO Forms screen (Figure 40). The
Change Submission Date screen (Figure 41) appears.
Figure 41: Change Submission Date Screen
ii. Enter the year in the Year field.
iii. Click on the Change button. The Change Submission Date screen
disappears, and the year is updated in the RO Forms screen.
The RO Forms screen contains a list of all submissions for all states and the State, RO,
and CO certification status of those submissions. Depending on your permissions, you
can browse the forms and/or certify them.
4.4.1 Browse Form
To browse any of the forms previously entered by the state:
1. In the RO Forms screen (Figure 40), select the Form from the drop-down.
2. Select the year.
3. Click on the Browse icon for the form you want to browse. Depending on the
form you have selected in Step 1, the Browse Form R-199 screen (Figure 18) or
Browse Form CMS-10180 screen (Figure 31) appears.
4. If you want to download the form in Excel format, click on the Excel button and
follow your browser’s instructions.
5. If you want to return to the RO Forms screen (Figure 40), click on the Return
button.
6. If you want IBNRS to generate a report of the form and email it to you, click on
the Print button. The form is sent to you in an email attachment. The Report
History appears. See Section 4.8 for details.
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4.4.2 Certify Form
To perform RO certification on a form:
1. In the RO Forms screen (Figure 40), select the Form from the drop-down.
2. Select the year.
3. Click on the Certify icon for the form you want to certify.
a. If the selected form for the state is already RO certified, an Already
Regional Office Certified message (Figure 42) appears.
Figure 42: Already Regional Office Certified Message
i. Click on the OK button. Depending on the selection you made in
Step 1, the Form R-199 Questionnaire, Filled out (Figure 21) or
Form CMS-10180 Questionnaire, Filled out (Figure 34) appears.
ii. Click on the Continue button. The Print Regional Office
Certification screen (Figure 45) appears.
iii. Continue as described in Step 4.
b. If the selected form for the state is not RO certified, the Regional Office
Certify screen appears. The example shown in Figure 43 is for Form R199 for the state of Florida for 2012.
Figure 43: Regional Office Certify Screen
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i. Read the certification statement.
ii. Click on the top Click to Review button. Depending on the
selection you made in Step 1, the Browse Form R-199 screen
(Figure 18) or Browse Form CMS-10180 screen (Figure 31)
appears.
iii. Read the state form.
iv. Click on the Close button in the form. The check box next to the
top Click to Review button is now checked, indicating that you
read the state form submission.
v. Click on the bottom Click to Review button. Depending on the
selection you made in Step 1, the Form R-199 Questionnaire, Filled
out (Figure 21) or Form CMS-10180 Questionnaire, Filled out
(Figure 34) appears.
vi. Read the questionnaire.
vii. Click on the Close button in the form. The check box next to the
bottom Click to Review button is now checked, indicating that you
read the state questionnaire and certification.
viii. Enter your name in the Signature field.
ix. Enter your title in the Title field.
x. Select either the Yes radio button to indicate you intend to certify
the form, or the No radio button to indicate you intend to deny
certification for the form.
xi. If you selected the No radio button in the previous step, a
Please Explain text box appears. Enter an explanation in the text
box.
xii. If you are not sure you want to RO certify this form, click on the
Cancel button. You are returned to the RO Forms screen (Figure
40).
xiii. If you are sure you want to RO certify this form, click on the OK
button. The Certification Complete window (Figure 44) pops up.
Figure 44: Certification Complete Window
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xiv. Click on the OK button. The Print Regional Office Certification
screen (Figure 45) appears.
Figure 45: Print Regional Office Certification Screen
4. If you want to print the certification, click on the Print button. The Report
History appears. See Section 4.8 for instructions how to use the Report History.
5. If you do not want to print the certification, click on the OK or Cancel button.
You are returned to the RO Forms screen (Figure 40).
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Central Office
The Central Office (CO) utilities allow you to CO certify and uncertify Medicaid Form R199 and CHIP Form CMS-10180. To access this functionality:
1. Click on the Central Office button in the Navigation Bar. The CO Forms screen
(Figure 46) appears.
Figure 46: CO Forms Screen
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2. Select a form type from the Form drop-down.
3. Select the year using one of two methods:
a. Click on the Previous Year or Next Year icons until the year shown is the
year for which you want to certify forms.
b. Use the Change Submission Date screen (Figure 47):
i. Click on the year link in the CO Forms screen (Figure 46). The
Change Submission Date screen (Figure 47) appears.
Figure 47: Change Submission Date Screen
ii. Enter the year in the Year field.
iii. Click on the Change button. The Change Submission Date screen
disappears, and the year is updated in the CO Forms screen.
The CO Forms screen contains a list of all submissions for all states and the State, RO,
and CO certification status of those submissions. Depending on status, you can
browse the forms, certify them, or uncertify them.
4.5.1 Browse Form
To browse any of the forms previously added by the state:
1. In the CO Forms screen (Figure 40), select the Form from the drop-down.
2. Select the year.
3. Click on the Browse icon for the form you want to browse. Depending on the
form you have selected in Step 1, the Browse Form R-199 screen (Figure 18) or
Browse Form CMS-10180 screen (Figure 31) appears.
4. If you want to download the form in Excel format, click on the Excel button and
follow your browser’s instructions.
5. If you want to return to the CO Forms screen (Figure 40), click on the Return
button.
6. If you want IBNRS to generate a report of the form and email it to you, click on
the Print button. The form is sent to you in an email attachment. The Report
History appears. See Section 4.8 for details.
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4.5.2 Certify Form
To perform CO certification on a form:
1. In the CO Forms screen (Figure 46), select the Form from the drop-down.
2. Select the year.
3. Click on the Certify icon for the form you want to certify.
a. If the selected form for the state is already CO certified, an Already
Central Office Certified message (Figure 48) appears.
Figure 48: Already Central Office Certified Message
i. Click on the OK button. The Print Central Office Certification
screen (Figure 51) appears.
ii. Continue as described in Step 4.
b. If the selected form for the state is not CO certified, the Central Office
Certify screen appears. The example shown in Figure 49 is for Form
CMS-10180 for the state of Florida for 2012.
Figure 49: Central Office Certify Screen
i. Read the certification statement.
ii. Enter your name in the Signature field.
iii. Enter your title in the Title field.
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iv. If you are not sure you want to CO certify this form, click on the
Cancel button. You are returned to the CO Forms screen (Figure
46).
v. If you are sure you want to CO certify this form, click on the OK
button. The Certification Complete window (Figure 50) pops up.
Figure 50: Certification Complete Window
vi. Click on the OK button. The Print Central Office Certification
screen (Figure 51) appears.
Figure 51: Print Central Office Certification Screen
4. If you want to print the certification, click on the Print button. The Report
History appears. See Section 4.8 for instructions how to use the Report History.
5. If you do not want to print the certification, click on the OK or Cancel button.
You are returned to the CO Forms screen (Figure 46).
4.5.3 Uncertify Form
To uncertify a form:
1. In the CO Forms screen (Figure 46), select the Form from the drop-down.
2. Select the year.
3. Click on the Uncertify icon for the form you want to uncertify. The Uncertify
screen appears. The example shown in Figure 52 is for form CMS-10180 for the
state of Florida for the 2012 Annual submission.
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Figure 52: Uncertify Screen
4. Select the radio button for the appropriate Uncertify Level.
5. If you are not sure you want to uncertify the form, click on the No button. You
are returned to the CO Forms screen (Figure 46).
6. If you are sure you want to uncertify the form, click on the Yes button. The
Uncertify Complete window (Figure 53) pops up.
Figure 53: Uncertify Complete window
7. Click on the OK button. You are returned to the CO Forms screen (Figure 46).
4.5.4 Reports
To generate a report, click on the Reports button. See Section 4.7, Reports, for details.
4.6
Administrative Functions
The following Admin functions are available:
User Maintenance
System Messages
Email
System Email Messages
User Audit
Open Periods
To access any of the Admin functions:
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1. Click on the Admin button on the Navigation Bar. The Admin screen (Figure 54)
appears.
Figure 54: Admin Screen
2. In the Admin screen, select the applicable text link.
This section provides step-by-step instructions on how to use the listed Admin functions.
4.6.1 User Maintenance
To perform maintenance on user accounts, click on the User Maintenance text link on
the Admin screen (Figure 54). The Manage User Accounts screen (Figure 55) appears.
Figure 55: Manage User Accounts Screen
This screen contains a list of current users, and allows you to perform the following
tasks:
Sorting the list of users
Searching for a user account
Adding a new user account
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Modifying a user account
Deleting an existing user account
Running user reports
If your User Account allows you to manage user accounts, you can perform all tasks on
all accounts. You cannot modify your own user account.
4.6.1.1
Sorting the List of Users
The Manage User Accounts screen (Figure 55) contains a list of users. You can sort
this list by name, User ID, and email. To do so, click on the column header.
4.6.1.2
Searching for Users
To search for an existing user:
1. In the Manage User Accounts screen (Figure 55), enter search criteria in the
fields of the Search By: area.
2. Click on the Search button. The list of users is updated to match the search
criteria.
4.6.1.3
Adding a New User
To add a new user:
1. Click on the Add New User button on the Manage User Accounts screen (Figure
55). The Step 1: Enter User Base Information screen (Figure 56) appears.
Figure 56: Step 1: Enter User Base Information Screen
2. Enter the User ID and Email Address. Both must be unique.
3. Enter the First Name and Last Name.
4. Select a role from the Select Role drop-down.
5. If you are not sure you want to add the user, click on the Cancel button. You are
returned to the Manage User Accounts screen (Figure 55).
6. If you are sure you want to add the user, click the Add button. A pop-up
appears.
7. Click the Continue button. The Modify User Information screen showing the
User Information tab (Figure 57) appears.
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Figure 57: Modify User Information Screen, User Information Tab
8. Continue as shown in Step 5 in Section 4.6.1.4.
4.6.1.4
Modifying a User
To modify user information:
1. If necessary, search for the user as shown in Section 4.6.1.2.
2. Click on the Select link for the user. The User Information tab of the Modify User
Information screen (Figure 57) for the user appears.
3. Change all relevant user information.
4. Click on the Modify User Information button.
5. Click on the State Access tab. The State Access tab of the Modify User
Information screen (Figure 58) for the user appears.
Figure 58: Modify User Information Screen, State Access Tab
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This tab contains a list of states for which the user already has access, plus
check boxes indicating what kind of access (Read, Update) the user has for each
state. If this list is empty, the user has no state access yet. Users must have
access defined for at least one state.
6. To modify existing state access for an individual state:
a. Click on the Edit link for the state. The Edit link is replaced by an Update
link and a Cancel link; the check boxes for Read Access and
Update Access for the state become active.
b. Check or uncheck the appropriate boxes.
c. If you change your mind about modifying access, click on the Cancel link.
d. If you want to modify the state access, click on the Update link. The
access for the state is changed.
e. Repeat this step as often as needed.
7. To add states to the list or to modify multiple states, entire regions or all states,
click on the Make Single/Multiple State Access Changes button. The
appearance of the tab changes (see Figure 59).
Figure 59: Modify State Access
8. To add access for a single state:
a. Select the state from the State drop-down.
b. Check the appropriate Access boxes (Read and/or Write).
c. Click on the right-most Update State Access button. The State Access
list is updated.
d. If you need to add more states for this user, return to Step 7.
9. To modify the access for all states:
a. Select All States Access from the Select Action drop-down.
b. Check the appropriate Access boxes (Read and/or Write).
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c. Click the left-most Update State Access button. A confirmation pop-up
appears.
d. Click on the OK button. The State Access list is updated.
e. If you need to make more State Access modifications for this user, return
to Step 6.
10. To modify the access for all states of a specific region:
a. Select Specific Region Access from the Select Action drop-down. A
Select Region drop-down appears.
b. Select the region from the Select Region drop-down.
c. Check the appropriate Access boxes (Read and/or Write).
d. Click the left-most Update State Access button. A confirmation pop-up
appears.
e. Click on the OK button. The State Access list is updated.
f. If you need to make more State Access modifications for this user, return
to Step 6.
11. Click on the Function Access tab. The Function Access tab of the Modify User
Information screen (Figure 60) for the user appears.
Figure 60: Modify User Information Screen, Function Access Tab
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The screen contains check boxes for the available functions.
12. Check the appropriate boxes.
13. Click on the Save Function Access button. A confirmation pop-up appears.
14. Click on the Continue button.
15. Click on the Return to User List button. You are returned to the Manage User
Accounts screen (Figure 55).
4.6.1.5
Deleting an Existing User
To delete a user:
1. If necessary, search for the user as shown in Section 4.6.1.2.
2. Click on the Delete link for the user. A confirmation window pops up.
3. If you are not sure you want to delete the user, click on the Cancel button.
4. If you are sure you want to delete the user, click on the OK button. A pop-up
appears.
5. Click on the Continue button. If you deleted any user other than your own User
ID, you are returned to the Manage User Accounts screen (Figure 55). If you
deleted your own User ID, you are logged off.
4.6.1.6
Running User Reports
To run a report for user accounts:
1. In the Manage User Accounts screen (Figure 55), make a choice from the
Select Report drop-down.
2. If you selected Users Not Logged In Recently, enter a number under 1,000 in
the No of Days Since Last Login field.
3. Click on the Run Report button. The Report History appears. See Section 4.8
for instructions how to use the Report History.
4.6.2 System Messages
The system provides two categories of system messages. To access either, click on the
System Messages (BCast News / Billboard) text link on the Admin screen (Figure
54). The System Messages Choose Function screen (Figure 61) appears.
Figure 61: System Messages Choose Function Screen
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4.6.2.1
Using the System
BCast News
To change the message that appears on the IBNRS Welcome Screen (Figure 12):
1. Select the BCast News radio button on the System Messages Choose Function
screen.
2. Click on the Select button. The Update Bcast News screen (Figure 62) appears.
Figure 62: Update Bcast News Screen
3. Change the text as appropriate.
4. Click on the Update Bcast News button. The IBNRS Welcome Screen (Figure
12) appears, showing the updated welcome text.
4.6.2.2
Billboard
To add or modify any of the billboard messages:
1. Select the Billboard radio button on the System Messages Choose Function
screen (Figure 61).
2. Click the Select button. The Billboard screen (Figure 63) appears.
Figure 63: Billboard Screen
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This screen allows you to add new items to the billboard, to modify existing
items, and to view files that are associated with an item.
3. To add a new item to the billboard:
a. Click on the Add button. The Add Message screen (Figure 64) appears.
Figure 64: Add Message Screen
b. Enter appropriate text in the Title and Message fields.
c. If you need to attach a file to the message:
i. Click on the Browse button. The Choose File to Upload dialog
appears.
ii. Navigate to the folder containing the file you want to attach.
iii. Select the file you want to attach. This must be a file in TXT, PDF,
Word, or Excel format.
iv. Click on the Open button. The full path to the file appears in the
Associated File text field.
d. If you are not sure you want to add the message, click on the Cancel
button. You are returned to the Billboard screen (Figure 63).
e. If you are sure you want to add the message, click on the Add button.
The entry is added to the top of the Billboard.
4. To modify an existing message on the billboard:
a. Click on the Modify button for the message. The Edit Message screen
(Figure 65) appears.
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Figure 65: Edit Message Screen
b. Change the data per your requirements.
c. If you are not sure you want to add the message, click on the Cancel
button. You are returned to the Billboard screen (Figure 63).
d. If you are sure you want to add the message, click the Update button.
Your Billboard entry is updated.
5. To view a file associated with an item:
a. Click on the hyperlink in the Associated File column.
b. Follow your browser’s instructions to open or save the file.
6. Click on the Cancel button to return to the System Messages Choose Function
screen (Figure 61).
7. Click on the Done button to return to the Admin screen (Figure 54).
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4.6.3 Email
To send an email from the application:
1. Click on the Email text link on the Admin screen (Figure 54). The Email screen
(Figure 66) appears.
Figure 66: Email Screen
2. Enter at least one valid email address in the To, Cc, or Bcc fields. If necessary,
click on the To, Cc, or Bcc button to assist you in finding the email addresses of
the intended recipients.
3. Enter a subject in the Subject field.
4. Enter your message in the large text box in the middle of the screen.
5. If you want to attach a file:
a. Click on the Browse… button. The Choose File to Upload screen
appears.
b. Navigate to the folder containing the file you want to attach.
c. Select the file you want to attach.
d. Click on the Open button. The full path to the file appears in the field
between the Remove and Browse… buttons.
e. Click on the Add button. The file name appears in the Attachments field.
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6. If you want to remove an attached file:
a. Select the file name in the Attachments field.
b. Click on the Remove button. The file name is removed from the
Attachments field.
7. Repeat the previous two steps as often as needed.
8. Click on the Send button. A confirmation window appears.
9. Click on the OK button. You are returned to the Admin screen (Figure 54).
4.6.4 System Email Messages
The system sends automatically generated email message to users for the following
events:
CMS-R199 Certification
CMS 10180 Certification
Account Disabled
Account Locked Out
Password Reset
Regional Office Approval
User ID Reminder
Account About to Be Disabled
User Creation (one for the User ID, and one for the temporary password)
You can modify any of these messages. If applicable, you can also change after how
many days the message is sent.
To edit any of these messages:
1. Click on the System Email Messages text link on the Admin screen (Figure 54).
The System Email Messages screen (Figure 67) appears.
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Figure 67: System Email Messages Screen
2. Click the Select button for the message you want to edit. The message appears
below the list of messages. The Edit and Done buttons also appear.
3. If you do not want to make any changes to the message, click on the Done
button. You are returned to the System Email Messages screen (Figure 67).
4. If you want to make changes to the message, click on the Edit button. The CC,
BCC, Reply To, Subject, Message, and Send After (if applicable) fields
become editable.
5. Make your changes.
6. If you are not sure you want to make the changes, click on the Cancel button
nearest the bottom of the screen.
7. If you are sure you want to make the changes, click on the Save button.
8. Click on the Done button.
9. Click on the Return button. You are returned to the Admin screen (Figure 54).
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4.6.5 User Audit
To audit the activity of a specific user:
1. Click on the User Audit text link on the Admin screen (Figure 54). The Audit
User Accounts screen (Figure 68) appears.
Figure 68: Audit User Accounts Screen
2. Select the user for whom you want to perform an audit from the User drop-down.
3. Select the audit type from the Audit Type drop-down.
4. Enter a date in the From Date field, if necessary using the calendar drop-down.
5. Enter a date in the To Date field, if necessary using the calendar drop-down.
Note: The To Date is not inclusive. If you want to include today’s activities, set it
to tomorrow’s date.
6. To receive the report in Excel format, click the Report button. The Report
History screen (Figure 76) appears. See Section 4.8 for details.
You will also receive an email with the report attached.
7. Repeat Steps 2 through 6 as often as needed.
8. Click on the Return button. You are returned to the Admin screen (Figure 54).
4.6.6 Open Periods
State users can only enter data into the Medicaid CMS-R199 and CHIP CMS-10180
forms during a specific time of the year. The time during which states can enter data is
called an Open Period. Administrative personnel with appropriate access privileges can
manage the Open Periods by performing the following steps:
1. Click on the Open Periods text link on the Admin screen (Figure 54). The Open
Periods screen (Figure 69) appears.
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Figure 69: Open Periods Screen
2. To add an Open Period:
a. Click on the Add button. The Add Open Period screen (Figure 70)
appears.
Figure 70: Add Open Period
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b. Enter the Fiscal Year. This must be a year after 2005.
c. Select the form from the Form drop-down.
d. If you entered a year prior to 2008, select a Submission Type from the
drop-down. For years since 2008, this is always Annual.
e. Enter a Start Date and End Date for the open period. If necessary, use
the Calendar drop-downs to pick both dates.
f. If you are not sure you want to create the new Open Period, click on the
Cancel button. You are returned to the Open Periods screen (Figure 69).
g. If you are sure you want to create the new Open Period, click on the Save
button. You are returned to the Open Periods screen (Figure 69).
h. Repeat this step as often as needed.
3. To modify and existing Open Period:
a. Click on the Modify button for the Open Period you want to modify. The
Modify Open Period screen (Figure 71) appears.
Figure 71: Modify Open Period Screen
b. Change the Start Date and/or End Date as appropriate.
c. If you are not sure you want to modify the Open Period, click on the
Cancel button. You are returned to the Open Periods screen (Figure 69).
d. If you are sure you want to modify the Open Period, click on the Save
button. You are returned to the Open Periods screen (Figure 69).
4. Click on the Return button. You are returned to the Admin screen (Figure 54).
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4.7
Using the System
Reports
To obtain a report:
1. In the Medicaid R-199 Forms screen (Figure 14), CHIP CMS-10180 Forms
screen (Figure 27), or CO Forms screen (Figure 46), click on the Report button.
The Report Options screen appears. The example shown in Figure 72 was
opened from the Medicaid R-199 Forms screen (Figure 14).
Figure 72: Report Options Screen
2. Select a Reports Type. The default shown in this drop-down depends on the
screen from which you entered the Report Options screen. The appearance of
the screen changes depending on your selection:
a. If you selected MEDICAID for the Reports Type, select one of the radio
buttons under Medicaid Reports. Continue at Step 3.
b. If you selected CHIP for the Reports Type, select one of the radio buttons
under CHIP Reports. Continue at Step 3.
c. If you selected CO for the Reports Type, the screen looks as shown in
Figure 73. Make the following selections:
i. Select a form from the Form drop-down.
ii. If you want to include the average number of business days that
elapse from when a service is provided to a Medicaid beneficiary
until the state reimburses the provider for the claim in the report,
check the box labeled Include Average Days.
iii. Check the boxes for the line items that you want to include in the
report.
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Figure 73: Report Options Screen, Type = CO
3. If you want to generate a report for one state, select it from the State drop-down.
Continue at Step 8.
4. If you want to generate a report for multiple states, check the Multiple States
box. The appearance of the top part of the screen changes as shown in Figure
74.
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Figure 74: Report Options Screen, Multiple States
5. If you want to pick from a list of all states, select Select by State from the
Report By drop-down.
6. If you want to pick from a list of states in a specific region:
a. Select Select by Region from the Report By drop-down.
b. Select the region from the Region drop-down.
7. Check the boxes for the states you want to include in the report.
8. If you are not sure you want to generate the report, click on the Return button.
The screen to which you are returned depends on your Reports Type or Form
selection.
9. If you are sure you want to generate the report, click on the Generate Report
button. The report is generated and the Report Complete screen (Figure 75)
appears. Click on the here link to view the report on-screen. Follow your
browser’s instructions.
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Figure 75: Report Complete Screen
10. If you want to rerun the report, click on the Rerun Report button and return to
Step 2.
11. Click on Return button. The screen to which you are returned depends on your
Reports Type or Form selection.
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4.8
Using the System
Report History
The Report History screen allows you access to a list of previously requested reports.
To view a previously requested report:
1. Click on the Report History button in the Navigation Bar. The Report History
screen appears (Figure 76):
Figure 76: Report History Screen
The Report History screen has the As of control. Use this control to only
show those reports that were generated since the date.
2. If you want to change that date, enter the new date in the As of text field or:
a. Click on the calendar icon. The Report History Calendar drop-down
(Figure 77) appears.
Figure 77: Report History Calendar Drop-down
b. Click on the forward and back arrows at the top corners to move to the
desired month.
c. Click on the desired day. The selected date now appears in the As of
textbox.
3. To view a report you have previously generated, click on the Open Report link
for the report. Your browser will ask you what you want to do with the file: open,
save in your browser’s default download location, or save in a folder of your
choice.
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Troubleshooting & Support
5. Troubleshooting & Support
5.1
Error Messages
5.1.1 IBNRS Session Expiration Pending Alert
Your IBNRS session expires after 15 minutes of inactivity. The message shown in
Figure 78 pops up 3 minutes prior to session expiration, allowing you to renew the
current session.
Figure 78: Pending Session Expiration Alert
To prevent your session from expiring, click on the OK button. The previously
accessed screen will be retained. To exit the session, click on the Cancel button.
Note: If 3 minutes have already passed, you must log in again. As advised in the
Session Expired Alert (Figure 79), all data entered in the form you were working on is
lost.
Figure 79: Session Expired Alert
5.1.2 Error/Warning Message Pop-ups
Error or warning pop-ups occur when attempting to save items with missing or incorrect
data. More than one error may be reported at the same time. The error message popup shown in Figure 80 identifies 28 errors on the same form. Red asterisks identify
where the errors were made on the form.
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Figure 80: Error Message Example
If you receive an error or warning message pop-up:
1. Click on the OK button. You are returned to the form.
2. Locate any red asterisks to the immediate right of the textboxes.
3. Make the required corrections on the form.
4. Click on the Save button.
5.1.3 Error Information Screens
Figure 81 shows a sample of an error screen. To expedite resolution of the error, all
errors occurring in the system will be logged and tracked using the Error ID number.
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Figure 81: Sample Configuration Error Screen
5.2
Resolving Password Issues
This section provides step-by-step instructions for forgotten passwords and User IDs.
5.2.1 Forgotten Password
Perform the following steps if you forgot your password:
1. On the IBNRS Login screen (Figure 2), click on the Forgot Password link. The
Forgot User ID or Password dialog (Figure 82) appears.
Figure 82: Forgot User ID or Password Dialog
2. Enter your email address in the Email Address field.
3. Click on the Forgot Password button. A Password Reset message (Figure 83)
appears. You will also receive an email message with a temporary password.
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Figure 83: Password Reset Message
4. Click on the Return to Login Page button. You are returned to the CMS
Warning page (Figure 1).
5. Follow the instructions from Step 3 in Section 3.3, Accessing IBNRS.
5.2.2 Forgotten User ID
Perform the following steps if you forgot your User ID:
1. On the IBNRS Login screen (Figure 2), click on the Forgot Password link. The
Forgot User ID or Password dialog (Figure 82) appears.
2. Enter your email address in the Email Address field.
3. In the Forgot User ID or Password dialog, click on the Forgot User ID button. A
User ID Sent message (Figure 84) appears. You will also receive an email with
your user ID:
Figure 84: User ID Sent Confirmation
4. Click on the Return to Login button. You are returned the CMS Warning page
(Figure 1).
5. Follow the instructions from Step 3 in Section 3.3, Accessing IBNRS.
5.3
Special Considerations
Not applicable.
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5.4
Troubleshooting & Support
Support
If you have any questions or issues that cannot be resolved while using this user
manual, please contact one of the following individuals:
Table 5:
Contact
Support Points of Contact
Phone
Email
Beverly Boher
410-786-7806
[email protected]
Tu Phan
410-786-7172
[email protected]
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Acronyms
Acronyms
Table 6:
Acronym
Acronyms
Literal Translation
CHIP
Children’s Health Insurance Program
CMS
Centers for Medicare & Medicaid Services
CO
Central Office
COR
Contracting Officer’s Representative
DCCA
Data Computer Corporation of America
EUA
Enterprise User Administration
FFP
Federal Financial Participation
FY
Fiscal Year
IBNRS
Incurred But Not Reported Survey
MDCN
Medicare Data Communications Network
O&M
Operations and Maintenance
RO
Regional Office
TRA
Technical Reference Architecture
URL
Universal Resource Locator
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Glossary
Glossary
Table 7:
Glossary
Term
Definition
N/A
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Referenced Documents
Referenced Documents
Table 8:
Document Name
Referenced Documents
Document Number and/or URL
Issuance Date
N/A
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Record of Changes
Record of Changes
Table 9:
Version
Number
Date
Record of Changes
Author/Owner
Description of Change
1.4
12/28/12
L. Haas - DCCA
Initial version to support the 3-zone
architecture.
1.5
5/3/13
L. Haas - DCCA
Removed the use of Access Manager
for logging on. Affected sections:
3.2, User Access Considerations
3.3, Accessing IBNRS
3.4.2.2, Profile Link
3.5, Exiting the System
5.2, Resolving Password Issues
Removed Approvals page per CMS
instructions.
1.6
5/8/2013
1.7
3/21/2014 L. Haas - DCCA
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L. Gamerman - CMS
Restored Approvals page to document,
using USPTO style s-signatures (as
approved by CMS XLC standards team.
Changed Support Points of Contact.
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