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City and County of San Francisco Fiscal/Billing Workgroup May 28, 2009 RRG Revenue Reporting Groups What is an RRG? Description: An RRG is a code assigned to a program that determines how revenue will be reported for many of the basic system generated billing reports. Revenue groups are related to programs and must be assigned when a program is defined. RRG should be based on the lowest level of reporting required. This association allows the agency to determine Programs by clinical requirements and RRG’s by fiscal requirements. It is important to note that while many programs can consolidate to a single RRG, for each RRG, there must be at least one corresponding program. Revenue reporting groups is equivalent to cost centers. You can have multiple programs assigned to a single cost center but you can not have multiple cost centers to a program. This field is used to run and sort your financial reports. Who does RRG have an impact on? Revenue Reporting Groups are often used by fiscal staff for budgetary decisions, grant writing, Board of Supervisor reports, etc. They are typically large groups of programs that meeting a certain criteria within the business processes and policies. Typically, individuals interested in high-level grouping reports are: • Chief Executive Officers (CEO) • Chief Financial Officers (CFO) • Executive Directors (ED) • County Administrative Analysts (CAA) • Budget Officers (BO) Where is RRG assigned? RRG is assigned at Program Maintenance. Each program is assigned to one Revenue Reporting Group. Path: System Maintenance → System Definition → Program Maintenance REMEMBER! More than one program can be assigned to a single RRG. (Think Big Buckets) What does the RRG to Program relationship look like? Illustration of One RRG to Many Programs RAMS RRG Seneca Program (RU) UC Citywide Mental Health Mission MH South of Market PPN RRG Proposal for SF File Build Note: Representative Sample; not entire listing RRG Mental Substance Health Abuse SFGH South of RAMS UC Westside UC Child RAMS Walden Mission MH Seneca Edgewood Westside Ward 7 A Market Adult Citywide Adult MH Crisis Children Residential Program (RU) Does RRG appear within Avatar other than Program Maintenance? Examples: • Options: • Program Transfer – appears for informational purposes for the program that the client is being transferred to. Is not editable. • Reports: - RRG is used to combine together or filter programs into a larger grouping. • Open Claims • Payments/Adjustments • Active Receivables • Earned Income • Can be used for Custom Crystal Reports for BOS reports, Budget reports, etc. Wait! Where can we define Inpatient versus Outpatient, Civil Service versus Contract for reporting? There are two more fields, Treatment Setting and Treatment Service, that will be utilized in the Program Maintenance that may include additional information to be able to filter information for reporting. Example as follows: Program (RU): FSA Program (RU): FSA Older Adult TAY Treatment Service: Treatment Service: 65+ Adult Contract 14-21 Adolescent Contract Treatment Setting: Treatment Setting: Outpatient Outpatient RRG: Mental Health RRG: Mental Health Using the FSA examples – How RRG, Treatment Setting and Treatment Service could be used for filtering: Report to include all Report to include all RRGs RRGs of “Mental Health” of “Mental Health”, all will have: Treatment Setting of “Outpatient”and only Treatment Service of “65+ Adult Contract” will have: • FSA Older Adult • FSA Older Adult • FSA TAY The report on the right has the same RRG and Treatment Setting assigned to both programs but TAY is not assigned the same Treatment Service. Additional Questions: • “How do Avatar define a program? I have concerned on the statement 'one RRG per program'. What if it is a medi-medi or MediCal –Insurance crossover revenues; or a combination of EPSDT and MediCal; or MHSA and General fund; or Grants and General Fund in a program?” (Lizza Leviste) Programs are defined as per User’s business policies. Most CA counties use the relationship of Provider Number to Program or designate program by the type of services they offer (i.e. mental health outpatient children). This will be covered in more detail during Program File Build. Medi-Medi, EPSDT, MHSA, etc. are assigned by the guarantor in the clients financial eligibility. The relationship is the payer source to the client and then which program they received services in. RRG is normally a grouping of services types rather than a groups of guarantors. RRG is not used to define services into CA Cost Reporting detail. (Think High Level Groupings to non- Fiscal Departments.) Additional Questions: • “How does RRG get assigned?” (Lizza Leviste) In Program Maintenance only. (See slide 4) • “What are the classification or category of RRG? Is it by Outpatient and by Inpatient only?” (Lizza Leviste) Depending upon reporting requirements of the User. Dictionary is completely customizable by the User to fit the reporting requirements for items such as budget reports, BOS reports, etc. Treatment Setting of the Program is used to define Inpatient, Outpatient or Partial Day. Additional Questions: • “In substance Abuse, where do Avatar classify the Narcotic Treatment? Preventions Services? DUI Services? this can be done if RU is defined this way. does this correspond to mode of service? is this the complete list? are RU's specific to these categories?” (Lizza Leviste) For CSI and CalOMS reporting, mode of service is defined in Program Maintenance. For mode of services outlined above for ADP are further classified at the service code level. These questions will be covered in more detail during Program and Service Code file builds. RRG is a higher classification or grouping of services or programs determined by fiscal reporting needs. • “RRG - does this correspond to mode of service (via RU)?” (Children’s MH Director) Mode of service is assigned at the service code level not RRG or Program (RU). See above. Additional Questions: • “I don‘t understand RU table definition so we need to discuss the structure civil service vs contract - no need for this in RRG? (ie. can we get this from other data fields)” (Children’s MH Director) As possible suggestion is to utilize the Treatment Service dictionary to designate a civil service vs. contract. Or within the Program Code designation. This can be further explored in Program file build and analyzed during billing scenarios walk thru. • “PPN - how is this reflected in RRG?” (Children’s MH Director) Depending upon the desired reporting groupings for services and programs. See above for suggested alternatives. Remember RRG is utilized for high level financial reporting to BOS, Budget Officers, etc. who want to see a big picture (i.e. How many services are delivered from mental health services versus substance abuse?) RRG does not effect billing or CSI /CalOMS reporting.
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