CMS Pub. 100-16, ch. 7, § 120.2.8

CMS communicates the status of risk adjustment submissions via reports delivered to

submitters’ mailbox. The reports remain in the submitters’ mailbox for 14 days. MA

organizations may access reports through CSSC. Table 25 provides an overview of the

Risk Adjustment reports received from the Front End Risk Adjustment System (FERAS)

and the Risk Adjustment Processing System (RAPS).

Table 25. Reports Overview

Report Description Frequency

FERAS Response

Report

• Indicates file is accepted or

rejected

• Identifies reasons for rejection

• Report layout format

Same business day for Secure

Website and FTP users

Next business day for

Connect:Direct and Gentran users

RAPS Return File • Contains the entire submitted

transaction

• Identifies 300-, 400-, and 500-level errors

• Flat file layout

Next business day after

submission

RAPS Transaction

Error Report

• Communicates errors found in

CCC records during processing

Next business day after

submission

• Displays only 300-, 400-, and

500-level error codes

• Report layout

RAPS Transaction

Summary Report

• Summarizes the disposition of

diagnosis clusters

• Report layout

Next business day after

submission

RAPS Duplicate

Diagnosis Cluster

Report

• Identifies diagnosis clusters with

502-error message

• Clusters accepted, but not stored

• Report layout

Next business day after

submission

RAPS Monthly Plan

Activity Report

• Provides monthly summary of

the status of submissions by

submitter ID and Plan Number

• Report layout

Available for download the

second business day of the month

RAPS Cumulative

Plan Activity Report

• Provides cumulative summary

of the status of submissions by

submitter ID and Plan Number

• Report layout

Available for download the

second business day of the month

RAPS Monthly Error

Frequency Reports

• Provides a monthly summary of

all errors associated with files

submitted in test and production

• Report layout

Available for download the

second business day of the month

RAPS Quarterly

Error Frequency

Reports

• Provides a quarterly summary of

all errors on all file

submissions within the 3-month

quarter

• Report layout

Available for download the

second business day of the month

following each quarter

Examples of risk adjustment reports are available in the Edits and Reports module of the

Risk Adjustment Training Participant Guide at http://www.csscoperations.com. Once at

the web site, select “Training Information,” then select that latest “Risk Adjustment

Training Information” link, and then select “Participant Guides.”