Document
Hospital Financial Disclosure Independent Gov Cost Est
ICR 200710-0938-003 · OMB 0938-0995 · Object 4553001.
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| Total | Task 1 | Task 2 | Task 3 | Task 4 | Task 5 | Task 6 | Task 7 | Task 8 | ||||||||||||
| FTEs | Rates | Database | Bi-Weekly Status Reports | Legal Analysis | Auditing/Financial Review | Preparation of Referrals | Follow-up Actions | Final Report | Administrative Action | |||||||||||
| Cost Elements | Hours | Total | Hours | Total | Hours | Total | Hours | Total | Hours | Total | Hours | Total | Hours | Total | Hours | Total | TOTAL | |||
| Direct Labor | ||||||||||||||||||||
| Professional/Technical | ||||||||||||||||||||
| Program Director | 1.00 | $300.00 | 4 | $1,200.00 | 4 | $1,200.00 | 75 | $22,500.00 | 75 | $22,500.00 | 75 | $22,500.00 | 20 | $6,000.00 | 50 | $15,000.00 | 20 | $6,000.00 | $96,900.00 | |
| Technical Writer | 1.00 | $45.00 | 0 | $- | $- | $- | $- | 100 | $4,500.00 | 25 | $1,125.00 | 250 | $11,250.00 | $- | $16,875.00 | |||||
| Legal Counsel | 2.00 | $150.00 | $- | $- | 4800 | $720,000.00 | 40 | $6,000.00 | 150 | $22,500.00 | $- | 75 | $11,250.00 | $- | $759,750.00 | |||||
| Benefit Integrity Manager | 1.00 | $83.00 | 8 | $664.00 | 50 | $4,150.00 | 150 | $12,450.00 | 250 | $20,750.00 | 200 | $16,600.00 | 200 | $16,600.00 | 125 | $10,375.00 | 20 | $1,660.00 | $83,249.00 | |
| Data Analyst | $35.00 | 2000 | $70,000.00 | 50 | $1,750.00 | $- | $- | $- | $- | $- | $- | $71,750.00 | ||||||||
| IT Developer | 1.00 | $53.00 | 100 | $5,300.00 | 50 | $2,650.00 | $- | $- | $- | $- | $- | $- | $7,950.00 | |||||||
| Auditing/Finance | ||||||||||||||||||||
| Audit/Reimbursement Mgr. | 15.00 | $50.00 | $- | $- | $- | 2000 | $100,000.00 | 250 | $12,500.00 | 50 | $2,500.00 | 100 | $5,000.00 | $- | $120,000.00 | |||||
| Accounting/Reimbursement Technician | 15.00 | $17.00 | $- | 200 | $3,400.00 | $- | 1500 | $25,500.00 | 25 | $425.00 | 75 | $1,275.00 | 75 | $1,275.00 | $- | $31,875.00 | ||||
| Administrative Asst | 10.00 | $19.00 | 100 | $1,900.00 | 200 | $3,800.00 | $- | 75 | $1,425.00 | 75 | $1,425.00 | 500 | $9,500.00 | 75 | $1,425.00 | $- | $19,475.00 | |||
| Subtotal Direct Labor | $79,064.00 | $16,950.00 | $754,950.00 | $176,175.00 | $80,450.00 | $37,000.00 | $55,575.00 | $7,660.00 | $1,207,824.00 | |||||||||||
| Fringe Benefits | 0.15 | $11,859.60 | $2,542.50 | $113,242.50 | $26,426.25 | $12,067.50 | $5,550.00 | $8,336.25 | $1,149.00 | $181,173.60 | ||||||||||
| Total Direct Labor | $90,923.60 | $19,492.50 | $868,192.50 | $202,601.25 | $92,517.50 | $42,550.00 | $63,911.25 | $8,809.00 | $1,388,997.60 | |||||||||||
| Indirect G&A | 10% | $9,092.36 | $1,949.25 | $86,819.25 | $20,260.13 | $9,251.75 | $4,255.00 | $6,391.13 | $880.90 | $138,899.77 | ||||||||||
| Subtotal Costs before fee | $100,015.96 | $21,441.75 | $955,011.75 | $222,861.38 | $101,769.25 | $46,805.00 | $70,302.38 | $9,689.90 | $1,527,897.37 | |||||||||||
| Fixed Fee | 7% | $7,001.12 | $1,500.92 | $66,850.82 | $15,600.30 | $7,123.85 | $3,276.35 | $4,921.17 | $678.29 | $106,952.82 | ||||||||||
| TOTALS | $107,017.08 | $22,942.67 | $1,021,862.57 | $238,461.68 | $108,893.10 | $50,081.35 | $75,223.55 | $10,368.19 | $1,634,850.19 |
| File Type | application/vnd.ms-excel |
| File Title | Hospital Financial Disclosure Independent Gov Cost Est |
| Author | CMS |
| Last Modified By | CMS |
| File Modified | 2007-08-28 |
| File Created | 2007-04-02 |