Provider information and attestations
Page updated: 6/27/25
This section of the cost report collects information to identify the provider organization, including:
DHS may use this contact information to request clarifying details and supporting documentation about the provider organization’s completed cost report.
Category | Instructions |
Provider business information | Provide all the following information: Note: The Federal Employer Identification Number (FEIN) automatically populates. If the FEIN is incorrect, email dhs.costreport@state.mn.us. DHS will give a placeholder FEIN to a reporting entity when the reporting entity only has an NPI or UMPI. DHS placeholder FEINs begin with Z, followed by numbers (e.g., Example Organization has an FEIN of Z00000001). Quick tip: Unless the organization filed paperwork to become a non-profit or government entity, the organization is a for-profit organization. |
Contact information for cost report preparers | Use this optional section to add contact information for additional cost report preparers (i.e., members from your organization or third party vendors that will help complete the cost report). The system automatically includes the authorized agent’s contact information. To add additional cost report preparers, provide all the following information: After the authorized agent saves the additional cost report preparers, the system sends them a welcome email with login information. If you receive an error, email dhs.costreport@state.mn.us to add the additional cost report preparers to your report. For more information, refer to authorized agents and provider users. |
Cost-reporting period | Provide the start date and end date of the fiscal year for which the organization is providing revenue and cost information. The cost-reporting period must be a 12-month period that ended no more than 18 months before submission of the cost report, as required by Minn. Stat. §256B.4914, subd. 10a(b). For most organizations, the cost-reporting period will be the previous calendar year (e.g., Jan. 1, 2024, to Dec. 31, 2024). Example: If the organization is reporting in 2024, the organization’s cost report will most likely be for calendar year 2023. |
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