IEP Case Manager 3rd Party/MA Billing Training

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  • 1. PLEASE TURN ON YOUR SPEAKERS.This tutorial will take about 15 minutes.
  • 2. Why do we do MA billing? Federal funds ~ separate “extra pot” of money  Since beginning MA reimbursement the ASEC districts have received over $2.1 million  Assists schools with budgetary dilemas  Aids special education students/programs It’s the LAW!
  • 3. District Responsibility Establish a system for maintaining records to document billing MA. This responsibility is generally the function of the district bookkeeper or business manager. For your district specific information See Handout A-MA District Contacts and Supervisor of PCAs list.
  • 4. IEP Case Manager Responsibility Check student MA eligibility list on SpEd Web periodically for MA eligible students (required at the start of EACH school year) Determine if the student has a MA billable service If the student has a billable service determine if the student has MA consent on file and if the student does not; Obtain MA parental consent to bill DHS
  • 5. STEP 1:Check student eligibility list on SpEd Web1. Log on to SpEd Web at http://15.spedforms.org/0997/2. Click on “Work with Students”3. At the to of the list of students you will see the option to indicate “MA ELIGIBLE” Check the MA eligible option. These are your current eligible students.TRY IT NOW…log on your SpEd Web and find your list of students.
  • 6. Step 2:Determine if the student has a MA billable service Physical Therapy Occupational Therapy Speech Language Pathology and Audiology Services Nursing Services Personal Care Assistance Services Assistive technology devices Special Transportation Interpreter Services (oral or sign) IEP Evaluations
  • 7. Step 3:Determine if consents are on file:1. Specific student “Work on this file”2. Click MA forms (3rd yellow box on top of forms)3. Go to “MA billing setup” The next slide will give you a sample view of what you will see and what to look for.
  • 8. Determine if consent is on file: If YES is checked on  If NO is checked or “Signature on file” then nothing is indicated on the student DOES have “Signature on file” then consent on file. the student DOES NOT have consent on file. Some students will  You will need to email require ANNUAL lea@asec.net to have her consents (PCA or private either mail or email you with MA) the consents. Indicate your preference in your email.
  • 9. Step 4:Obtain MA Parental Consent to bill DHS (IMPORTANT) Without this consent the biller cannot seek a reimbursement for your district.The consents will either be emailed or mailed to you by the MA biller.Best time to get consents signed are after the IEP meeting. But if timing doesn’t allow for that please get the signature the best way possible from that parent.
  • 10. Informed ConsentWithin your consent packet I will include the requiredDHS consent information that you need to share withparents. It is titled “MHCP IEP Services~Informationfor families” And looks like this:
  • 11. MA Consent Page 1: “Combined Consent to Share Data & Seek Payment for IEP Health Related Services A” PAGE 1 ~ SEE SAMPLE HANDOUT CPage 1 is required for ALL MA eligible studentsMedical Release section of page 1 needs to be completed if the student receives nursing or PCA services.
  • 12. MA Consent Page 2: Page 2 of the Combined Consent will only be sent or emailed IF the MA eligible student ALSO has PRIVATE INSURANCE. The services that the student receives need to be INITIALED by the parent at top of page 2. Assure the parent this information is used only so I can ASK the insurance company if they will pay for the IEP service. And THEY DON’T! I am only seeking a denial from them so I then can bill DHS. Assure the parent I will NEVER bill a private insurance.
  • 13. Consent Page 2 Cont: Please make sure that parents confirm the private insurance information that DHS has provided the MA biller. Also make sure the parent includes the Date of Birth of the Policy holder. I will make sure that it is highlighted. This page NEEDS to be signed and dated as well. This will need to be done annually for students who carry both MA and private insuarance.
  • 14. Consents Page 3:Page 3 of the Combined Cosent form~Handout C-2 sampleThis page is only used in a few circumstances:IF parent refuses or denies MA billing they need to sign and date this page only. This is also used if the want to deny billing after consent has already been given. I can provide this at any time. And the parent has the right to do so.Also parent CAN sign it if they have private insuarnce and I will make sure that I have checked the “Bill my private insurance” tab under Section 4.
  • 15. WHEW! Now that you have the consent WHAT DO YOU DO!?IMPORTANT!• Give the original consent to the MA District Contact and send a copy to the MA biller (ASEC office). You may also fax it.Complete the IEP Third party checklist for IEP Casemanagers to send with the copy of the consent.• Once consents are on file I will notify the service providers to begin billing. I will update you as needed if annual consents are required.
  • 16. ASEC MA BillerLea DuckstadArea Special Education Coop1505 Central Ave NWEast Grand Forks, MN 56721lea@asec.net218-773-0924 faxEmail is the best way to contact me ifyou need me to call you..email meand I will do so on my “down” time.Please feel free to contact me withany questions. I am here to support you!