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IEP Case Manager 3rd Party/MA Billing Training
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 Web
1. 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.
9. 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.
10. 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.
11. Informed Consent
Within your consent packet I will include the required
DHS consent information that you need to share with
parents. It is titled “MHCP IEP Services~Information
for families” And looks like this:
12. MA Consent Page 1:
“Combined Consent to Share Data & Seek Payment for
IEP Health Related Services A” PAGE 1
~ SEE SAMPLE HANDOUT C
Page 1 is required for ALL MA eligible students
Medical Release section of page 1 needs to be completed
if the student receives nursing or PCA services.
13. 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.
14. 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.
15. Consents Page 3:
Page 3 of the Combined Cosent form~Handout C-2 sample
This 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.
16. 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 Case
managers 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.
17. ASEC MA Biller
Lea Duckstad
Area Special Education Coop
1505 Central Ave NW
East Grand Forks, MN 56721
lea@asec.net
218-773-0924 fax
Email is the best way to contact me if
you need me to call you..email me
and I will do so on my “down” time.
Please feel free to contact me with
any questions.
I am here to support you!