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PLEASE TURN ON YOUR SPEAKERS. This tutorial will take about 15 minutes.

IEP Case Manager 3rd Party/MA Billing Training

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Page 1: IEP Case Manager 3rd Party/MA Billing Training

PLEASE TURN ON YOUR SPEAKERS.This tutorial will take about 15 minutes.

Page 2: IEP Case Manager 3rd Party/MA Billing Training

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!

Page 3: IEP Case Manager 3rd Party/MA Billing Training

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.

Page 4: IEP Case Manager 3rd Party/MA Billing Training

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

Page 5: IEP Case Manager 3rd Party/MA Billing Training

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.

Page 6: IEP Case Manager 3rd Party/MA Billing Training

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

Page 7: IEP Case Manager 3rd Party/MA Billing Training

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.

Page 8: IEP Case Manager 3rd Party/MA Billing Training
Page 9: IEP Case Manager 3rd Party/MA Billing Training

Determine if consent is on file: If YES is checked on

“Signature on file” then the student DOES have consent on file.

Some students will require ANNUAL consents (PCA or private with MA)

If NO is checked or nothing is indicated on “Signature on file” then the student DOES NOT have consent on file.

You will need to email [email protected] to have her either mail or email you the consents. Indicate your preference in your email.

Page 10: IEP Case Manager 3rd Party/MA Billing Training

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.

Page 11: IEP Case Manager 3rd Party/MA Billing Training

Informed ConsentWithin your consent packet I will include the required DHS consent information that you need to share with parents. It is titled “MHCP IEP Services~Informationfor families” And looks like this:

Page 12: IEP Case Manager 3rd Party/MA Billing Training

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 students

Medical Release section of page 1 needs to be completed if the student receives nursing or PCA services.

Page 13: IEP Case Manager 3rd Party/MA Billing Training

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.

Page 14: IEP Case Manager 3rd Party/MA Billing Training

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.

Page 15: IEP Case Manager 3rd Party/MA Billing Training

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.

Page 16: IEP Case Manager 3rd Party/MA Billing Training

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.

Page 17: IEP Case Manager 3rd Party/MA Billing Training

ASEC MA BillerLea DuckstadArea Special Education Coop1505 Central Ave NWEast Grand Forks, MN [email protected] faxEmail 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!