Third Party Billing for Service Coordinators

What is Third Party Billing? Service Coordinators What is Third Party Billing? What is a claim? Federally funded program Pursues Medicaid reimbursement of some costs of direct and administrative services under IDEA Submits Medicaid claims to recover costs of some medical-related services provided to children who receive specialized services. Records a billable service rendered to a student with special needs Identifies recipient of service, date of service, type of service, diagnosis code, provider of service, and amount charged for the procedure Same as the claim submitted by your physician to your health insurance after an office visit.

Who can provide services? Service Coordinators What is a false claim? Who can provide services? Federal Offense Contains any of the following false info Incorrect student Service did not occur Provider reporting the service did not render the service Incorrect or false date of service Incorrect or false type of service An employee or contractor who is currently licensed by Maryland Department of Health: Occupational Therapist Physical Therapist Speech/Language Pathologist Audiologist Social Worker Psychologist Licensed Professional Counselor An employee or contractor who is currently certified by the Maryland State Department of Education: Advanced Professional Certification Standard Professional Certification

How do I get to the Third Party Billing web site? Service Coordinators How do I get to the Third Party Billing web site? Open Google Chrome. Type bcpss 9041, then enter.

How do I get to the Third Party Billing web site? Service Coordinators How do I get to the Third Party Billing web site? Click the Overview link.

How do I get to the Third Party Billing web site? Service Coordinators How do I get to the Third Party Billing web site? Scroll down.

Service Coordinators How do I log in? Select the link for the TPB/SAS system.

Service Coordinators How do I log in? Logon using your network ID and password.

Service Coordinators How do I log in? Before each use, you promise to not commit Medicaid fraud. Report your services only.

Printing the Service Coordination/Medical Assistance Consent Form Service Coordinators Printing the Service Coordination/Medical Assistance Consent Form Medicaid cannot be billed without the parent’s consent. Pre-printed letters arrive in time for distribution on the first day of school. If you did not receive a pre-printed consent letter for a student, go to the Reports tab. Click Consent Form Creator.

Printing the Service Coordination/Medical Assistance Consent Form Service Coordinators Printing the Service Coordination/Medical Assistance Consent Form Search for by student ID, last name, or first name. Highlight the student and click to select.

Printing the Service Coordination/Medical Assistance Consent Form Service Coordinators Printing the Service Coordination/Medical Assistance Consent Form Select the language. Click Create Form and a new window opens. Verify the student’s information.

Printing the Service Coordination/Medical Assistance Consent Form Service Coordinators Printing the Service Coordination/Medical Assistance Consent Form For a print preview, hold down the Ctrl key and press ‘P’. To change the letter to one page, select ‘+ More Settings...’. Change margins to Minimal and uncheck all options. Uncheck Headers and footers. Click ‘Print’.

Printing the Service Coordination/Medical Assistance Consent Form Service Coordinators Printing the Service Coordination/Medical Assistance Consent Form If you are the Primary Service Coordinator for the student, this letter must be completed and distributed before any services can be reported for billing. Print your name and the names of two (2) alternates. Sign, make a copy, then give the original to the student for the parent’s signature. Send a copy of the form signed by the parent to Third Party Billing Room 201.

Reporting Service Coordination Service Coordinators Reporting Service Coordination Your name is displayed here. Click the SC tab. Report services that you provided.

Reporting Service Coordination Service Coordinators Reporting Service Coordination If your student is not listed, Search Students. You may need to scroll down to get to the button.

Reporting Service Coordination Service Coordinators Reporting Service Coordination Type the student’s pif, last name, or first name. Click the highlighted entry, then Search to pull your student.

Reporting Service Coordination Service Coordinators Reporting Service Coordination Mouse over Update to use the hyperlink. Click Update to enter services.

Reporting Service Coordination Service Coordinators Reporting Service Coordination Reported services are displayed. Student info is from Online IEP and cannot be changed.

Reporting Service Coordination Service Coordinators Reporting Service Coordination Use the calendar widget to select the date you provided the service.

Reporting Service Coordination Service Coordinators Reporting Service Coordination Use the drop down list and click the service you provided. First service of the year is Sent Parent Service…Form.

Reporting Service Coordination Service Coordinators Reporting Service Coordination Outcome Statement is automatically generated. Click submit to promise placing supporting documentation in the student’s confidential folder.

Reporting Service Coordination Service Coordinators Reporting Service Coordination Verify the information you entered. If correct, click Submit. If incorrect, click Back and make corrections. The service has been reported.

Service Coordinators How do I view reports? Go to the Reports tab and click on a report. The Transaction History Report lists your reported meetings for two quarters.

Service Coordinators How do I view reports? Disable pop-up blocker. Select Period and run.

Transaction History Report Service Coordinators Transaction History Report Displays services for students reported by the logged in provider. Available for Current Month, Current Quarter, and Prior Quarter. Save trees. Do not print these reports. Close both report tabs to return to the Reports Menu.

Service Coordination Report Service Coordinators Service Coordination Report Displays ‘1’ for services reported for students. Missing services are indicated by ‘0’. Report end date is previous month. Patterns of zeros may indicate unreported services by a particular provider.

Printing the Service Coordination Activity Log Service Coordinators Printing the Service Coordination Activity Log The Service Coordination Activity Log and supporting documents should be placed in the student’s folder when any of the following occurs: Student transfers mid-year; Student is dismissed from service mid-year; School year ends. Select the SC tab. Find your student. Hold Ctrl –P and click print.

Printing the Service Coordination Activity Log Service Coordinators Printing the Service Coordination Activity Log

Compilation of Services Reported during this session Service Coordinators Compilation of Services Reported during this session If your session has not expired, when you select the Log Out tab, you get a summary of your session activity.

Frequently Asked Questions Service Coordinators Frequently Asked Questions What are examples of billable service coordination? Billable service coordination may include: Meetings/conferences with child or parent/guardian; Progress reports/IEP report cards; Letters; Telephone calls…NOT messages left on an answering machine; Home visits; Emails (printed). Who can be a service coordinator? A Special or Regular educator who is most familiar with the student’s needs, who coordinates the student's IEP, and is certified by the state of Maryland with a Standard or Advanced Certificate. Related Service providers with Speech only students are service coordinators for those students.  

Frequently Asked Questions Service Coordinators Frequently Asked Questions Can a student have more than one service coordinator? No. The student must have one primary and at least one alternate coordinator. The primary service coordinator must be certified, identified on the IEP by name and title, and approved by the student’s parent/guardian. The alternate service coordinator(s), also certified, should appear on the Service Coordination/ Medical Assistance Coordination Consent letter sent to the parent. The primary coordinator is expected to provide services and enter service details in the Third Party Billing System. What are the responsibilities of the service coordinator? Provides coordination of care compliant with the IEP; Participates in the planning and implementation of the IEP; Makes contact with the parent/guardian and/or student throughout each month; Reports service details in the Third Party Billing System by the last day of the month in which services occur. Places appropriate supporting documentation of services in the student’s confidential folder; Sends a copy of the Service Coordination/ Medical Assistance Service Coordination Consent Form to Third Party Billing after the parent signs it;

Frequently Asked Questions Service Coordinators Frequently Asked Questions Under what conditions should service coordination should be reported to TPB? The student must have an IEP. Service coordination cannot be billed for students who are not enrolled in special education; There has been a direct contact (by meeting, visiting, telephoning, or writing) with the parent, guardian, or student; this direct contact occurs expressly to coordinate the IEP. When can the Service Coordination/ Medical Assistance Coordination Consent Form be sent home? On the student’s first day on your case load. How will I know my services have been reported to TPB? Verification is provided after the 2nd submit, at the end of your session when you click on the Log Out tab, and via the reports function. Can I bill for 504 or Service Plans? No. Students with 504 Plans or Service Plans are not billable.