Annual Provider Meeting UF North Central Early Steps FY 2018-19 Contract Period Review

Agenda Welcome Medicaid Updates MOA FY 2018-19 and accompanying forms Thursday May 24, 2018 4:30 pm – 7 pm 1329 SW 16th Street Room 4150 Welcome Medicaid Updates MOA FY 2018-19 and accompanying forms Fiscal Updates - Required Documentation, New Claims Form, Claims Process, Deadlines and Quality Assurance New IFSP – Policy and Procedures Update Eligibility Category – At Risk Department of Health - Demonstration Site Overview Pre-Adoption Language – IFSP Evaluation Team(s) Closing Comments/Questions Sharon

AHCA New Contracts for the Statewide Medicaid Managed Care Program

2018-19 North Central Early Steps Forms to be Completed 2018-19 Provider MOA Completed by all providers 2018-19 Interpreter MOA Completed by all interpreters Procedural Safeguards Statement of Understanding Completed by all providers and interpreters MMA and TPIN Plan Enrollment Summaries Completed by all licensed therapy providers *We are also requesting a copy of your current liability insurance

2018-19 UF Vendor Forms to be Completed UF Vendor Application Completed by any new providers (vendors) Completed by any vendors whose status has lapsed UF Vendor Tax Information Completed by all new or lapsed vendors Completed by any returning vendors who use a SSN rather than TIN UF Electronic Funds Transfer Form Completed by any new or lapsed vendors Completed by any vendors whose bank info has changed PLEASE NOTE: Must attach voided check or bank statement W-9 IRS Form Completed by returning vendors using a TIN (not SSN) Sharon/Emily

NCES Fiscal Team Emily Hurlston, Fiscal Team Lead ehurlston1@peds.ufl.edu | 352-273-8898 Claims process questions and training UF vendor set-up Monthly invoice processing Claims payment questions, EOBs, errors, etc. Adilene Hernandez, Program Assistant adilenehernandez@ufl.edu 352-273-8625 Internal charge entry Medicaid assistance Alexandra Salomon, Program Assistant Allie.salomon@ufl.edu | 352-273-8552 Data entry of claims Data entry of payments BDI entry Via Move-it: NCESFiscal@peds.ufl.edu Or Fax to our attention at 352-294-8088

Changes to NCES Claims Form There is now only one tab for claims. The entry tab is the final tab – “Claims Sheet” tab ES ID number can autofill from “Caseload” tab All instructions for completing the new form are provided on the “Instructions” tab Licensed providers have an added column for partial insurance payments. Use same form for all claims submissions Please begin using this form no later than July 1, 2018. Emily

NCES Claims Form Emily

NCES Claims Form Grey tabs are informational - Provider Codes, Taxonomy, Fee Schedule, Instructions You will be entering your case information on the Caseload tab and your claims on the Claims Sheet tab. Emily

NCES Claims Form Emily On the Caseload tab, type in your current caseload: names, ID#s and addresses. Save the form as a template to be reused. Add new kids to the Caseload tab as needed. If you need to correct or delete a line just type (or space) over it!

NCES Claims Form Emily On the Claims Sheet tab, enter your name, provider type, invoice number, and invoice date at the top of the page.

NCES Claims Form Emily If the Caseload tab is used, the ES ID number will autofill when the child’s name is entered here on the Claims Sheet.

NCES Claims Form Emily You can use the dropdown menu for the location column or enter the location by tabbing/typing.

NCES Claims Form Emily This column is restricted to the services listed on the Taxonomy tab. If you get an error message, make sure you are typing in the correct service. Using the correct service will make the Rate and Total columns autofill.

NCES Claims Form Emily When you type in the service, the rate will autofill. When you type in the units or miles, the total will autofill.

NCES Claims Form Emily This column is for partial payments from insurance. Please enter as a positive number. Form will calculate the subtraction. This column can be removed/hidden for EI providers.

NCES Claims Form Emily If you have any communication to the NCES Fiscal Team about a specific claim, please enter it here.

NCES Claims Form If you get any of these error messages, you have entered something that is not valid. You can override this by hitting “yes” or “ok” to continue, however, the validated data is there for a reason – it’s what makes the form work. Try to determine what you are doing wrong by referring to the instructions, dropdown menu, or Taxonomy! Emily

NCES Claims Form Emily The form will keep a running total at the bottom of the sheet. When you are done with the sheet, “save as” with a new name.

Reminders for NCES Claims Form Please start with your template for each submission. Copying and pasting into previous claims sheets may cause errors. Questions about services, codes, fees? Please see “Fee Schedule” or “Taxonomy” tabs. Always save entire file in Excel format and send via Move-it to NCES Fiscal Team. Always expect a response. If you do not receive one, please contact Fiscal to inquire about your submission. Claims should be submitted within 30 days from DOS. Claims will be denied if submitted more than 60 days from DOS. Emily

Protected Health Information (PHI) No PHI? Move-it or Fax E-mail is okay Emily Always use Move-it or Fax when sending information containing any patient identifiers. Do not use e-mail.

NCES Fiscal Claims Process Overview STEP 1 Receipt of claims via Move-it STEP 2 Claims entry to database STEP 3 Creation of invoices STEP 4 Allocation of funds STEP 5 Approval in UF Payment Solutions STEP 6 Payment to Provider Emily

NCES Fiscal Claims Timeline 1st day of the Month Claims receipt deadline for Invoice Batch E First week of the month Claims entry, invoicing, allocations & approvals of Batch E 2nd/3rd week of month Payment (dependent on UF System – time estimated) of Batch E 15th day of the Month Claims receipt deadline for Invoice Batch F Third week of the month Claims entry, invoicing, allocations & approvals of Batch F End of month or first week of next month Payment (dependent on UF System – time estimated) of Batch F Emily

End of UF Fiscal Year Timeline and Deadlines June 30, 2018 End of Fiscal Year for UF and NCES DEADLINE to contact NCES Fiscal about ANY remaining claims issues from previous months. July 1, 2018 DEADLINE to submit your 2018-19 MOA renewal packet to NCES Fiscal. July 13, 2018 DEADLINE to turn in all CONT claims and any claims with established EOB denials. DEADLINE to notify NCES Fiscal of any pending claims. Action will be decided on a case-by-case basis. Claims with DOS on or before 6/30/18 CANNOT be paid after these FY deadlines. Claims with DOS on or after 7/1/18 will be processed on the regular schedule once UF Systems reopen in July. JUL-E may be skipped or combined with JUL-F depending on the timing and volume of claims in July.

NCES Quality Assurance NCES Quality Assurance Audits take place monthly and consist of the following: Review of one month of claims/documentation from each provider at least once during the fiscal year Review of each child’s monthly progress note to confirm the following: Dates of service during that month Start/end time of each service Parent signature confirming each service took place Signature of provider on monthly note Comparison of monthly progress note with submitted/paid claims for that month: Are all billed dates of service documented? Do times documented support units billed? Is there sufficient explanation for NESF/travel associated with cancelled service(s)? Report and Summary to provider with results of audit Possible denial or recoupment for overbilling, billing in error, and/or ongoing insufficient documentation issues Additional training, if needed, to support ongoing quality documentation and payment of claims

New IFSP – Policy and Procedures Update

A. A child is eligible based on an at-risk condition if the child has a physical or mental condition known to create a risk of developmental delay. B. Written confirmation from a licensed physician is required to establish at-risk eligibility and must be in the child’s Early Steps record. C. Services for infants and toddlers with a physical or mental condition known to create a risk of developmental delay will include the following: Individualized family support planning;Service coordination; Developmental surveillance; andFamily support.  

Pre-Adoption IFSP Language – Evaluation Teams

Emily and Sharon