Medicaid Billing Health Aides WCSEA

Eligible Students For aides to bill for services, students must meet the following criteria: Have an IEP Have Aide Support listed as a related service documented in the IEP Receive Aide Support for “health related activities.” This is not academic assistance, but behavioral redirection, toileting, transferring, etc. Be Medicaid Eligible (WCSEA will assist in determining this). Generally, those students with numbers beginning with 96 ARE NOT ELIGIBLE

Aide Billing Guidelines WCSEA will set your caseload in Embrace. Aides must have a Medicaid professional to co-sign, which will be the supervising special education teacher.

Embrace Log-In for Aides Medicaid Billing is done within the Embrace website https://www.outreachtime.com/login/ Username: wcsea email address Password: Password#1 (case sensitive) for first time users Go to: “embraceDS” tab Go to: “complete service sheet” Chose the month for which you are billing Your caseload will appear Chose the student

Billing Procedures for Aides Aides bill on a monthly basis for their eligible students Student billing: Only bill for individual, “health related” activities with students, not for academic assistance Behavioral Redirection Escorting between classrooms Hygiene Assist with Meals The total amount of billing for a school day cannot exceed the minutes in a school day (e.g. you have 4 students on your caseload and the school day is 6 hour. You can bill each student for 90 minutes each, for a total of 6 hours).

Billing Procedures It is optional to enter data on a daily basis onto a paper recording sheet. If preferred, you can enter data directly into the web-based system Record daily activities for each student. You will bill for “units.” A description of the time for each unit is included on the record sheet. Three options for billing: Medical Educational Absent Only record Medical and Absent. Do not record Educational activities Diagnostic Code will need to be entered the first time you bill for a student. The appropriate Diagnostic Code should be provided by the co-signer or WCSEA administrator. I encourage you to first work with your supervising special education teacher to determine the appropriate code based on the special education eligibility disability and any other documented diagnoses. If you need further guidance, please contact Janis Megow-Hamer. Once submitted, the co-signer will approve. Repeat for each student during each month.

Co-Signer (Special Ed. Teacher) Procedures Medicaid billing co-signing is done within the Embrace website https://www.outreachtime.com/login/ www.wcsea.us “staff only” “bds-powerIEP” Sign in using your Embrace/BDS password Go to: “embraceDS” Go to: “supervisor/co-signer” Click on the student name Click the checkbox in the “co-sign” box and save

Monthly Billing Billing should be completed on a monthly basis, by the 6th of the following month (e.g. October billing done by November 6th)

Questions Contact Janis Megow-Hamer at jmegow@wcsea.us or 309-367-4901 for assistance