Annual Provider Meeting UF North Central Early Steps FY 2019-20 Contract Period Review Welcome

Agenda Welcome MMA Updates MOA FY 2019-20 and accompanying forms Thursday June 6, 2019 4:30 pm – 7 pm 1701 SW 16th Ave. Building A Welcome MMA Updates MOA FY 2019-20 and accompanying forms Fiscal Updates Managed Health Care Plans Use of BDI-2 NU - Entrance and EXIT Child Outcomes Physical Therapy Evidenced Based Practices Amanda Guevara – Kids on the Move Closing Comments/Questions Agenda

2019-20 North Central Early Steps Forms to be Completed 2019-20 Provider MOA Completed by all providers 2019-20 Interpreter MOA Completed by all interpreters Procedural Safeguards Statement of Understanding Completed by each individual provider and interpreter MMA Plan Enrollment Summary TPIN Plan Enrollment Summary Completed only by licensed therapy providers *We are also requesting a copy of your current liability insurance. Quickly run over items needed to renew. Documents are available for download from Resources section of NCES website Renewing providers: MOA Procedural Safeguards – one per individual MMA Summary – all providers this year TPIN Summary – therapy providers only at this time Copy of your liability insurance policy coverage page Documents can be turned in to fiscal staff today. If you don’t have everything with you today, please turn it in before July 1, 2019.

2019-20 UF Vendor Forms to be Completed UF Vendor Application Completed by any new providers/interpreters (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 EIN 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 only by returning vendors using an EIN (not SSN) In addition, please update your vendor status by turning in either a W-9 or tax information form. You can only use the W-9 if you have an employer identification number. You cannot use your social security number. If you use your social security number, then please complete the vendor tax information form instead. You do not need to complete the other vendor forms unless there is a change to your information.

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 Introductions – Adilene: Medicaid provider enrollment help Alexandra: BDI entry, back-up for claims issues

NCES Claims Form Claims form – quick overview. If you use the caseload tab, your Child ID numbers will auto-populate onto the claims form. Please save as a template. 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 You will not need to retype the number each time. If you need any assistance with this form, please schedule a time to meet with me. If the Caseload tab is used, the ES ID number will autofill when the child’s name is entered here on the Claims Sheet.

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. Always start with a clean template – if you are copying and pasting you may run into issues. Please refer to the tabs at the bottom for help with services/codes/fees. Always save the entire file and send only via Move-it to NCES Fiscal Team. Please remember to always look for a response. If you do not get a response from us, assume we did not receive your claims. Please submit your claims on time. Claims are due within 30 days from date of service. Claims are late and denied if they are more than 60 days from date of service. Exception – EOBs.

Reminders for EOB / Denial Submissions Private Insurance EOBs One per calendar year (per child, per service) is sufficient unless: insurance changes or partial payment amount changes. EOBs must include: name of child, date(s) of service, insurance company name, claim number, and denial reason. Billing errors and missing information are not valid denial reasons. Claims must be marked as denied (not just pending). MMA Denials Please verify coverage and send denials at least once a month. MMA plans should be paying for all EI claims unless coverage has lapsed. You may be required to submit an AHCA complaint before attempting to receive contract dollar reimbursement. Denials must include: name of child, date(s) of service, MMA name, claim number, and denial reason. When you have a primary or secondary payer to bill before Early Steps, please make sure to send proper documentation to us. An EOB or denial letter must include: Name of child Date of service Insurance or plan name Claim number VALID DENIAL REASON For EI claims to MMA plans – since plans should be paying for all EI services, you’ll be required to attempt appeal/resolution with the plan, and possibly submit an AHCA complaint before attempting to get Early Steps reimbursement. If Medicaid coverage has lapsed, you can bill directly to NCES.

Reminders for Verifying MMA Coverage Use the FLMMIS site for verifying MMA coverage https://home.flmmis.com Do not rely on the IFSP or family’s MMA card alone Verify Medicaid is active under “Benefit Plan” Verify specific MMA plan under “Managed Care” If CMS (Children’s Medical Services) Health Plan is listed: Bill Wellcare If Medical Transportation Management is listed: Bill Medicaid (fee-for- service). If denied, submit an AHCA complaint. If no MMA specialty plan is listed, this is likely a new Medicaid case and an MMA has not been assigned yet. Please bill Medicaid (fee-for-service) until plan is assigned. If denied, submit an AHCA complaint. Coverage should be verified at least once a month. Please be sure to verify active coverage and specific MMA Plan in the FLMMIS portal before billing. Do not rely on the IFSP or family’s card alone. If CMS Health Plan is listed – Bill Wellcare If Medical Transportation is listed – Bill Medicaid under fee-for-service If no MMA plan is listed but coverage is active – Bill Medicaid under fee-for-service. I’ve tried to be very specific with step-by-step processes here because I know there have been a lot of changes. I will be posting this slideshow to our website, so please print out applicable slides to refer to regularly.

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 Just a reminder of our claims process and timeline. Unfortunately, once step 5 is finished, I have no control over the actual payment. I try my best to predict payment dates and to line the invoices up accordingly so you know when to expect payment. I think we are usually pretty close!

NCES Fiscal Claims Timeline 1st day of the Month Claims receipt deadline for Invoice Batch G First week of the month Claims entry, invoicing, allocations & approvals of Batch G 2nd/3rd week of month Payment (dependent on UF System – time estimated) of Batch G 15th day of the Month Claims receipt deadline for Invoice Batch H Third week of the month Claims entry, invoicing, allocations & approvals of Batch H End of month or first week of next month Payment (dependent on UF System – time estimated) of Batch H Here’s our monthly timeline for invoicing. All claims received by the 1st of the month make it into our first invoice batch. All claims received by the 15th of the month make it into our second invoice batch.

Protected Health Information (PHI) No PHI? Move-it or Fax E-mail is okay Just a reminder. Please do not include names, birthdates, initials, or other identifying information in e-mail. Send this information only via Move-it. Remember that the subject line of a Move-it message comes through in the package delivery notice via e-mail, so please do not use kids’ name in the subject line of Move-it messages. Always use Move-it or Fax when sending information containing any patient identifiers. Do not use e-mail.

End of UF Fiscal Year Timeline and Deadlines June 30, 2019 End of Fiscal Year for UF and NCES July 1, 2019 DEADLINE to contact NCES Fiscal about ANY pending/past claims that have not been paid. DEADLINE to submit your 2019-20 MOA renewal packet to NCES Fiscal. July 14, 2019 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.) Here are the upcoming deadlines. I have sent these out via e-mail and gotten responses from all of you. Thank you! The main date to remember is July 14. All claims with a date of service on or before June 30 must be submitted to our fiscal team by July 14. If you are able to submit earlier, that would be appreciated! Claims with a DOS on or before 6/30/19 CANNOT be paid after these FY deadlines. Claims with DOS on or before 6/30/19 will be processed as JUN-H but delayed to mid-July to allow time for submission. JUL-G invoice batch will be skipped due to UF financial system shutdown for end of fiscal year. Claims with DOS on or after 7/1/19 will be processed as JUL-H on the regular claims schedule.

NCES Quality Assurance Services for dates that are missing from a progress note cannot be paid by NCES. Travel/NESF for dates that are missing from a progress note cannot be paid. Travel/NESF for dates that are marked “cancelled” can only be paid if provider documents on progress note that they “called ahead to confirm appointment” and family was “no show” or “cancelled at the door.” Dates of service without a parent signature cannot be paid by NCES. Date discrepancies will not be denied, but clarification may be requested. Travel/NESF cannot be billed for same child/same day unless two different services at different times are required and documented. Travel/NESF cannot be billed twice for siblings (one trip = one travel/NESF claim) Services without a start and end time cannot be paid by NCES. Claims for a child whose progress note was not provided to NCES cannot be paid unless note is provided. We’ve had a full year of ongoing quality assurance (or claims audits) and it has been very successful. Most of you are doing a great job of making sure documentation matches claims submitted! This is just an overview of what I send out monthly with the audit reports. If you ever have any questions, please arrange time to meet with us. We are happy to help you understand the process better and have success with your Early Steps claims submissions.

NCES Quality Assurance Documentation of start/end time must match units/hours billed. This is another slide for quality assurance. Just a chart of the minutes to units conversion. Please note: It is your responsibility to correct any billing errors with MMA plans and/or private insurance.

Any questions about Early Steps claims process?

Sharon

Physical Therapy Evidenced Based Practices Amanda Guevara Kids on the Move Amanda

Sharon