Attendant Care Services For Medicaid School Based Billing Part 2: Using the Kompas Care Tracking Form Attendant Care Services, Part 2, Using the Kompas Care Tracking Form ©2015 Kompas Care LLC

Attendant Care Services 2-Page Form The Kompas Care Cover Page & Tracking Sheet are used as a 2-page form collect information for: Submitting Attendant Care Services to Medicaid for reimbursement Monitoring compliant documentation Record retention for auditing This is the Kompas Care Attendant Care Services 2-page tracking form. The form is used for one month, and should be completed for all Medicaid eligible students who receive attendant care services. It is important to accurately and completely fill in this form each month to ensure that Kompas Care can bill the minutes recorded. Kompas Care consultants will review the entire form prior to billing and may contact you if the form is incomplete or if there are questions about the amount of minutes being submitted. This form is retained by your district for five years and could be used in an audit to verify the reimbursement your district has received. ©2015 Kompas Care LLC

Cover Page - Student Information Student Information should be filled out completely. Including the Special Education Teacher’s name, Room #, Email and Work Phone to ensure that we can work with the teacher and aides when questions arise. Use the Additional Comments for any additional information. For example, if a student was out due to extensive illness. A Diagnosis Code must be included. Let’s take a look at the Cover Page…. The Cover Page should be completed each month. Your school district and the month and year of the form should be filled in at the top of the page. The Student Information box below your district name identifies the student. Please type or print clearly and complete all the fields in this area. While many people may assist the student throughout the day, we will contact the special education teacher if we have questions, so this information is very important to ensure that we can communicate with the staff who are billing for the student. The Additional Comments/Notes box can be used to include any information you would like to document to assist with Medicaid billing and auditing. For example, if the student had an extended illness that impacted the typical minutes billed. A diagnosis must be included to bill attendant care services. Let’s take a look at how to use this box… ©2015 Kompas Care LLC

Diagnoses for Medicaid Billing Special Education Teachers can print an online report of possible diagnoses. All tracking forms must include at least one diagnosis. Include the most appropriate, specific diagnosis that supports the Attendant Care services provided. On the Cover Page, write in the code associated with the diagnosis. Special Education teachers who access the Kompas Care software can print a report of diagnosis codes that are typically used for attendant care services. Reports may also be requested by email by contacting your Kompas Care representative. The Cover Page must include at least one diagnosis that best explains the reason the student requires the type of attendant care services being provided. If you enter additional codes, in some way, indicate which code is the primary code to support the Attendant Care Services billing. ©2011 Kompas Care LLC

Cover Page - Provider Information 20 5 5 Yes Provider Information includes: Name and Signature. Shift Start and Stop Times are the time working with the student or times the provider begins and ends their work day. The Typical Services Provided boxes are completed with the usual daily time this provider assists the student with these services. The form has 5 color coded boxes to be completed by the student’s attendant care providers. If the student receives attendant care services from more than 5 providers, a second cover page may be stapled to the form to accommodate up to 10 providers in a month. Please print clearly and fill in all the boxes including your name and signature. We cannot bill your time without them. Let’s look closer at the box for Provider number 1….. The State requires that you record your shift start and stop time. This can be the time you start working with the student to the time you stop working with the student, or it can be the times that you begin and end your day. Finally, the State requires that we document what type of attendant care assistance the student receives. To meet this requirement, and assist with auditing, we ask that you enter the approximate time you spend performing each area of attendant care. Because most days are very routine, you should be able to identify which types of services the student receives from you in a typical day. For example, you assist Johnnie daily during lunch. This includes helping him wash his hands, walking him to the lunch room, helping him make his tray and sitting with him while he eats, then you walk him back to the classroom. You might complete the front of the form by entering 5 minutes for mobility, 5 minutes for personal hygiene, and 20 minutes for eating and food prep. Remember this is for a typical day, the actual daily total time that you will enter on the tracking sheet will vary. However, this area will meet the State requirement that we document what type of services the student receives and entering the typical minutes will also assist Kompas Care with auditing. It may be very difficult to enter a typical amount of minutes in the Behavioral Supervision/Cuing box. Especially if your time spent in this area occurs sporadically throughout the month. If you cannot estimate your time you can simply write “Yes” in the box to indicate the student receives supervision and cuing as part of his or her attendant care services. ©2015 Kompas Care LLC

Kompas Care Attendant Care Tracking Sheet Complete the tracking sheet with the student name and date of birth, District name and current month/year. If using a blank template, create the calendar in the Date fields. The form is ready to be used daily! Each person will record their time in the boxes that match their color block on the front of the page. Now lets take a look at the Attendant Care tracking sheet. The form is a monthly calendar for up to five providers to track their attendant care minutes. Be sure that the District and student’s name is at the top of the form. Also that the month and year of the tracking sheet is filled in for the correct month. If using a form with a blank calendar, start with the first week and fill in the calendar days down the form to complete the month. Now the color-coded form is ready to be used by the five providers from the cover page for their daily tracking of attendant care services. ©2015 Kompas Care LLC

Kompas Care Attendant Care Tracking Sheet Daily Attendant Care Tracking The color coded box on the front of the form matches a column on the back. 1 2 5 6 7 8 9 12 13 14 15 16 19 20 21 22 23 26 27 28 29 30 To Optimize Scanning: Complete all fields at the top of the form. Print clearly and within the boxes. Do not make any marks in the boxes on days you did not provide attendant care services. The color of the provider information box you completed on the cover page of the form corresponds to the colored columns on the tracking sheet, where you will record your daily attendant care minutes. The boxes should be completed by the person who is providing the services, they should not be completed by or on behalf of someone else. Kompas Care may use a scanning system to read the form and extract the minutes that will be billed. In order to maximize the effectiveness of scanning we ask you to be sure the district and student name, date of birth, month and year of the form are filled in at the top of the tracking sheet. Please print clearly and within the boxes provided. If you do not have minutes to record on a day, do not mark in the minute box. If you want to add information that is not billable, use the Details box to the right of the day. For example, if the student was absent you could write this in the details box. It is not necessary for you to complete the Total Minutes column, but it will assist us in timely submission of your minutes for Medicaid reimbursement. Finally, make sure that your name is printed and your signature is on the bottom of the form. ©2015 Kompas Care LLC

Kompas Care Attendant Care Tracking Sheet That’s it! Monthly - complete the Cover Page and set up the calendar on the Tracking Sheet. Daily - record time spent providing Attendant Care to the student each day you provide services. Completed forms should be turned into your School Districts Special Education or Pupil Services Office promptly. That’s it. Each month, complete the Cover Page of the form and use a prefilled monthly tracking page or set up the calendar on a blank tracking sheet. Daily, enter your time on the tracking sheet if you provided Attendant Care Services to the student. The complete 2-page forms will be collected by the Special Education teacher, who will check the forms for completeness and then turn them into your Special Education or Pupil Services department on the first of the following month. This will ensure timely Medicaid billing of the minutes recorded. ©2015 Kompas Care LLC

Tracking Reminders Don’t use quotes or arrows instead of numbers, each day must be documented. Don’t enter “zero” minutes. Do not include teaching or curriculum time. Do not include time for medication, g-tube, catheterization or other medical related activities, these should be recorded on School Health/Nursing logs. Do not track time riding the bus from home to school and back. Do not include time assisting a therapist during a therapy session, only one service can be billed at a time. Do not track time spent doing personal care activities on behalf of the child. Do not keep completed forms in your room, return them to the district office on the first of the following month. Finally, here are a few things to keep in mind when recording Attendant Care time. Each day record your minutes. Do not use quotes, arrows or lines in the boxes to indicate that the information is repeated. We will not be able to bill your time without proper documentation. Do not enter a zero, or any other information in the minutes box that scanning will try to read as billable minutes. Do not include time spent teaching or reinforcing curriculum. These activities do not meet the definition of attendant care services. Do not include time for administering medications, g-tube feedings or other medical related activities, these should be recorded on School Health Services or Nursing logs. If you accompany a student to or from school, this is billed as Alternative Transportation, therefore do not include that time in your attendant care minutes. Do not include time assisting a therapist during a therapy session, only one service can be billed at a time. Only activities done with a student can be submitted, do not include time spent doing attendant type services on behalf of the student. For example, preparing a snack can only be included if you are working with the student in the preparation. Remember to send the forms to your district special education or pupil services office when they are completed this is important to ensure timely billing. ©2015 Kompas Care LLC

Kompas Care Representatives Notify your Kompas Care representative if you have questions. Amy Holcomb Amy@KompasCare.com Peggy Brown Peggy@KompasCare.com Holly Neale Holly@KompasCare.com Lisa Demler Support@KompasCare.com Kim Buttke MySupport@KompasCare.com Thank You! Kompas Care encourages questions, concerns and suggestions. Please don’t hesitate to contact us if you requires assistance. ©2015 Kompas Care LLC