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

2. 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 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

3. AHCA New Contracts for the Statewide Medicaid Managed Care Program

4. 2018-19 North Central Early Steps Forms to be Completed
Provider MOA
Completed by all providers
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

5. 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

6. NCES Fiscal Team Emily Hurlston, Fiscal Team Lead|
Claims process questions and training
UF vendor set-up
Monthly invoice processing
Claims payment questions, EOBs, errors, etc.
Adilene Hernandez, Program Assistant
Internal charge entry
Medicaid assistance
Alexandra Salomon, Program Assistant |
Data entry of claims
Data entry of payments
BDI entry
Via Move-it:
Or Fax to our attention at

7. 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

8. NCES Claims Form
Emily

9. 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

10. 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!

11. 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.

12. 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.

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

14. 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.

15. 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.

16. 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.

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

18. 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

19. 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.

20. 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

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

22. 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

23. 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

24. 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 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.

25. 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

26. New IFSP – Policy and Procedures Update

27. 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.

28. Pre-Adoption IFSP Language – Evaluation Teams

29. Emily and Sharon