Simple Billing - Direct Service Administrative Resources Billing... · To create a billing record...
Transcript of Simple Billing - Direct Service Administrative Resources Billing... · To create a billing record...
-
Simple Billing
1
-
Simple Billing Quick Reference Guide
How do I change my password?.............................................................................................4
How do I build my caseload?.................................................................................................5
How do I keep my caseload accurate?...................................................................................6
How do I delete a student on my caseload?...........................................................................7
How do I change minutes?.....................................................................................................8
How do I change IEP dates?..................................................................................................9
How do I know who is Medicaid eligible?...........................................................................10
How do I add, view and access uploaded file(s)?...........................................................11-12
How do I generate an electronic One-Time Parental Consent…………………………13-14
How do I create a billing record for Medicaid eligible students?...................................15-16
Evaluation and Re-evaluations Information………………………………...………….….17
How do I enter evaluations and re-evaluations?...................................................................18
Diagnosis and Service Code Information………………………………………………….19
How do I check the billing record for accuracy?.............................................................20-22
How do I correct the billing record?................................................................................23-24
Documentation of Simple Billing………………………………………………………25-27
Documentation Rubric……………………………………………………………………..282
-
Training Objectives:
1. Learn how to create a caseload.
2. Learn how to keep your caseload
accurate and up to date.
3. Learn how to enter information accurately
and steps to correct mistakes.
3
-
How do I change my password?
3. Click change my password.
4. Enter new password.
5. Click
4
1.Click
2. Click
-
How do I build my caseload?
1.3 Type the last
and first name of
a student on your
caseload.*
*Student names are submitted on a student roster from your administrator.
Contact_______________________, if you cannot find a student on your
caseload.5
1.1 Click
under Therapist Tools tab.
1.2 Click
1.4 Record actual minutes as documented
on the IEP for your specific service.
Defaults to week but you have other
choices in drop down menu.
1.5 Click When searching for a student with a common last name you may have to enter the full last name, followed by a comma and a space, before typing the student’s first name. You may also search for a name by using
the Student ID, this may be helpful when a student has a hyphenated name or uses a nickname.
-
How do I keep my caseload
accurate?
• By adding and deleting students as your
caseload changes.
• By changing minutes to reflect the current
IEP.
• By updating IEP date.
6
-
How do I delete a student on my
caseload?
If you delete a student from
your caseload, the student’s
information remains archived in
the system. If necessary to
reinstate the student, the student
record will be available when
you add them to your caseload.
7
1. From the Caseload
page, select the student
and Click Delete.
2. Click
-
How do I change IEP service
minutes ?
8
1. From the Caseload
page, Select student and
Click Edit.
2. Enter minutes.
3. Click
-
How do I change IEP dates?
Re-Eval Date is not required for Medicaid billing. This information may be
required by your district’s administrator. Notes:
9
1. From the Caseload
page, Click IEPs/Goals.
2. Click 2. Click
4. Click
This will display a listing of IEP
dates entered by therapists and
administrators.
3. Enter month, day and
year OR use calendar to
select date.
-
How do I know who is Medicaid
eligible?
➢Students highlighted in yellow and green are Medicaid eligible.
➢You should enter data for all students highlighted in yellow or green.
➢If administrator has entered the One-Time parental consent information,
student will be highlighted in green.
➢Therapylog automatically runs student Medicaid eligibility with MO
HealthNet (MHD) weekly to determine eligibility.
10
Students highlighted in
green are Medicaid
eligible
and One-Time consent has
been signed.
Students highlighted
in yellow are
Medicaid eligible.
-
11
All folders and uploaded files can be viewed and accessed from
under the Therapist Tools tab. Uploaded files will display on the My
Attachments screen and can be downloaded, viewed and printed as needed by
clicking the download icon.
•
How do I add, view and access
uploaded file(s)?
-
How do I add, view and access
uploaded file(s)? [cont.]Create new Folders for Files
2.1 Folders for individual student worksheets, parent
notes, notices etc. can be created and added to My
Attachments. Type name of folder in box and click
to create a new folder.
2.4 Click Upload File. Find the document to upload
from your computer and click Open.
2.2 Click on
the name of
folder where
you want to
upload the
file.
2.3 Select the student name from the drop down. All
students on your caseload will be available for
selection.
-
How do I generate a One-Time
Parental Consent? Step 1: Locate electronic One-Time Parental Consent form
13
1. 1 From the
Caseload page,
Select student and
Click Edit.
1.2 Click Generate
Parental Consent.
-
14
How do I generate a One-Time
Parental Consent? Step 2: Select options and complete information
2. 1 Click drop down arrow to select
form option.
2. 2 Type parent name, confirm
default dates or change as
appropriate Consent Start Date and
Consent Signed Date, Have parent
sign. Select Preview, Save or
Cancel.
-
How do I create a billing record for Medicaid eligible students?Step 1: Select a Billing Month
▪This page will show the number of students on your caseload that are
Medicaid eligible each month.
▪Double click on a month and it will show the names of students that are
Medicaid eligible for that month.
1.3 Use the drop down menu to select
the month and year for which you want
to enter data and click
15
1.1 Click
under Therapist Tools tab.
1.2 Click on
Online Billing Data Entry Form.
-
How do I create a billing record for Medicaid eligible students?
Step 2: Enter Student Specific Information
2.1 Select student from drop down box.
2.2 Select Diagnosis from drop down box.
2.3 Enter start and end time of service.
2.4 Select location from drop down box.
2.5 Select Service Code from drop down box.
2.6 Select date of therapy (automatically populates to current date).
2.7 Click 16
Only students that
are Medicaid
eligible for the
selected month
will appear in the
drop down box.
-
Evaluation and Re-evaluation BillingTherapist should follow the steps below to create a billing record for evaluations.
Initial Evaluation Billing
In order to create a billing record for an initial evaluation, the following rules must be met:
The Initial Evaluation must result in an IEP
The student must be Medicaid (MO HealthNet) eligible
The student must be entered on therapist’s caseload
*Only time spent evaluating students may be billed. Time spent scoring evaluation, writing evaluation report, or discussing evaluation
results are not billable activities.
Recommended process for entering Initial Evaluations in Therapylog.com:
Keep a record of Initial Evaluations. This record should contain the following information:
Name of student, Start Time, Stop Time, Notes
Keep a record of students evaluated that resulted in IEPs.
At the end of the month, therapist should add students that received initial IEPs to their caseload and enter the evaluation time.
Re-Evaluation Billing
In order to create a billing record for a re-evaluation, the following rules must be met:
The student must have a current IEP documenting service in the area being assessed.
The student must be Medicaid (MO HealthNet) eligible.
The student must be entered on therapist’s caseload.
*Only time spent evaluating students may be billed. Time spent scoring re-evaluation, writing re-evaluation report, or discussing re-
evaluation results are not billable activities.
17
-
How do I enter evaluations and re-evaluations?To create a billing record for evaluations using Simple Billing:
Therapist should:
• select student from drop down box
• select relevant Diagnosis code
• enter start and end time of testing, according to evaluation record
• select location from drop down box
• select Service code, i.e.,
– PT Evaluation (High) (Moderate) (Low)
– PT Re-eval
– OT Evaluation (High) (Moderate) (Low)
– OT Re-eval
– Behavioral and Qualitative Analysis of Voice & Resonance
– Eval of Speech Sound Production
– Eval of Speech Sound Production w/ Eval of Lang Comprehension and Expression
– Eval of Lang Comprehension and Expression ONLY
– Evaluation of Fluency
- Evaluation for Prescription of Speech-Generating AAC Device, 30 Additional Minutes
- Evaluation for Prescription of Speech-Generating AAC Device, First Hour
- Evaluation for use and/or fitting of voice prosthetic device to supplement oral speech
• select date of testing, according to evaluation record.18
-
Diagnosis and Service CodesDiagnosis Codes in drop down box are
specific for each discipline. The codes in
Therapylog are codes most commonly used.
If you need a code added, please contact a
member of the MSBA Medicaid Consortium
Team.
Service Codes in drop down box are also
discipline specific. See below for complete
list of Service Codes.
Physical Therapy Service Codes
-Gait Training- Manual Training
-Neuromuscular Re-Education
-Orthotic Training
-Prosthetic Training
-PT Evaluation (High/Mod/Low)
-PT Re-Evaluation
-Self Care Management Training
-Wheelchair management/
propulsion training
-Therapeutic Activities
-Therapeutic Exercises
-These codes apply to individual
treatment
.
Occupational Therapy Service Codes
-Dev of Cognitive Skills to Improve
Attention, Memory
-Neuromuscular Re-Education
-OT Evaluation (High/Mod/Low)
-OT Re-Evaluation
-Self Care Management Training
-Sensory Integration
-Wheelchair management/propulsion
training
-Therapeutic Activities
-Therapeutic Exercises
These codes apply to individual
treatment.
Speech/Language Service Codes
-Speech/Language Therapy-Group-Speech/Language Therapy-Individual
-Behavioral and Qualitative Analysis of Voice & Resonance
-Eval of Speech Sound Production
-Eval of Speech Sound Production w/ Eval of Lang
Comprehension and Expression
-Eval of Lang Comprehension and Expression ONLY
-Evaluation of Fluency
-Evaluation for Prescription of Speech-Generating AAC
Device, 30 Additional Minutes
-Evaluation for Prescription of Speech-Generating AAC
Device, First Hour
-Evaluation for use and/or fitting of voice prosthetic device
to supplement oral speech
These codes apply to group and individual treatment.
19
-
How do I check the billing record for accuracy?Step 1: Go to My Reports
20
1.1 From the Simple Billing
page, click Home.
1.2 Click
under Therapist Tools on the Home page.
-
How do I check the billing record for accuracy?Step 2: Select and Create a Customizable Report
2.1 Click
Customizable Report.
2.2 Use the controls to customize your report and Click
Information entered by therapists remains in Therapylog
for 72 hours. Run The Customizable Report within 72
hours to correct mistakes before your therapy
transactions are bundled for claim submission to MHD.
21
If the therapy transaction has been paid, the district will need to request that the transaction
by voided. Please send email to your District’s Direct Service Administrator with service
date, service time, therapist name, and student’s name of the transaction(s) to be voided.
-
How do I check the billing record for accuracy?Step 3: Use Weekly Notes to Review Report for Accuracy
3.1 Check your report to make sure that all information is accurate.
Your report will look like this:
22
-
How do I correct the billing record?Step 1: Go to Your Calendar
• If you see an error on The Customizable Report, you can
correct the error through your calendar.
• You can access your calendar page two ways:
From The Customizable Report page click on
Calendar at the top, right side of the screen.
or From your home page, click
23
-
2.1 Click on the gray box
that contains the date you
want to correct.
2.2 Click
2.3 Click to delete the
session.
2.4. After you delete a session, you re-enter
the correct billing information for the
session.
How do I correct the billing record?Step 2: Locate and Delete the Error
24
-
Documentation of Simple Billing
25
-
2.3.A Adequate Documentation
All services provided must be adequately documented in the medical record. 13 CSR 70-3.030, Section (2)(A) defines
“adequate documentation” and “adequate medical records” as follows:
• Adequate documentation means documentation from which services rendered and the amount of reimbursement
received by a provider can be readily discerned and verified with reasonable certainty.
• Adequate medical records are records which are of the type and in a form from which symptoms, conditions, diagnoses,
treatments, prognosis and the identity of the patient to which these things relate can be readily discerned and verified with
reasonable certainty. All documentation must be made available at the same site at which the service was rendered.
26
-
13.4 Special Documentation Requirements
For physical, occupational and speech therapy services, the MO HealthNet Division requires that the following
documentation be included in the recipient’s medical record:
• Participant’s complete name;
• Participant’s date of birth;
• Date service was provided;
• actual treatment provided for the participant (more than “treatment given”) on the specific date of service;
• individual or group therapy;
• the setting in which the service was rendered;
• time service was delivered (e.g., 4:00-4:15 p.m.);
• The name, title, and signature of the therapist who provided the service;
• the plan of care must include treatment, evaluation(s), test(s), findings, results, and prescription(s)/referrals;
• documentation for the need of the service(s) in relationship to the participant's treatment plan;
• The participant's progress toward the goals stated in the treatment plan; and
• official Individualized Education Plan (IEP) or Individual Family Service Plan (IFSP) when billing therapy services
documented in an IEP or IFSP.
27
-
Documentation Rubric
Adequate documentation requirements state that services must be readily discerned and verified with reasonable certainty. According to MHD, therapists
must state level of progress toward the goal relative to the completed therapy session each time.
_____participant’s complete name;
_____participant’s date of birth;
_____date service was provided;
_____individual or group therapy;
_____the setting in which the service was rendered;
_____time service was delivered (e.g., 4:00-4:15 p.m.);
_____the name, title, and signature of the therapist who provided the service;
_____Actual treatment provided for the participant (more than “treatment given”) on the specific date of service.
1. Defined activity such as:
-flash cards to elicit target sounds
-Q and A ‘wh’ questions with therapist initiating the questions
2.Progress relative to therapy session:
-Every session requires an indication of progress relative to that day’s therapy session (progress, minimal progress, etc.)
3. Student response:
-Notes to include how the student responded (ex. student responded without hesitation; or, student struggled with answering “when” questions; or.
student’s behavior was disruptive during therapy) or conditions of response (responded with cues; responded following peer modeling; responded
with assistance or without assistance, etc.).
4. Periodically provide quantitative data (not required every time).
5. State any use of assistive technology in notes.
The student’s complete [medical] record must also include:
_____the plan of care, which must include treatment, evaluation(s), test(s), findings, results, and prescription(s)/referrals;
_____documentation for the need of the service(s) in relationship to the participant's treatment plan;
_____the participant's progress toward the goals stated in the treatment plan; and
_____official Individualized Education Plan (IEP) or Individual Family Service Plan (IFSP) when billing therapy services documented in an IEP or IFSP.
28