Post on 17-Apr-2018
CMAA Invoice Training - 2015
Presented by Nancy Leidelmeijer
805-216-6585
nleidel@healthreachconsulting.com
www.healthreachconsulting.com
TRAINING GOALS
•Ensure accurate MAA invoices
•Timely processing and payment
of invoices
•Avoid disallowances
HealthReach 2015
PURPOSE OF MAA INVOICE
•To determine the actual costs of
providing MAA services
•To determine the federal
reimbursement amount (FFP)
HealthReach 2015
COMPUTATION OF FEDERAL CLAIM
A. Adjusted cost pools (after revenue offset)
B. Percentage of time survey activities
C. Federal Financial Participation (FFP) Rate
D. Federal reimbursement
A x B x C = DHealthReach 2015
SUMMARY OF STEPS
1. Read MAA Invoice instructions
2. Gather the required data and
documents
3. Analyze costs and funding sources
4. Develop supporting
documentation
5. Enter data in invoice templateHealthReach 2015
DATA TO GATHER
• Claiming plan functions grid
• Time survey results
percentages
• Labor and services and
supplies costs
• Indirect/overhead expenses
HealthReach 2015
DATA TO GATHER
• Discount methodology
percentages
• Direct charged expenses
• Funding sources
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CATEGORIZING EXPENSES
6 Cost Pool categories:
CP 1 - SPMP
CP 2 - Non-SPMP
CP 3a - Non-Claimable
CP 3b - Non-Claimable direct charge
CP 4 - SPMP direct charge
CP 5 - Non-SPMP direct charge
CP 6 - Allocated costs
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COST POOL 1
• Skilled Professional Medical Personnel (SPMP) who participated in the time survey
• Clerical staff who are supervised by SPMP and who provide direct support to the SPMP
• Supervisors of the SPMP
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COST POOL 2
• All Non-SPMP staff who participated in the time survey
• Clerical staff who work for Non-SPMPs
• Supervisors of the Non-SPMPs
• Supervisors of clerical staff who directly support Non-SPMPs
• Personal services contractors who participated in the time survey
HealthReach 2015
COST POOL 3A
• Staff who did not time survey and are not included in other cost pools or direct charged
• Staff who exclusively provide treatment, counseling, clinical services, lab services or other non-claimable activities of the claiming unit
HealthReach 2015
COST POOLS 3B, 4, AND 5
These totals are automatically
transferred from other worksheets in
the invoice template
HealthReach 2015
COST POOL 6
General or administrative staff who:
• Did not participate in the time survey
• Costs have not been direct charged
• Support the staff in the other cost pools
• Costs are not included in any indirect rate computation
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TIME SURVEY RESULTS
• Separate time surveys by
SPMP and non-SPMP
• Total the hours by activity
code
• Analyze time surveys
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LABOR DETAIL
Separate the amount for salaries and benefits
• SPMP staff from time survey percentages (and supervisors and support)
• Non-SPMP staff from time survey percentages (and supervisors and support)
• Non-claimable
• Direct Charge
• Allocated general and admin support staff
HealthReach 2015
OTHER COSTS
• Normal day-to-day operating expenses
necessary to run the claiming unit
• See PPL 09-003
• Indirect costs, external and/or internal
NOTE : Any labor costs included in
indirect must be excluded from other
cost poolsHealthReach 2015
OTHER COSTS
CP 1 - SPMP
1. Expenses that can be
attributed to SPMP staff
2. Overhead/Indirect
expenses
CP 2 - Non-SPMP
1. Expenses that can be
attributed to Non- SPMP
staff
2. Overhead/Indirect
expenses
HealthReach 2015
OTHER COSTS
Cost Pool 3
• Costs that can be attributed to non-
claimable staff
• Unallowable costs associated with
direct service
• Overhead/Indirect expenses
HealthReach 2015
OTHER COSTS
Cost Pool 5
• Expenses that can be directly
charged to MAA
• MAA specific contracted costs
• Overhead/Indirect expenses
HealthReach 2015
OTHER COSTS
Cost Pool 6
• Expenses that can be attributed to
allocated staff
• General office expenses
• Building maintenance expenses
• Utilities
• Overhead/Indirect ExpensesHealthReach 2015
OTHER COSTS
• Identify other costs and develop
backup document showing detail
and amount to be claimed
• For costs labeled, “Special,”
“Other,” “Departmental,” provide
description
HealthReach 2015
• MAA Coordination and claim admin
• Any 1 reimbursable MAA activity code
• LGA consortium participation fee
• Direct MAA expenses:
• Travel and transportation
• Flyers and brochures
• Subcontractors/consultants
DIRECT CHARGED EXPENSES
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REVENUES WORKSHEET
Purpose:
To offset funding against costs to
arrive at the net cost in which the
federal government will share and to
list CPE.
HealthReach 2015
REVENUES WORKSHEET
•Analyze all funding sources
•Determine allocation methodology
for offset to avoid double dipping
•Determine public funds eligible to
use as CPE
HealthReach 2015
WHAT TO OFFSET?
• All federal funds, including Maintenance of Effort (MOE) and match funding
• All state general funds that have been previously matched by the federal government including Medi-Cal fee for service funds
• Insurance collected from non-governmental sources for the delivery of direct client services
HealthReach 2015
WHAT NOT TO OFFSET?
•County General Funds
•Realignment Funds
•Other Local Funds (First 5)
•MAA Reimbursements
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REVENUES WORKSHEET
1) Medi-Cal Fees and Match
2) Federal Grants and Match
3) State General Funds
4) Medicare
5) Insurance
6) Fees
7) Other Revenue
HealthReach 2015
• Summarize your revenues
quarterly
• Annual revenues may be divided
equally into each of the 4
quarters
REVENUE SOURCES
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REVENUES WORKSHEET
Revenues are categorized as follows:
• Not Offset Funds
• CP 1 - SPMP
• CP 2 - Non-SPMP
• CP 3a&b - Non-Claimable
• CP 4 - Direct-Enhanced
• CP 5 - Direct-Non-Enhanced
• CP 6 - AllocatedHealthReach 2015
MEDI-CAL DISCOUNT PERCENTAGE
• Actual Client Count (ACC) or Countywide Average
• ACC - calculate percentage and compile documentation showing the percentage for that quarter
• Compile the eligibility verification used in the ACC
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SUPPORTING DOCUMENTS FOR OTHER COSTS AND CP6 EMPLOYEES
All invoices require the submittal of
supporting documents for other costs
every quarter:
• Include list of classifications for the
reported salaries and benefits of CP6
• Include a list of other costs associated with
the costs in CP1, CP2, and CP6
HealthReach 2015
THE CMAA INVOICE TEMPLATE
1. Summary page
2. TCM time survey results
3. Revenue worksheet
4. Invoice cost worksheet
5. Direct charges worksheet
6. Invoice claim calculation worksheet
7. Variance worksheetHealthReach 2015
CMAA CHECKLISTS
•Checklist For Preparing the MAA
Detail Invoice
•Checklist For Preparing the MAA
Summary Invoice
HealthReach 2015
PACKAGING YOUR INVOICE
1. Cover Letter (on LGA letterhead)
2. MAA Invoice template
3. Include checklists
• For MAA Detail Invoice
• For MAA Summary
• Other costs detail and staff classification for CP6 and other documentation when requested
HealthReach 2015
CONTACT RESOURCES
Department of Health Care Services website
www.dhcs.ca.gov/ProvGovPart/Pages/CMAA.aspx
LGA Consortium website
www.MAA-tcm.com
HealthReach Consultants
www.healthreachconsulting.com
Thank you for attending
HealthReach’s CMAA Invoice
Training - 2015
Nancy Leidelmeijer
805-216-6585
nleidel@healthreachconsulting.com
www.healthreachconsulting.com