Answers to your most pressing questions. Early Childhood CPT Codes Which procedure codes could be...

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Open Forum Q&A Answers to your most pressing questions

Transcript of Answers to your most pressing questions. Early Childhood CPT Codes Which procedure codes could be...

Page 1: Answers to your most pressing questions. Early Childhood CPT Codes Which procedure codes could be added/used for early childhood claims for OT, PT, Speech,

Open Forum Q&AAnswers to your most pressing questions

Page 2: Answers to your most pressing questions. Early Childhood CPT Codes Which procedure codes could be added/used for early childhood claims for OT, PT, Speech,

Early Childhood CPT CodesWhich procedure codes could be

added/used for early childhood claims for OT, PT, Speech, and Social Work? The models of many ISD programs is shifting to primary service provider and family based participation.

Page 3: Answers to your most pressing questions. Early Childhood CPT Codes Which procedure codes could be added/used for early childhood claims for OT, PT, Speech,

MAER Summary SoftwareWhy can't the MAER summary software

be sent to us earlier than Dec?

Page 4: Answers to your most pressing questions. Early Childhood CPT Codes Which procedure codes could be added/used for early childhood claims for OT, PT, Speech,

Partial Match FileIs there something we can do to ensure we

receive the partial match file in June?

Page 5: Answers to your most pressing questions. Early Childhood CPT Codes Which procedure codes could be added/used for early childhood claims for OT, PT, Speech,

Billing and RA QuestionWho should we be contacting at MDE

regarding medicaid billing questions and RA file questions?

Page 6: Answers to your most pressing questions. Early Childhood CPT Codes Which procedure codes could be added/used for early childhood claims for OT, PT, Speech,

September SPL Cutoff DateHow do ISD handle the certification of the

Oct-Dec SPL by Sept 4th when some Key Contacts are not returning until late Aug and school does not start until 9/8/15?

Page 7: Answers to your most pressing questions. Early Childhood CPT Codes Which procedure codes could be added/used for early childhood claims for OT, PT, Speech,

Referrals for Transfer StudentsWe are setting our process for using the 90 day retro on speech

referrals. A scenario came up that we need clarification on. If a student transfers in and we have a 30 day Consent for Immediate Placement, which includes time and frequency of service, can we use the previous districts IEP date for Medicaid purposes? We are providing the service according to that plan and logging for those services, however, our IEP may not be held until the end of that 30 days. Student transfers in, district completes a Consent for Immediate Placement with time and frequency of service dated 12/5/14 Speech provider begins services and logging in the system on 1/12/15 Our IEP held on 2/23/15 Physician concurs the speech referral on 3/5/15 Do we retro our speech referral back to the Consent for Immediate Placement date into our district? OR, in the case of transfer in students, can we only use from the actual date of our districts IEP???

Page 8: Answers to your most pressing questions. Early Childhood CPT Codes Which procedure codes could be added/used for early childhood claims for OT, PT, Speech,

Audit TimeframeHow many years back do they go for

Medicaid Audits?

Page 9: Answers to your most pressing questions. Early Childhood CPT Codes Which procedure codes could be added/used for early childhood claims for OT, PT, Speech,

Transportation ClaimsWhy can't we submit transportation claims

(school bus) for students with TPL? Third party insurance would not pay for school bus transportation

Page 10: Answers to your most pressing questions. Early Childhood CPT Codes Which procedure codes could be added/used for early childhood claims for OT, PT, Speech,

504 ServicesIs Michigan thinking about expanding School-

Based services to include 504 students?

Page 11: Answers to your most pressing questions. Early Childhood CPT Codes Which procedure codes could be added/used for early childhood claims for OT, PT, Speech,

Teacher ConsultantsCan teacher consultants bill Medicaid?

Can teacher consultants be TCM's?

Should we be putting teacher consultants on the staff pool list if they are not 100% federally funded and do not bill Medicaid?

Page 12: Answers to your most pressing questions. Early Childhood CPT Codes Which procedure codes could be added/used for early childhood claims for OT, PT, Speech,

RMTS TrainingIs there any training regarding the RMTS

process for the staff members. Training on how to fill / answer the questions?

Page 13: Answers to your most pressing questions. Early Childhood CPT Codes Which procedure codes could be added/used for early childhood claims for OT, PT, Speech,

Teachers (Case Managers) vs. Assistant Teachers (PC)Teachers (Case Mangers) vs. Assistant

Teachers (PC) on our staff pool list. How do we determine which would generate more Medicaid dollars?

Page 14: Answers to your most pressing questions. Early Childhood CPT Codes Which procedure codes could be added/used for early childhood claims for OT, PT, Speech,

Medicaid Consent LetterIf a student was eligible for Sp Ed, then

found ineligible and found eligible again. Would you need a new Medicaid Consent?

Page 15: Answers to your most pressing questions. Early Childhood CPT Codes Which procedure codes could be added/used for early childhood claims for OT, PT, Speech,

Federal OIG AuditWhat is currently happening with the federal

audit at Wayne RESA and Ingham?

Page 16: Answers to your most pressing questions. Early Childhood CPT Codes Which procedure codes could be added/used for early childhood claims for OT, PT, Speech,

Speech ReferralsHow far back can you go for a Initial speech

script? if 30 days, then from what date do you go back 30 days?

Page 17: Answers to your most pressing questions. Early Childhood CPT Codes Which procedure codes could be added/used for early childhood claims for OT, PT, Speech,

Adding School Psychologists to SPLIs anyone working toward letting school

psychologists be added to the direct staff pool?

Page 18: Answers to your most pressing questions. Early Childhood CPT Codes Which procedure codes could be added/used for early childhood claims for OT, PT, Speech,

Medicaid AuditsWhen will the remainder of the ISD's be

chosen for their Medicaid audit?

Page 19: Answers to your most pressing questions. Early Childhood CPT Codes Which procedure codes could be added/used for early childhood claims for OT, PT, Speech,

Paraprofessional BillingDo paraprofessionals need to bill Medicaid in

order to be included on the staff pool list?