As 2017-2018 medical billing claims are being reprocessed, some business managers might be wondering, “Where’s the money?” Even if you have submitted your claims, you may not have received compensation from the Department of Human Services. This is because you will not receive a check until you have paid back your recoupment balance from FY18.
We wrote about the reprocessing of FY18 claims in our December 10th blog post and explained how to use MA Forms to review your data. Business managers should have already completed processing and re-submitted claims for 2017-18. If the final rate calculated is less than the interim rate your district was paid, you will have a recoupment balance. Some districts may need to pay back thousands of dollars. The DHS does not request a check from schools, but will retain any payments of claims submitted in the future until their balance is paid in full.
In December, we explained how billing coordinators can utilize the Annual Rates report to help gather data to determine if their MA rates need to be updated. Business managers also play an important role in the rate setting process. Deciding to move costs of eligible providers to federal sources could have a significant impact on rates. Business managers need to ensure eligible providers, such as physical, occupational, and speech therapists, school psychologists and nurses have a proportionate amount of their salary or contracted service locally funded.
To view the report that contains the information the Department of Human Services uses in their rate calculation you visit the MDE’s Data Reports and Analytics page. To see data for salaries and contracted services, follow these steps:
- Select your district
- For Category, select “Special Education”
- For Report, select “Special Education Medical Assistance Report on Salaries, Contracted Services and FTE”
Here you can view your reported costs and FTE and verify that they are staying consistent from year to year, which will help your MA rates stay consistent as well. You can also request the Service Minutes and Groups MA report for each provider from the billing coordinator to ensure you have enough time coded to local funds.
To learn more about SpEd Forms’ medical billing software, MA Forms, please visit our website.