BILLING POLICIES AND PROCEDURES FOR ALL PROVIDERS

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1 BILLING POLICIES AND PROCEDURES FOR ALL PROVIDERS

2 N critical cmpliance issue Received in ur ffice n time Single sided 8 ½ x 11 inch white paper Blue r black pen N staples Any necessary back up Lg ntes filled ut cmpletely District specific frms Grup Recrd f Attendance All sessins accunted fr the entire mnth Child absent, therapist absent, missing Rx, schl clsures Persnal invice in ur preferred frmat Please submit separate invices fr schl age, Sufflk preschl, Nassau preschl, and early interventin.

3 YOUR COMPLETED BILLING IS DUE IN OUR OFFICE BY THE 7 TH OF THE FOLLOWING MONTH. FOR EXAMPLE, MARCH S BILLING IS DUE IN OUR OFFICE BY APRIL 7 TH. The fllwing Late Payment schedule applies: 7 days late (received the 14 th ) = 1% Deductin 14 days late (received the 21 st ) = 2% Deductin 21 days late (received the 28 th ) = 10% deductin We understand that emergencies arise, s please call ur ffice if yu are experiencing a prblem.

4 REPORTS Our ffice requires time t prcess all reprts thrugh ur quality cntrl prcedures and deliver the reprt t the district in a timely manner. Evaluatins are expected in ur ffice n the assigned due date. Service Prviders will be penalized $5 per day fr the first 1-3 days that the reprt is past due. If a reprt is 4-7 days past due, the penalty increases t $10 per day. We understand that extenuating circumstances ccur, s please cntact ur ffice if there is a prblem.

5 Yu are respnsible fr getting a cpy f the child s IEP. Please make a nte f start and end dates, frequency, and gals. They can vary frm district t district and child t child. Please call ur ffice if yu need passwrds r help accessing the website. The frequency and duratin f the services MUST match the child s IEP. Service Lcatin must match the child s IEP. N changes in the lcatin f service may be made withut cntacting ur ffice first. As a general rule, if a child has separate line items n their IEP, the services shuld be n separate lg ntes. Fr example, grup and individual services shuld be n separate lg ntes. If yu d nt accunt fr all sessins fr the mnth, yur billing is cnsidered incmplete. Including, but nt limited t: child absent, therapist absent, schl clsures, and missing prescriptins. Please check ur website regularly fr updates and frm changes. If yu ever have any questins please feel free t cntact ur ffice. We are happy t help.

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7 SCHOOL AGE BILLING Schl Age Billing crdinatr is Christine Flri. Sessin ntes must be filled in cmpletely, including date f birth, lcatin f service, and CPT cdes. Sessin ntes must indicate if a sessin is grup r individual. Due t Medicaid requirements, the grup rati must be listed n all sessin ntes. IEP Direct ntes must be entered in t the system within 5 days f the date f service r they will be cnsidered invalid. The Grup Recrd f Attendance must be cmpleted fr all grup sessins. Only include ne date/sessin per bx. Times must be included as well. All CSE Meetings must be accunted fr n a Prvider Sessin Nte. When billing fr an Evaluatin, the infrmatin must be dcumented n a Prvider Sessin Nte. Individual and Grup sessins must be n separate ntes. Ntes must be legible. Times f service shuld be literal. Make ups shuld nly be cnducted if the service prvider is absent and shuld be dcumented as such n any required dcumentatin. If billing fr a student absent withut ntice, hw the time was spent must be dcumented n a Prvider Sessin Nte. Sessin ntes must reflect IEP gals

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9 Nassau and Sufflk Cunty Preschl If smene ther than the parent is signing the lg ntes, we must have a parental cnsent fr signature n file. Please have whmever is signing the lg nte print their name alng with their signature. We need t be able t identify wh is signing the lg. Make Up sessins must be ffered and dcumented n lg ntes. When cnducting a make up sessin, it must be dcumented n the lg nte as a make up and what date is being made up. Only 1 CPSE Meeting is billable per year. All fields n the lg nte MUST be cmplete. If there blanks n the lg then it is NOT cmplete. Including, but nt limited t date f birth, district, service lcatin (must be specific), frequency, sessin time, ICD-9, NPI # and CPT cdes. If a child misses 5 r mre cnsecutive sessins yu MUST cmplete a Ntificatin f Extended Nn-delivery f Services Frm and frward a cpy t ur ffice a sn as pssible. Sufflk Preschl Billing Crdinatr is Kim Vecchi. Nassau Preschl Billing Crdinatr is Gina Gldsmith.

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11 EARLY INTERVENTION BILLING All infrmatin MUST be cmplete, including but nt limited t: Child s Date f birth Prvider s NPI number Child s ICD-9 Authrizatin Number Parent signature Desired utcme/observatins/strategies Nassau Cunty requires a cunt f sessins Nassau Cunty requires at least ne cntact with team member, parent r EIOD per mnth t be dcumented n the bttm f page 2. CPT Cdes must equal the length f the sessin OT/PT sessins require 1 CPT cde fr every 15 minutes f treatment IF ALL FIELDS ARE NOT FILLED IN YOUR BILLING WILL NOT BE PRECOESSED

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