Developmental Disabilities - For Providers
Can agencies continue to use the new service codes after 06/14/09 ?
A decision has not been made as of this date, however, you will be notified prior to 6/14/09.
Why can’t we put more than one activity on a service log?
In order to capture accurate data for the activities performed and the amount of time each activity requires, each service code must have its own start and end time. This will provide a truer picture of what support coordinators are doing for our participants and provide additional information needed to determine an appropriate rate of reimbursement for the population being served.
Can Support Coordinators just log with new codes in the testing period or must they do a separate with previous codes as well?
Refer to the timeframes provided for the training on 5/7. For the dates of 5/18/09 through 6/14/09 all old service codes will be turned off and only new codes can be used.
Is the time spent driving spent from home to work time we can use?
No, you cannot use this time, from home to place of employment.
Explain the term "leave."
Vacation time, sick leave, and time not spent performing support coordination activities.
Do we have to do a leave log when a supervisor is out?
Yes. Same for a support coordinator.
Will these codes be entered into LSCIS?
Yes. EPSDT activity codes will be turned on in LSCIS and will not appear in CMIS.
What code do we use for SIS assessments?
78 – Intake/Assessment/Reassessment – see 1.2.4.
Are activities entered into LSCIS for EPSDT?
The new codes will be turned on in LSCIS for the EPSDT activities. They will not appear in CMIS.
Do we have to log out when receiving/making phone calls while traveling?
Log off for travel time, log on for phone call, log off for phone call, log on for travel time. Times/activities may not overlap.
Is looking up eligibility for an EPSDT child billable?
No. Medicaid will not reimburse for contacting Medicaid. This has been moved to the allowable, not billable activities, code 96.
How does a support coordinator supervisor with a caseload of CC and EPSDT put their supervisory visits into CMIS/LSCIS?
Separate time spent for each population in to the appropriate system.
When do we get the service logs?
Service Logs, Code Sheets and the updated Rate Setting Project Service Definition information will be provided to all Agency Directors and On-Site Project Managers at about 3 pm 5/8/09. If you have not received the information, please contact your On-Site Project Manager.
For the NOW, we have to do an observation, quarterly visit and provider monitoring form. Does that all go under 78 for intake and assessment?
No. Code as Activity 81 Follow-up and Monitoring. If conducting an observation, the procedure code must also be included. Annual reassessment will be coded as Activity 78.
The SIS and shadowing – what activity should the person who does the SIS use and what should the shadower use?
Person doing SIS = 78 Intake/Assessment/Reassessment. Person shadowing will be 88 Training.
SIS Training, do we log all of this training in?
Yes. Provided is it conducted during this 4 week time period.
Do we enter our pre-links now?
Yes. Assign them a case number and enter the demographic information and you will be able to document activities performed.
Did I hear you say supervisors and project managers work is not billable if they are covering caseloads for someone else?
The original answer is being revised – We originally said that activities performed by the supervisor or project manager is allowable, but not billable if the individual for whom the service is being performed is not in their caseload. These activities would be considered a part of the supervisory/project manager duties (the cost for these individuals performing their duties will be included in the fiscal/administrative cost surveys). We provide the following: Support Coordination activities performed by supervisors and On-Site Project Managers and entered into the system will continue to count towards meeting requirements for payment (whether or not the individual for whom the service was provided is in their caseload) and will be used in determining the number of units of service to release for NOW and EPSDT.
We can’t enter data after 6 months, right?
We are gathering information for activities performed between 5/18/2009 and 6/14/2009 only. Any activities performed before this project are not relevant for this project.
If working at home, would documentation be the same except for the location?
Yes. All HIPAA requirements must still be met and followed.
Should the code be used to include documentation, which would be subtracted from a billable unit to show all minutes of the day? Such as telephone contact plus documentation.
Document the actual activity and the documentation activity on separate logs.
When recording a Travel log; do we use the "Type of Contact" documentation code #6 or do we use a code #1 or #4 with the #87 travel service activity code?
Code 1.
As Supervisors, are we required to bill for daily responsibilities such as CPOC annual/initial reviews, phone calls received on behalf of participant, etc.?
Typical supervisory activities, no. Calls received on behalf/with participant, yes.
When the agency is linked to SIS assessments and we open the case as recommended will it affect timelines?
No. Timelines are applicable upon linkage to begin the process to complete the plan of care.
What code should be used to follow up on and track 2025 charts? Should we use 81-Follow Up Monitoring even though these clients aren't yet billable? Do we use the training code to track the progress of training as well?
Use code 81 for follow-up on the 2025 charts. Training code used only if the SC is participating in training.
For staff meetings, should every staff at the meeting be completing a service log, supervisors and SCs?
See important update at beginning of the list of Q&A. Separate log for each support coordinator with Service Activity Code 90 and Participant Code 19.
Do both the supervisor and support coordinator write a log for weekly supervision?
No.
Does the supervisor write a log for the weekly staff meeting?
Not for their time spent.
In the past to document travel under type of contact there was a number 7 travel. How do we document type of contact for travel?
Use Code 1.
If a support coordinator is out sick and takes phone calls at home can we document for the time? Does this mean that they need to log out and back in for sick time?
Yes.
When training a new support coordinator in the field the supervisor goes into the field to train the new sc. How can we capture the training time and the quarterly, observation and cpoc if we can only write one log and need it to count for both training and requirements?
Each activity performed must have its own service log. Supervisor documents billable activities on separate service logs. Time SC spent in training is documented as training and also on a separate service log.
When shadowing occurs for training with the SIS/LaPlus do we enter the log under the case that is shadowed or do we enter it straight under the support coordinators ID of Supervisor ID?
Person doing SIS = 78 and person doing shadowing = 88.
How do we divide the supervision time for a supervisor who supervises a SC with a mixed CMIS and LSCIS population?
Separate service log for time spent on each population.
What service activity code should be used for filing?
Filing/file maintenance completed by the support coordinator would be coded based on the type of documentation being filed, i.e., if service log/documentation is related to an observation of services, 81. Filing completed by staff other than the support coordinator is not a billable activity and will be considered in the rate setting activity through the cost surveys completed by the Agency.
Regarding the SIS LAPlus prelinks that we are now to enter in CMIS, will SRI be able to isolate these from our regular linkages so that they do not show up on our aging reports?
They will not show on the aging reports.
Other than participant related activities, does the project manager log any other activities?
No.
Do logs have to be created for Lunch and any breaks taken in the day? If so what codes should be used?
No.
The new codes are not working in CMIS as of 5/11/2009.
If you have not downloaded the new version, please do so immediately. To update CMIS, send an information file and pull down the new version. Once the new version is downloaded, exit the software and then come back in to install the new version.
When traveling to a recipient's home it would be coded 87 activity and participant 01, would this also be true for the return trip?
Yes.
Will we still be able to enter logs completed through May 15th with the old codes after May 18th?
Yes. System is programmed to accept entry for services completed through May 17th.
What type of contact code do we use when "searching" for community resources for consumers?
If in person, 1; if via phone, 2.
Why is Documentation identified in each activity codes 78 through 82 as allowable/billable service activities, but not billable if contact code of 3 (written) or 6 (documentation only) is used?
Documentation should be coded as a 6 and should be used when preparing plans, revisions, etc. Code 3 has historically been defined as written correspondence to or for the participant and is not a billable activity.
The statement on the modified business rules sent out on 5/11 regarding the 3 not being billable. Since unit billing began for the NOW and EPSDT, a 3 (written) or 6 (documentation) has counted towards billable units. Is this no longer the case? If so, then how would we document the writing of a revision?
Use code 6.
In reviewing the business rules it states that a contact of 3/written is nonbillable. Is it that a 3 is nonbillable or does it just not count for minimum requirements but counts as billable units?
Code 3 is allowable, not billable.
When traveling to a workshop and you see multiple participants, would you code the time spent traveling to just one participant or use "no one"?
Use “no one” since multiple participants are involved.
When the code of 81 is entered into CMIS for a Quarterly visit and the observation code is entered. It only recognizes the quarterly visit and not the observation on the Required Action. How do we proceed.
If you have documented and entered the time spent for the actual quarterly visit and the observation of services separately, since the service activities have been compressed and there is no specific activity “observation of services”, the Required Action report will not reflect that the observation was completed, however, the system does capture that the requirement was met. During this project, 2 separate cells must be used.
When inputting the new Rate Study codes, we're noticing that monthly & quarterly service events--when entered using activity code 81--are not showing up on the Required Action report, under Support Coordinator Activity. Any ideas?
See answer to previous question.
Do we need to enter all of our SIS LAPlus prelinks to date?
Only if you will be performing any activities for them during the period of 5/18/09 through 6/14/09.
Does a supervisor complete a services log(s) for each individual weekly SC supervisory session? If so, what codes are used?
See previous posted responses related to supervisory sessions and the update at the beginning of the questions and answers.
On the billing codes there are 4 and 5 for type of contact and documentation combined. In one of the answers, it states that we must write a separate log for documentation. Which is right?
The answer is correct. Please be reminded that each activity must be documented separately.
In reviewing the business rules it states that a contact of 3/written is nonbillable. Is it that a 3 is nonbillable or does it just not count for minimum requirements but counts as billable units?
Code 3 is allowable, not billable."- A written contact should be billable. Example: a letter requesting information about a service, or to a family about their services, etc. should be billable time. Contact Code '3' is direct work for the participant and therefore should be billable. Contact Code 3 continues to be an allowable, not billable activity.
I have a follow up question (representing the members of the LSCA)regarding the fact that during the time study, individual requirements (for example observations) will not show up on the required action because they are being collapsed into code 81; because of this, we cannot track our requirements in CMIS. Will this be reversed once the time study is completed? Will we be able to again see that our individual requirements are completed? It's important that we do particularly to ensure end of quarter payment. If this is not the case and the more important issue here is to collect the true time during this study, can our requirements for this quarter be relaxed so that we are not in jeopardy of denied claims?
As advised during the training and included in responses posted on the website, the decision has not been finalized related to returning to the previous service log/codes as they existed – there are some activities being captured during this project that we believe we should continue to capture. We project a revised service log to include those in addition to returning to previous codes until OCDD, OAAS and BHSF can develop one service log to be applicable to all populations/offices. As to the issues with the observation of services, if the data was entered into CMIS and the procedure code was identified, there should not be a “denied claim”. If you identify that you have been penalized units for not completing the observation of services and you know the activity was completed and the data was entered, please send OCDD central office a copy of the service log and supporting documentation of the penalty being imposed and we will take the necessary corrective action.
The question of what code to use for written contact has been addressed previously and we understand that we are to use a 6 instead of a 3 during the time study, however, when we use a 6, CMIS populates a code 98 for participant (none). This code (98) appears to be defined as nonbillable. We need these activities (revisions, CPOC completion, correspondence, etc) to be billable and count towards our NOW and EPSDT units as they are integral parts of our activities. Can you confirm whether or not these activities are counting towards our billable units for these populations? If not, this will greatly impact our units.
Code 98 appears as the “participant” since the support coordinator may be by themselves completing the documentation. The activity still counts towards billable activities.
I see that revisions, CPOCs, and such should be logged as a 6 (documentation) instead of a 3 (written). If we are sending faxes (example: to OCDD) or mailing (example: to OCDD or to providers), do we log this as a 6 as well? This could take a good bit of time.
Use Code 6.
The SIS LAPlus prelinks are showing up on our aging report, is there a way to prevent/block this?
SIS LA Plus pre-links show up only on the aging reports for the support coordination agencies, are not reflected on the reports being monitored by OCDD and should not impact any timelines previously established for these individuals.
Concerning service logs for the rate study: Entering a service log with NOONE for supervision purposes, utilizing a "13" as place of service, a "1" as type of contact, and a "90" as the activity, the CMIS system automatically populates a "98" as the service participant:, it does not give you the option to choose a "19". Am I the only person experiencing this problem?
The activity is still captured and is related to the support coordinator if the support coordinator’s information was put on the log. We would then assume that the supervisor on record in CMIS is the supervisor conducting the supervisory session.
What are we doing with the individuals that we assigned a case number to (pre-link) and then are re-linked? Are we to close them and re-assign a case number because of the change in the open date? If we do not re-assign with a new date then it will look like we are not meeting deadlines.
You have two choices: 1) Give the pre-linked and the relinked client separate case numbers, OR 2) Change the case open date for the recipient once they are re-linked. Option 2 is the easiest and does not require double entry. Either is acceptable.
During the Video Conference (7/7/09) the question was asked regarding using the Billing Checklist and the reply was "If you complete logs and file in the client's book then you don't need the Checklist". I think that we will still need to complete the Billing Checklist for actual billing purposes -- as the SC's will be completing logs for ALL services -- not just BILLABLE services. If we don't complete the Billing Checklist I feel that it will make billing very difficult to assure actual billable (Units) are correct and billed.
You can complete the billing checklist also, or just code the service log with the non billable activities.
When a support coordinator is doing a home visit for a Quarterly Review, all services are being entered separately, which includes a monitoring of home binder and observation of companion care and observation of LTPCS services, and a PERS unit the S.C. uses the code of 81. If that S.C. comes back to the support coordination office and fills out the billing sheet the S.C. would use a 81 for monitoring, and observation, and type of contact would a 1, but if the S.C. filled out all the billing sheets in the home, then the type of contact would be a 4. Also, if while making a monthly phone contact, which is the service activity of a 81 and while on the phone one completely filles out the billing sheet then the type of contact would be a 5; however, if one hung up the phone and then completed the billing sheet, then the type of contact would be a 2. Is this correct? Also, when a data entry person is entering the billing forms, onne is unable to enter the amount of time spent documenting log if the type of contact is only a 4 or 5. Is this correct. This answer relates to the first question that I asked.
The system will not allow for more than one activity per service log during this data collection period. You will need to complete a log for the visit and each of the activities performed at that visit and if completing documentation later, a second log for that activity. Contact code for that would be 6, documentation only.