EDMS

Archives for September 2014

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Upcoming Webinars (Massachusetts)

In an effort to maximize our outreach during this busy fall start up season, and to better meet the needs of our districts, we are offering a more robust webinar series.  Over the next few weeks, we are offering districts the opportunity to attend brief – 30 minutes or less – webinars on specific topics that will help with preparation for the school year.

Upcoming topics:

  • Required Lumea Admin Items
  • Running Student & Special Ed Rosters

These offerings are being updated regularly, so please be sure to check our Training and Events page frequently.

We are also pleased to announce that, as part of our webinar expansion, we will work with interested districts to create custom webinars to help meet training needs more effectively and efficiently.  We can host these webinars for select members of your staff that may need additional support or updates, and we can usually record these programs and provide them to you for use later.

If you are interested in a custom webinar, or information about pre-scheduled programs for later in the fall, please contact Steve Courter.

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Suggested ITP Templates-Available Now!

The Wait is Over!

MSB™ is proud to announce the official release of our Section 65 and Section 28 suggested ITP Templates and APS Mapping Documents. We would like to wholeheartedly thank each of you who attended one of our forums for the valuable
input and reviews you provided as we worked through the drafting process. This was truly a team effort, and you were all MVPs of that team!

Our goal for providing the suggested ITP template is to capture, on a single document, all information from the clinician for an ITP as well as a Prior Authorization (PA) request, which will assist a district administrator in submitting the PA request. With this one tool, districts can now document elements of an ITP as set forth in policy and assist with the APS prior authorization process. By using one digital form, your district can now have confidence that whomever is managing the data entry on APS Care Connection has information that is required before starting – no more delays while trying to find the pieces. Additionally, by faxing this document, as required, to APS along with the IEP, you will provide greater clarity to the reviewers as your ITP includes all required APS fields.

The accompanying suggested APS Mapping Documents show administrators what information from the suggested ITP templates will go into the specific windows of APS Care Connection. This map provides a step-by-step explanation to assist with the completion of a Prior Authorization initial request through to a Continued Stay Review (CSR). The screen shots, when appropriate, have been labeled with numbers that correspond with boxes from our suggested ITP Template. The goal with this document is to speed up the process of finding information needed to complete each screen and make the process more manageable for the APS contact in your district to complete all data entry required within the Care Connection website.

The Cover Page provides a brief synopsis of the suggested ITP template’s purpose, and a list of the boxes required for APS. We even provide a formula you can use to
calculate units needed for a child.

As always, we encourage you reach out to your Program Specialist with questions or concerns, thank you for your continued support, and we look forward to your feedback!

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Action Required: Rates Template Due (Maine)

This is just a friendly reminder that the Rate Information deadline is September 19th. It is crucial that we receive all rate information from you by this date so that the processing of your district’s claims is not delayed.

In addition to salary and benefit information, please provide the percent or total dollar amount for anyone who is being paid through Federal funds. If your district has contracted with MSB for the List of Excluded Individuals and Entities (LEIE) verification services, you must include each provider’s date of birth on the rate template as well.

The template is available on our website and should be returned to meratescoordinator@eddatasolutions.com by September 19.

If further information or clarification is needed, please do not hesitate to contact Tina Benjamin at 800-618-3111 x162.

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What has Changed with Speech Codes (New Hampshire OOD Facilities)

MSB was recently made aware that a notice was sent to NH Medicaid to School Providers indicating that some retroactive changes have been made to speech
evaluation and consult codes.

The changes involve the expiration of the speech evaluation/consult procedure code 92506 – Evaluation of speech, language, voice communication and /or auditory processing (use for evaluation and re-evaluation). This change is effective December 31, 2013, which means this code can no longer be used by speech providers for evaluation/consult dates of January 1, 2014 and later.

The changes also involve the addition of four new, more specific speech evaluation procedure codes effective 1/1/2014. These codes must be used for speech evaluations dated January 1, 2014 and later. MSB has created new Speech Transaction Logs (this will be a link to our new log that we will develop) to reflect these changes. Per the notice, the new consult code will be provided in the near future, and at that time, we will update our transaction logs.

Procedure CodeModifier 1DescriptionRateNotes
92521TMEvaluation of speech fluency$114.27
per
event/eval
92522TMEvaluation of speech sound production (e.g., articulation, phonological process, apraxia. dysarthia)$92.78
per
event/eval		*code 92522 & 92523
are restricted from the combination of same day billing; select the most appropriate code to bill either 92522 or
92523 but not both
92523TMEvaluation of speech sound production (e.g., articulation, phonological process, apraxia. dysarthia); with evaluation of language comprehension and expression (e.g. receptive and expressive language)$192.73
per
event/eval		*code 92522 & 92523
are restricted from
the combination of
same day billing; select the most appropriate code to bill either 92522 or 92523 but not both
92524TMBehavioral and qualitative analysis of voice and resonance$96.72
per
event/eval

Your MSB OOD Claims Analyst will be in contact with you with further instructions.

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New Mass Admins – Training on Required Admin Items (Massachusetts)

In order for MSB™ to seek reimbursement for your district, there are certain areas of Lumea™ that must be managed and updated by administrators on an ongoing basis. Below are items that are required to be completed/updated in order for us to submit claims. You may also access our Lumea Required Administrative Items document on our website.

Please have these areas of Lumea™ updated so that we can submit claims for your district:
User Management > User Details:

  • Summary Tab: Requires Professional Oversight: Check this box for all service providers who require supervision and the electronic signature of their supervisor on Medicaid documentation
  • Types Tab: Assign the appropriate State Approved Service Provider Type to all service providers in Lumea
  • Credentials Tab: Add a record for the appropriate credentials for all service providers recording in Lumea

User Management > User Approval:

  • User Approval: Approve users who will be utilizing Lumea and assign their Role when approving them (they can be changed later in the Roles Tab)

Student Management

  • Adding Students: Add your entire special education student roster into Lumea
  • Student’s Name: Use student’s full legal name
  • School Name: Select the name of the school that the student is attending DOL: Enter a record each time the student’s District of Liability (“DOL”) changes to indicate which DOL should be receiving reimbursement Special Education Status: If the student is a special education student, select “Yes”
  • Medicaid ID: Enter the student’s Medicaid number OK to bill Medicaid: Set toggle to “Yes” if you would like MSB to bill for the student (“no selection” also allows billing to be submitted)
  • Gender: Select the appropriate gender of the student
  • Exit Information: If the student has exited the district, change the student’s status to “Inactive” and add the exit date
  • Parental Consent: If you choose to manage parental consent in Lumea, please enter the date of the one-time consent here
  • Special Education Status: If the student is a special education student, select “Yes”

Student Identity Verification:

  • Verify that the students that have been added by your service providers are students in your district receiving services and that the information is accurate

Calendar Management:

  • Update district and school calendars with any non-school days (holidays, vacations, snow days) MassHealth imposes a strict 90 day billing deadline. If the above referenced fields are not completed, claims may withheld. If you would like to schedule a training, please contact Jen Surina at 800-618-3111 ext. 122 or jsurina@msbservices.com.

Notices