Guidelines for Billing

Non-Billable Logs
Providers can add comments that are not part of a student service log in the Service Portal.  If an IEP has not been finalized, non-bIllable logs should be created to document a service.  A non-billable log will not be sent to DPHHS for reimbursement, but remains permanently in the Service Portal records. 

Non-Billable logs are created using the Service Log Wizard.  Instead of choosing a service code, choose NoProc-NonBillable from the drop-down menu.  Notes can then be added in the comments section.  A detailed explanation of how to create a non-billable log can be found here.

A student with a Medicaid number will show as bold in the Service Portal.  You should use the service code and not a non-billable log for non-Medicaid students with IEP directed services.  This will allow services to be reimbursed should eligibility change.

Progress Reports
Progress notes should summarize the service comments and indicate the student's progress toward medical status, IEP goals, and changes in treatment plans with rationale for change.

Evaluations can be billed for a student only once each year per service type.  This can be tricky since most evaluations occur over several days and sessions.  Before adding an evaluation to the service portal, wait until the evaluation is complete, a primary disability has been determined, and the IEP finalized.   The total time for an evaluation should be logged for the final evaluation day.  Specific dates and session times can be included in the comment section of the log.   

Medicaid Annual Notice
Parents that give consent to bill Medicaid should receive an annual notice.

A parent needs to sign the Consent To Bill Form only once while a student is in the district.  The annual notice should be mailed or given to parents that have signed the consent form.  This annual notice does not need to be signed.

SWMSS likes to get copies of these forms too as proof of compliance with this regulation.  We keep track of the annual notice in the student records file in the service portal.

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