Medicaid Man welcomes you… Medicaid Fee for Service Program 2008-09. Medicaid Support. Regina Smith, Program Supervisor (O) 313.873.4085 Tanisha Vogl, Financial Specialist (O) 313.873.4283. We’re here to help you!. Fee-For-Service Recovery Effort.
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We’re here to help you!
Seeks reimbursement for medically-related services provided to Medicaid eligible students pursuant to their IEP or IFSP.
These “services” will not generate claims, but should be made “ready to bill” to keep them off the “open services” report.
Is the student Learning Disabled or Cognitively impaired ONLY? (No speech, social work, OT, PT, psychology, nursing, O&M, etc. on the IEP)
Good = Met with parents and social worker to discuss progress on behavioral goals
Bad = Parent Meeting
1/16/08 Met with RN to discuss change in medications
3/31/08 Contacted parents to discuss …therapy, counseling, meds, speech goals, BIP…
10/17/08 Conference with parents/service providers regarding…medical issues/ goals (describe)
4/4/08 - Behavior
Math, Reading, Language, Work Skills
No Services this month
This new service may affect your classroom
Detroit Public Schools is committed to ensuring that its coding, billing and reimbursement procedures comply with all federal and state laws. However, we cannot ensure that the services reported were provided as stated, that they were medically necessary or were not false or misleading.
If you have knowledge or information that School-Based Services being reported to Detroit Public Schools Risk Management Office for the purposes of Medicaid billing are false or fraudulent, such as the falsification of records or submitting services for billing that were not performed, please report the situation to your supervisor or to the Attorney General’s Health Care Fraud Division at: 800-242-2873.
Federal and state law prohibit any retaliation or retribution against any person who reports suspected fraudulent billing to law enforcement officials or who file “whistleblower” lawsuits on behalf of the government.
Your name has been put in a “pool” with all of the other Designated Case Managers in the state.
Out of this pool comes the Random Moment Time Study. This is the tool that Michigan uses to determine the amount of time school staff spend on activities that are in support of the Medicaid program
Every quarter, names will be drawn and you could be chosen at any point to participate in one or more of these random moment time study surveys.
There is no limit to how many times your name can be drawn in a quarter.
If you are selected to participate, you will receive notification in the mail that you need to complete a RMTS survey on-line. This should take no more than 10 minutes of your time. It is mandatory to complete your moment within 24 hours of the date/time of selected moment.
In the Random Moment Time Study, a “moment” is one minute of time. Completion of the time study moment will require you to answer four questions regarding the activity you were performing during that one moment of work time.
(Not exactly worded like this, but you get the idea)
Getting ready for my day
Catching up on Paperwork
Only Public Consulting Group (PCG) sees your answers… RESA and your district cannot.
If you are not descriptive enough and clarity is needed, you will receive a follow-up call from Public Consulting Group.
Please return follow-up phone calls promptly.
Contact the DPS Medicaid Office.