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Medicaid Time Study Training for Alaska Public Health Nursing. How to Use the New Web-Based Time Survey for Medicaid Claiming -- June 2006 --. About today’s training session. Brief look at who, what, when, where, why Main focus of training is how to complete survey

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medicaid time study training for alaska public health nursing

Medicaid Time StudyTraining for Alaska Public Health Nursing

How to Use the New Web-Based Time Survey for Medicaid Claiming

-- June 2006 --

about today s training session
About today’s training session
  • Brief look at who, what, when, where, why
  • Main focus of training is how to complete survey
  • Lots of discussion about coding
  • Time for Q & A

DPH Nursing Time Study Training

who will participate
Whowill participate?
  • About 80 public health nurses and a few health practitioners
  • Basic rule – everyone who participated in the old time study will do this one, too
  • List of participants is updated each quarter by Regional Nurse Managers and DPH Director’s Office

DPH Nursing Time Study Training

what is this survey for
What is this survey for?
  • Medicaid pays for many activities performed by Alaska Public Health Nurses – this time study is necessary to make our claim
  • New methodology is easier for nurses and complies with federal requirements

DPH Nursing Time Study Training

when will the survey occur
When will the survey occur?
  • All participants will be surveyed 5 times per quarter (total is same as old time study – 20 survey days per year)
  • Survey dates to be chosen randomly by computer
  • Time study will be administered simultaneously – all participants do it on same 5 survey days

DPH Nursing Time Study Training

where will i do this
Where will I do this?
  • At your computer – the new time study is completely web-based
  • Itinerants can print and take a paper survey on the road, then complete the time study when they return – the survey stays open for 10 days
  • You will be notified about the survey 5 days before the actual survey day

DPH Nursing Time Study Training

why are we changing
Why are we changing?
  • Again, it’s easier for nurses
  • Easier for DHSS to administer and make claim
  • Feds said we must be more random, and make claim quarterly – not annually
  • Part of national cost-containment effort

DPH Nursing Time Study Training

so how will this work
So, how will this work?
  • 5 days before survey, you’ll receive an email notifying you of the survey date
  • On the survey date, you’ll get a second email with instructions and link to survey website
  • You’ll open the survey, fill it out and – once it’s complete – click on ‘Save Survey’
  • That’s it – you’re finished

DPH Nursing Time Study Training

how basic goals of survey
How … basic goals of survey
  • To determine time DPH nurses spend on Medicaid vs. non-Medicaid administrative activities
  • To differentiate between administrative claiming and direct services
  • To continue to receive reimbursement from federal government

DPH Nursing Time Study Training

how three basic categories
How …three basic categories
  • Administrative claiming – a way to account for time spent on activities such as outreach, referral and community assessment (and other work necessary) to support the administration of the Medicaid program
  • Direct services – any activity that is done to correct or ameliorate a condition
  • Other – anything else that isn’t an administrative claim or direct service

DPH Nursing Time Study Training

how four simple steps
How … four simple steps

1. Select time period

2. Select main code for that time period

3. Select sub-code in pull-down menu, if needed

4. Click on ‘Save Survey’

DPH Nursing Time Study Training

how a demonstration
How … a demonstration
  • All information about the DPH Nursing time study can be found on this website:

http://www.mesd.k12.or.us/mac/alaska/

DPH Nursing Time Study Training

reviewing the codes
Reviewing the codes

Now only 10 main codes to describe your work

A1 Outreach Related to Medicaid Services

A2 Outreach Related to Non-Medicaid Services

B1 Referral, Coordination or Training Related to Medicaid Services

B2 Referral, Coordination or Training Related to Non-Medicaid Services

C1 Transportation or Translation Related to Medicaid Services

C2 Transportation or Translation Related to Non-Medicaid Services

D1 System Coordination / Community Assessment of Medicaid Services

D2 System Coordination / Community Assessment of Non-Medicaid Services

E Direct Health Care Services

F Other Work Activities

DPH Nursing Time Study Training

code a1
Code A1

Outreach Related to Medicaid Services

Interviews, group meetings, phone contacts or home visits that inform Medicaid-eligible and potentially Medicaid-eligible individuals and their families about the benefits and availability of services provided by the Medicaid program. Informing individuals and their families on how to access, apply for, use and maintain participation in health care resources including Medicaid, Early Periodic Screening, Diagnosis and Treatment (EPSDT), Denali KidCare (DKC), etc.; disseminating materials to inform children and families about Medicaid; helping fill out forms; and related staff travel and paperwork.

DPH Nursing Time Study Training

code a115
Code A1

Sub-Codes in A1 Pop-Up Menu

A1.1 Conducted individual or group session to inform Medicaid-eligible or potentially Medicaid-eligible individuals about the benefits and availability of services provided by Medicaid programs.

A1.2 Disseminated materials to inform individuals or families about Medicaid; helped with applications / forms.

A1.3 Checked a person's Medicaid status.

A1.4 Contacted a pregnant woman or parent about the availability of Medicaid / DKC for prenatal and well-baby care programs.

A1.5 Conducted a health education outreach program or campaign targeted specifically to Medicaid-covered services such as family planning, prenatal care, immunizations, etc.

A1.6 Staff travel or paperwork related to outreach and application assistance for the Medicaid program.

DPH Nursing Time Study Training

code a2
Code A2

Outreach Related to Non-Medicaid Services

Activities that assist the patient/client in gaining access to non-Medicaid services, and effectively utilizing social services and community wellness programs. Examples of such non-Medicaid programs are housing, heating assistance, food stamps, food banks, the Women’s Infant and Children (WIC) program, foster care, Temporary Assistance for Needy Families (TANF), legal aid, exercise and weight loss programs, childcare, after-school programs, visitor and vocational services. Include activities that assist the client in applying for these services, including disseminating materials, helping fill out forms, and related staff travel and paperwork.

DPH Nursing Time Study Training

code b1
Code B1

Referral, Coordination or Training Related to Medicaid Services

Making referrals for and coordinating the delivery of diagnostic and preventive service and treatment for health, vision, dental, developmental, mental health, substance abuse and other services such as specialty clinics. Includes staffing to coordinate Medicaid case plan services (participation in multidisciplinary team meetings, conferencing on health, developmental issues, consultations), gathering background information and supportive information, such as medical histories, writing case plans, or summaries and preparing and/or presenting materials for case review, arranging for health services and coordinating services (i.e., psychological counseling, health, substance abuse counseling and consultation, inpatient services); conducting or attending training or education related to the delivery of Medicaid services and related staff travel and paperwork.

DPH Nursing Time Study Training

code b118
Code B1

Sub-Codes in B1 Pop-Up Menu

B1.1 Referred a person for medical, mental health, dental health and substance abuse evaluations, specialty clinics and other services covered by Medicaid/DKC. (Includes gathering information in advance of referrals)

B1.2 Coordinated the delivery of medical health, mental health, dental health and substance abuse services covered by Medicaid/DKC. (Includes participation in multidisciplinary team meetings, conferencing on health, developmental issues, consultations, and preparing or presenting materials for case review)

B1.3 Conducted or attended training or education related to the delivery of Medicaid services.

B1.4 Participated in Medicaid time study.

B1.5 Staff travel or paperwork related to Referral, Coordination and Training of Medicaid Services

DPH Nursing Time Study Training

code b2
Code B2

Referral, Coordination or Training Related to Non-Medicaid Services

Making referrals for and coordinating the delivery of non-Medicaid social services and community wellness programs (including housing, food stamps, food banks, WIC, foster care, TANF, exercise and weight loss programs, energy assistance, child care, after school programs, friendly visitor and vocational services) arranging transportation for these services and related staff travel and paperwork.

DPH Nursing Time Study Training

code c1
Code C1

Transportation or Translation Related to Medicaid Services

Assisting an individual to obtain transportation to services covered by Medicaid and/or arranging for or providing translation services to facilitate access to Medicaid services. Include related paperwork, clerical activities or staff travel required to perform these activities.

DPH Nursing Time Study Training

code c121
Code C1

Sub-Codes in C1 Pop-Up Menu

C1.1 Scheduled or arranged transportation to Medicaid covered services (not as part of the direct services billing for transportation)

C1.2 Scheduled, arranged or provided translation for Medicaid covered services (translation for access to or understanding necessary care and treatment)

C1.3 Staff travel or paperwork related to Medicaid transportation and translation (not as part of the direct services billing for transportation)

DPH Nursing Time Study Training

code c2
Code C2

Transportation or Translation Related to Non-Medicaid Services

Assisting an individual to obtain transportation to services not covered by Medicaid, or arranging for or providing translation services related to social, vocational, or educational programs. Include related paperwork, clerical activities or staff travel required to perform these activities.

DPH Nursing Time Study Training

code d1
Code D1

System Coordination / Community Assessment Related to Medicaid Services

Working internally and with other agencies to improve Medicaid health services, identify gaps in services, improve capacity and expand access to community medical and health services and their utilization by Medicaid-eligible target populations; gathering information about the target population to improve early identification of health and developmental problems; and related staff travel and paperwork.

DPH Nursing Time Study Training

code d124
Code D1

Sub-Codes in D1 Pop-Up Menu

D1.1 Worked internally or with other agencies and/or providers to improve the coordination and collaboration and delivery of medical, mental health and substance abuse services, including workgroups, coalition building and planning for community health fairs or roundups.

D1.2 Staff travel or paperwork related to System Coordination and Community Assessment Related to Medicaid Services

DPH Nursing Time Study Training

code d2
Code D2

System Coordination / Community Assessment Related to Non-Medicaid Services

Working internally and with other agencies to improve social services, identify gaps in services, expand and improve capacity to engage in non-Medicaid activities, expand access and linkage to non-Medicaid services, their utilization by target populations; and related staff travel and paperwork.

DPH Nursing Time Study Training

code e
Code E

Direct Health Care Services

Providing direct health care services to a patient, such as well baby checkups, immunizations, disease management, epidemiological investigation, counseling, and medical case management or other activities that are an integral part or extension of a patient visit. Included is all related paperwork, clerical activities, staff time, or travel required to perform these services.

DPH Nursing Time Study Training

code e27
Code E

Direct Health Care Services: Sub-Codes in E Pop-Up Menu

E1.0 – Adult Medicaid Services (old code 200)

E1.1 – Adult Non-Medicaid Services (201)

E2.0 – EPSDT / Children’s Medicaid Services (300, 301)

E2.1 – Children’s Non-Medicaid Services (305)

E3.0 – Prenatal and Postpartum Medicaid Services (351)

E3.1 – Prenatal and Postpartum Non-Medicaid Services (352)

E4.0 – Family Planning Medicaid Services (361, 371)

E4.1 – Family Planning Non-Medicaid Services (362, 372)

E5.0 – Breast and Cervical Medicaid Services, after diagnosis (381)

DPH Nursing Time Study Training

code f
Code F

Other Work Activities

All other paid work activities that do not fall under one of the above categories. This includes time off for vacation, sick leave, family leave, holidays, jury duty and breaks. Such activities also may include maintaining inventories, ordering and stocking supplies, developing budgets and related paperwork, clerical activities or staff travel.

DPH Nursing Time Study Training

theoretical coding examples
Theoretical coding examples
  • PHN does Hepatitis A contact investigation on a recently diagnosed food service worker and his co-workers, including travel to restaurant. 2 hours (Code E)
  • PHN sees mom and 2-year-old son in office. Mom concerned about a possible ear infection and heard the nurse will check the child’s ears. PHN is also worried about infection and refers son to local clinic for diagnosis and treatment. Mom worried about paying. 30 minutes (Code B1.1)
  • During same visit, PHN explains Denali KidCare and helps mother complete application. 15 minutes. (Code A1.2)

DPH Nursing Time Study Training

theoretical coding examples30
Theoretical coding examples
  • PHN participates in meeting of local multi-agency coalition working to make sure community is prepared and has needed info in case avian flu is found in the migrating ducks hunted for food. 3 hours (Code D2)
  • PHN talks with Community Health Aide about dentist’s upcoming village visit and specific children the PHN wants the dentist to see on this trip. 30 minutes. (Code D1.1)
  • PHN calls a mom at home, gives her bus schedule times and address for state office where she can apply for WIC and Food Stamps. 15 minutes. (Code C2)

DPH Nursing Time Study Training

things to remember
Things to remember
  • IMPORTANT - Always record client’s Medicaid ID number on encounter form; it’s especially critical on survey days
  • When selecting time periods for survey, can choose 15-minute blocks or much longer periods
  • Think preponderance of work in each time block
  • Can break up visits [i.e., 45 minutes direct services (Code E) for well-child exam, 15 minutes outreach (Code A1) in same visit for explaining benefits of Denali KidCare]

DPH Nursing Time Study Training

contact information
Contact information

Coding questions?

  • Your Nurse Manager
  • Bruce Scandling, DPH Director’s Office, 465-3486 bruce_scandling@health.state.ak.us
  • Rhonda Richtsmeier or Corky Olson, DPH Nursing, 465-3151 rhonda_richtsmeier@health.state.ak.us

corrine_olson@health.state.ak.us

Technical / IT questions?

Nurse Managers may call Wendy Chase, Multnomah Education Service District, 503-257-1775 wchase@mesd.k12.or.us

DPH Nursing Time Study Training