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Indiana Early Intervention Fiscal Structure and System Overview

The Indiana Early Intervention fiscal structure and system involve various staff members, contract management teams, fund sources, and claiming processes. It highlights the roles of different individuals, the sources of funds for early intervention services, and the claiming process via commercial insurance, Medicaid, family cost participation, TANF, SSBG, State funds, and Federal funds. Additionally, it outlines the financial monitoring and audit procedures implemented by FSSA to ensure accountability and quality service delivery.

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Indiana Early Intervention Fiscal Structure and System Overview

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  1. Indiana Early Intervention Structure & System Fiscal 3/15/2024 1

  2. Fiscal 3/15/2024 2

  3. Fiscal Staff & Support Fiscal Staff: Paul Bowling – FSSA CFO David Nelson – FSSA Controller Josh Potter – DDRS Controller Joe Gibbons – DDRS Financial Analysist Contract Management: LeadAgency: Christina Commons, David Brandon-Friedman, Maggie McCall, Constance Young DDRS Contracts Development Team: RobertScott, Regina Snyder, Jennifer Kinman FSSA Audit Staff: FSSA Accounting Operations Staff: Judy Wieneke– Deputy Director Rinali Patel – Accountant Laura Cowan, Director of Audit Services Robert Millikan, Audit Manager Brenda Wilson- Accountant FSSA Investigations Staff: PCG Billing Staff: Chris Clark – Claims Analyst Carolynn Tabulog– Claims Analyst Dale Owens – Senior Business OperationsAnalyst Sherree Sinclair – Senior Manager Revenue Cycle Wendell Hoskins, Chief of Investigations Indiana Department ofAdministration (Central Procurement) TeresaDeaton-Reese, Procurement Consultant (FSSA Lead) 3/15/2024 3

  4. Fund Sources for Early Intervention Commercial Insurance/ TPL Family Cost Participation Medicaid TANF State Part C Funds Federal Part C Funds SSBG 3/15/2024 4

  5. Description of Fund Sources Commercial Insurance – CRO submits claims to private insurance based upon the consent to bill and insurance policy provided by the family. This information is stored within the case management portal of EI Hub. Medicaid– CRO submits claims to public insurance based upon the consent to bill and type of policy provided by the family. CRO verifies RID numbers and MCE type. This information is stored within the case management portal of EI Hub. MedicaidAdmin funds are used to support the administration of First Steps. Family Cost Participation – Family income is collected at intake and cost participation is generated based upon income and ability to pay. Families receive a statement monthly for their cost participation based upon insurance payment of each claim. If insurance pays anything, no cost participation is assessed. Temporary Assistance For Needy Families (TANF) – After private and public insurance have been claimed a report is run for all children/families who meet the TANF eligibility criteria outlined in the IAwith DFR. A report is run every 3 months and is provided to fiscal team and DFR. A journal entry is created by the fiscal team noting which type of TANF (State or Federal) are utilized for the provision of services.TANFAdmin funds are used to support the administration of First Steps. Social Services Block Grant – Department of Child Services has written in their State Plan for the Social Services Block Grant the provision of services by First Steps. These funds fill fiscal gaps each year. State Part C Funds – General Assembly creates and approves a budget for early intervention every two years Federal Part C Funds – Indiana ensures federal funds are used as the payor of last resort for IDEA services. These funds are also used to support the infrastructure of Indiana First Steps (e.g. State staff salaries, coaching model, data system, provider training, etc.). 3/15/2024 5

  6. Service Claiming Process Indiana’s Central Finance Fee for Service Pay and Chase Model Service Log submitted into EIHub by provider Log taken off hold and moved to billing and claiming by agency CRO Submits Claims to: Claim moves through system adjudication CRO submits claims and ensures POLR CommercialInsurance CRO generates report and State sends to DFR for use of TANF CRO pays agency claims Medicaid Family Cost Participation is requested from family

  7. Fiscal Monitoring FSSA Audit • • SPOE/Provider Agencies Annual Cycle FSSA Investigations • SPOE/Provider Agencies • Initiated due to allegations/complaints Independent Audit Reports • SPOE Contractors • Filed with Indiana State Board of Accounts Biennial Provider Agency Monitoring Visits • Provider Agencies • Includes quality review of service log documentation to support delivery of services 3/15/2024 7

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