medicaid/education reports
DESCRIPTION
Medicaid/Education Reports. August 8-9, 2012. Address. Medicaid. Diagnosis Code. Diagnosis Code. Enter new billing. General. PDF . Page down. Random Moment Time Studies. Inappropriate Responses to RMTS Example 1: (Would not be coded as Medicaid allowable cost. Needs more detail.) - PowerPoint PPT PresentationTRANSCRIPT
Medicaid/Education Reports
August 8-9, 2012
Address
Medicaid
Diagnosis Code
Diagnosis Code
Enter new billing
General
Page down
Random Moment Time Studies
Inappropriate Responses to RMTSExample 1: (Would not be coded as Medicaid allowable cost. Needs more detail.)
1. Who was with you?• No one
2. What were you doing?• Duty
3. Why were you doing this activity?• Assigned duty
4. Is this activity regarding a Special Education student?• No
Inappropriate Responses to RMTSExample 2: 1. Who was with you?
• A group of people charged with carrying out the work of an establishment
2. What were you doing?• Inputting the last “moment in time” documentation
instead of using my scheduled paperwork time to prepare for the two IEPs that I have next week.
3. Why were you doing this activity?• You keep sending me these “moments.” I am itinerant
and MCS will not provide me with a computer, IPad, or other internet access to use during treatment blocks of time. Scheduled office time is the only time I can complete these “moments.”
4. Is this activity regarding a Special Education student?• NA
Preliminary Results of 1st RMTSFebruary - March
Response rates – 85% required (3000 moments per “pool”)
» 92.13% - Direct Services» 83.20% - Care Coordination» 78.60% - Personal Care» 89.47% - Admin
PCG’s Time Study Team – “less than appropriate responses were submitted.”
A number of inappropriate responses were received by staff participating in the RMTS.
Two areas of concern:
• Incomplete responses• Rudeness/Frustration
Preliminary Results of 1st RMTSFebruary - March
Service percentages responses
» 49.16% - Direct Services» 4.24% - Care Coordination» 20.21% - Personal Care
Cost Settlement Calculation Example – Neutral
WV: Introduction to Medicaid Cost Based School Based Health Services 40
1.0 Total Costs of Eligible SBHS Provider Costs (county’s cost) $1,000,000
2.0 Indirect Cost Rate 115.00%
3.0 Total Costs of Eligible SBHS Provider Costs $1,150,000
4.0 RMTS Direct Medical Percentage Results (Statewide results) 65.00%
5.0 Direct Medical Services Costs $747,500
6.0 Application of Medicaid Eligibility Rate (IEP Ratio) (county’s) 50.00%
7.0 Medicaid Direct Medical Services Costs (for the county) $373,750
8.0 Medicaid Interim Payments Received (by the county) $373,750
9.0 Medicaid Cost Settlement (at the end of the year – July 2013) $0
