July 6, 2006

 

 

 

 

 

TO:              Personal Care Services Agencies, Aged and Disabled Waiver Agencies, Traumatic Brain Injury Waiver Agencies, Developmentally Disabled Waiver Agencies, Assisted Living Facilities, Certified Family Homes

 

FROM:        Leslie M. Clement, Administrator

 

SUBJECT:  CHANGES TO BILLING FOR INDIVIDUALS WITH A CLIENT CONTRIBUTION

 

There has been confusion in the past in billing for individuals with a client contribution.  This occurs most often when the billing week spans a month; that is, when the week starts in one month but changes to a new month somewhere within that week.  When this occurred, all services rendered for the complete week were applied against the contribution amount for the new month making it difficult to clearly see what portion was allocated to prior month.

 

Effective August 1, 2006 changes have been made to the billing system to eliminate this confusion.

 

In order to facilitate this change, when billing the codes listed below, it will be necessary to bill the code only within the month the service was delivered.  If the service spans two months, it will be necessary to bill on two lines, one for each month. The client contribution will be deducted for the month in which the service occurred.

 

This change should make it easier for individuals to understand how their client contribution is being applied and to aid providers in explaining the client contribution.

 

                       

 

If you have questions regarding this information, please contact Christine Baylis at 208-364-1891.  We appreciate your continued participation in the Idaho Medicaid Program.

 

LMC/cb/sw