Third Party BillingThird Party BillingWhat Building What Building

Administrators Need Administrators Need to Know?to Know?

Independent School District #728

What is Third Party Billing (TP)

• Federal Intent– Use state, local, and private sources to

pay for services

• MN Statute July 1, 2000– School Districts can seek

reimbursement from third party sources for additional revenue for special education

• Medical Assistance (MA)• MinnesotaCare (MC)• Tax Equity and Responsibility Act 1982

(TEFRA)• Private Insurance (We will not be using this

option)

Background For T.P.

• Fiscal Audit in 2004-2005 School Year– Citation regarding third party

billing– Corrective action

• Begin third party billing 2005-2006 school year

• Corrective Action Timeline– Fall 2005 study T.P. (get smart) – Winter 2005/2006 develop forms– Spring 2006 in-service and

implement

Who Do Districts Answer to for T.P.?

• Minnesota Department of Education (MDE)

• Minnesota Department of Human Services (DHS)

How Our District is Addressing Third Party

Billing?

• We are billing for the following health related services:– Personal Care Assistance

(PCA<para>)– Speech and Language Services– Occupational Therapy– Physical Therapy – Psychologists (Evaluations)– Assistive Technology– Special Transportation

What Are The Responsibilities for Staff To

Complete T.P.?

• They need to:– Understand T.P.

• Identify what services are billable

– Be able to explain T.P. to parents– Seek permission to bill T.P. annually– Inform other service providers of

billing status– Document services correctly in the IEP

to meet DHS standards– Complete correct documentation of

services – Send forms to District Office staff for

billing by the 3rd of each month

Additional Responsibilities for Staff

• No pencil/white out/ditto marks/arrows

• Only original signatures• Do not pre date forms• Must use student’s full given name-

No nick names• Must have correct birth date on form• Do not use the word safety when

describing service• Do not document in the IEP student

is eligible for third party billing• Do not hold documentation sheets

for multiple months