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Florida Regional Conferences in West Palm Beach and Gainesville

Therap is hosting conferences in Florida in West Palm Beach and Gainesville on 21 and 23 August, 2018 respectively. We welcome you to join these conferences to discuss how Therap will work for individuals receiving services through the Florida Agency for Persons with Disabilities (APD), Agency for Healthcare Administration (AHCA), Florida Developmental Disabilities Council, to name a few. Learn how Florida Intellectual and developmental disabilities providers are using Therap to generate professional claims for Florida Medicaid while complying with Florida’s ADT Billing rules.

To register for the West Palm Beach, Florida conference, click here

To register for the Gainesville, Florida conference, click here

Did You Know

Florida providers have successfully passed Delmarva audits, APD amd AHCA surveys using Therap. Visit our Florida state page to learn more.

By |2018-07-15T06:26:57+00:00July 15th, 2018|Categories: Uncategorized|Tags: , , |Comments Off on Florida Regional Conferences in West Palm Beach and Gainesville

Florida User Group Meeting on March 14, 2018

Therap welcomes its Florida users to a User Group Meeting being held at Goodwill Opportunity Center on March 14 from 10 am to 1 pm (EDT). Therap has a long history of service and excellence in Florida and is used by providers across the state. It is a wonderful opportunity to share new and exciting ideas and practices with other users in your area. Therap team members Maureen O’Connell and Tricia Woods will be at hand to answer technical questions and transmit the group’s consensus state needs and requirements to the Therap development team for review.

Click here to register.

Lunch will be provided for our registered attendees. We look forward to seeing you there!

By |2018-02-18T15:15:21+00:00February 18th, 2018|Categories: User Group Meeting|Tags: , , , , , , |Comments Off on Florida User Group Meeting on March 14, 2018

New Personal Care and Support Coordination Rates for APD providers

New Rates for July 1, 2015

APD announced that effective July 1, 2015, Personal Supports QH, Personal Supports Day, Support Coordination and CDC+ Consultant will all have an increased rate.  Please see the link below for all the new rates.  The changes to the cost plans and budgets will be made electronically and will not require the WSCs to redo any service authorizations and will not require the Regions to re-approve any service authorizations. That is the good news!

1) iBudget will be brought down on July 1st so the changes can be made.  All FY 15-16 cost plans must be in approved status.  Any cost plans that are in draft, or pending review status will have to be deleted by IT and any changes that have been made to those plans will be lost.

2) Please review all cost plans that are Pending Area Office Review for FY 15-16 and get them to approved status as soon as possible.  If the reason for the pending review is due to a rejected service authorization that you are unable to resolve, complete a help desk ticket.

3) State Office staff will be reviewing any cost plans in Pending State Office Review to get them in approved status.

4) If support coordinators have consumers who currently have a FY 15-16 budget, however; they will not have a cost plan built prior to 7/1/15; the support coordinator will need to work with Region staff to get the budgets adjusted manually.  Since those cost plans may or may not come for Region review, they will need to notify you who those consumers are.

5) Please encourage support coordinators to stop making any changes to cost plans after June 28, 2015 unless there is an emergency.  This will give both the Region and State Office staff time to assist with getting all plans into approved status.

AHCA Alert-ABA for Children under 21

Florida Agency for Health Care Administration

Better Health Care for All Floridians

 

FLORIDA MEDICAID
A Division of the Agency for Health Care Administration

Florida Medicaid Health Care Alert
January 2014


Provider Type(s): 07, 16, 25, 26, 67, 68, 70, 71, 72, 77, 91

Revised Alert for Developmental Disabilities Home and Community Medicaid Waiver Providers:  Medicaid Coverage and Prior Authorization of Applied Behavior Analysis for Children Under 21 with Autism Spectrum Disorder

This alert includes information for Developmental Disabilities Home and Community Medicaid waiver providers. Information for other qualified provider types can be found in the applicable provider alert. This revised alert supersedes the information specific to Developmental Disabilities Home and Community Medicaid waiver providers in previous alerts posted on 4/2/12, 4/17/12, 5/17/12, 6/15/12, 7/6/12, and 9/6/12.

This alert describes provider qualifications, recipient eligibility criteria, the prior authorization request process, service codes and reimbursement rates, the billing process, place of service codes, and instructions for managed care plans. These services require prior authorization.

Provider Qualifications:

ABA services described in this alert must be rendered by Certified behavior analyst (CBA) and certified associate behavior assistant (CABA) providers who meet the qualifications outlined in 65G-4.003 of the Florida Administrative Code, are enrolled as Medicaid waiver providers through the Developmental Disabilities Home and Community Medicaid waiver programs and have received prior authorization from Medicaid for the service.

Recipient Eligibility Criteria:

Qualified treating practitioners may render medically necessary ABA to children under 21 years old having any of the following ICD-9 diagnosis codes:  299, 299.0, 299.00, 299.01, 299.1, 299.10, 299.11, 299.8, 299.80, 299.81, 299.9, 299.90, or 299.91.

Prior Authorization Request Process:

ABA services must be prior approved by Medicaid.  If a physician determines that a Medicaid eligible child diagnosed with an autism spectrum disorder needs Applied Behavior Analysis (ABA), the provider must submit a request to the Medicaid area office. The following information must be included:

  1. Recipient name, date of birth, Medicaid ID, and current mailing address.
  2. Requesting provider name, national provider identifier, address, and telephone and fax numbers.
  3. Diagnosis of recipient and diagnosis code.
  4. If already assessed, expected duration of ABA treatment.
  5. The primary focus of ABA treatment.
  6. Medical records that document the diagnosis of autism spectrum disorder.

An optional form for this purpose is available online at the Child Health Check-Up web page. This optional prior authorization form has been revised effective January 10, 2014.Prior authorization documentation as described above must be submitted to the recipient’s Medicaid area office. Contact information for the area offices can be found on the Public Provider Web Portal.

Service Codes and Reimbursement Rates:

Instructions for Developmental Disability Waiver Providers
to Bill Fee-For-Service for Non-Waiver Recipients

ABA services must be prior approved by Medicaid. Providers should consult the Medicaid Developmental Disabilities Waiver Services Coverage and Limitations Handbook for provider qualifications and documentation requirements (requirements for review of documentation by a Local Review Committee and submission of documentation to the waiver support coordinator do not apply). Billing for ABA services in a group setting is not allowable. A total of up to 160 quarter-hour units per week of combined service may be authorized. Eligible service codes and rates of reimbursement for Applied Behavior Analysis services are:

Description of
Service

Procedure
Code

Modifier
1

Modifier
2

Rate

Limits

Assessment Services
Behavior Analysis Assessment for Autism

H2020

UD

$299.85 per assessment

One assessment per state fiscal year

Treatment Services
Behavior Analysis Level 1 for Autism

H2019

UD

HP

$19.05 per quarter hour

Maximum combined daily limit of up to 32 quarter-hour units
Maximum combined weekly limit up to 160 quarter-hour units of all treatment services

Behavior Analysis Level 2 for Autism

H2019

UD

HO

$16.64 per quarter hour

Behavior Analysis Level 3 for Autism

H2019

UD

HN

$10.35 per quarter hour

Behavior Assistant Services for Autism

H2019

UD

HM

$4.31 per quarter hour

 Instructions for Developmental Disability Waiver Providers
for Waiver Recipients

Scenario Coverage
Existing DD waiver recipient receives ABA waiver services APD continues to cover these ABA hours through the waiver.
Existing DD waiver recipient receives ABA waiver services but requests an increase in services APD reviews the request to determine if additional hours are medically necessary. If yes, then APD will cover the additional hours through the waiver. If no, then the recipient may request authorization to receive ABA through the state plan.
Existing DD waiver recipient, who does not receive ABA services, requests ABA APD reviews the request to determine if additional hours are medically necessary. If yes, then APD will cover the service through the waiver. If no, then the recipient may request authorization to receive ABA through the state plan.
Individual on the DD waiver waiting list who is Medicaid eligible applies for the waiver through the crisis process. ABA is one of the identified service needs. APD will refer the individual to the ABA state plan authorization process for coverage of ABA.
Individual on the DD waiver waiting list who is Medicaid eligible and requests ABA services. APD will refer the individual to the ABA state plan authorization process for coverage of ABA.

Billing Process:

To bill for the services, providers must submit claims in accordance with the Provider Reimbursement Handbook, CMS-1500 located on the Provider Handbook page of the Public Provider Web Portal. All claims for ABA services for children with autism spectrum disorders must be billed fee-for-service, even for those recipients enrolled in a Medicaid managed care plan. When billing for services for treatment of autism spectrum disorders, the claim must include one of the following primary diagnoses: 299, 299.0, 299.00, 299.01, 299.1, 299.10, 299.11, 299.8, 299.80, 299.81, 299.9, 299.90, or 299.91. Enter “1” for the diagnosis code reference number (pointer) to relate the procedures performed to the primary diagnosis.

Billing is allowed for dates of service beginning with the date of prior authorization.

DO NOT SEND any attachments or medical records to the Medicaid fiscal agent with the CMS-1500 claim form. Regardless of place or dates of service, attachments for Applied Behavior Analysis are not required. All CMS-1500 claims for Applied Behavior Analysis services for children with autism spectrum disorders will be processed per these instructions.

Place of Service Codes:

Services must be billed using the correct place of service code for the location of the service provided. These services may be provided in the provider’s office, the recipient’s place of residence or anywhere in the community. However, in all cases, behavior analysis services must also be provided in the setting(s) relevant to the behavior problems being addressed.

The following place of service codes should be used by DD Waiver Providers when submitting claims (see page 2-22 of the Developmental Disabilities Waiver Services Coverage and Limitations Handbook):

11 – Office
12 – Home
13 – Assisted Living Facility
14 – Group Home
49 – Independent Clinic
53 – Community Mental Health Center
99 – Other Place of Service

Place of service code “99 – Other Place of Service” is not acceptable except for unusual circumstances that are documented in the recipient’s treatment or service plan, or in the recipient’s treatment notes.Medicaid will monitor providers who frequently utilize place of service code 99.

Instructions for Managed Care Plans:

Managed care plans are not currently required to authorize or cover Applied Behavior Analysis Services for the treatment of autism spectrum disorders. If a child enrolled in a Medicaid managed care plan requires ABA services, the plan may refer the recipient to any of the identified qualifying providers to receive the service under Medicaid fee-for-service. Alternatively, the managed care plan may refer the recipient to the Medicaid area office for assistance with finding a qualified provider. Managed care plans must share information on how to access ABA services with their contracted community behavioral health and physician providers.

Other Key Information:

For questions, contact your local Medicaid area office. Contact information for the area offices can be found on the Public Provider Web Portal.

 


 

LINKS

Florida Medicaid Web Portal | Florida Medicaid Health Information Network | Florida Medicaid HIPAA Information | HIPAA Transactions & Code Sets Standard | National Provider Identifier Standard (NPI) | Florida Medicaid EHR Incentive Program | FloridaHealthFinder.gov


QUESTIONS ABOUT FLORIDA MEDICAID?

Please direct questions about Medicaid policies to your local Medicaid area office. The Medicaid area offices’ addresses and phone numbers are available on the Area Offices Web page.


ALERTS INFORMATION

The Florida Medicaid program has created an e-mail alert system to supplement the present method of receiving Provider Alerts information and to alert registered subscribers of “late-breaking” health care information. An e-mail will be delivered to your mailbox when Medicaid policy clarifications or other health care information is available that is appropriate for your selected area and provider type.

Visit the Florida Medicaid’s Health Care Alerts page to subscribe now. You may unsubscribe or update your subscription at any time by clicking on the “Manage your subscription” icon in the footer of each e-mail. Other questions regarding the e-mail alert system can be sent to the Florida Medicaid Alerts Administrator.

 

© 2014 Agency for Health Care Administration

 

 

This message was sent from Florida Agency for Health Care Administration tocswilley@floridaarf.org. It was sent from: Florida Agency for Health Care Administration, 2727 Mahan Drive Tallahassee, FL 32308. You can modify/update your subscription via the link below.

Florida AHCA Alert: ADT Daily Billing

 

Better Health Care for All Floridians

FLORIDA MEDICAID
A Division of the Agency for Health Care Administration

Florida Medicaid Health Care Alert
   September 2013


Provider Type(s): 67,  096,  098

Update to Billing Instruction Reminder

Developmental Disabilities iBudget Providers should bill according to the Individual Budgeting Waivers Provider Rate Tables.  For example, providers billing for services under procedure codes T2021UC or S5102UC must use hourly units of services, up to a maximum of 8 units per day.

Please disregard recent instructions regarding situations when the same number of units of service is provided daily on consecutive days, and completion of the date span using the “From—To Dates” dates of service.

A new claim line must be used for each day.

Please contact your local Medicaid Area Office for assistance with billing issues. Contact information for your local Medicaid Area Office may be found at http://mymedicaid-florida.com.

Therap Florida Regional Conference-West Palm Beach

Therap Conference in West Palm Beach, Florida October 22-23, 2013

Therap Services will be hosting a regional conference in West Palm Beach, Florida this October.

Attending the conference will be a good opportunity to learn about recent developments in Individual support documentation and reporting, electronic health records (EHR) and training management from technology leaders in the developmental disabilities field. The training intensive event will include beginner, intermediate, and advanced level sessions conducted by Therap experts on various Therap modules.

Conference highlights will include sessions on:

  • Therap’s health tracking modules for appointments, seizures, lab tests, vital signs, and medication histories
  • Therap Medication Administration Records (MAR)
  • Therap Individual Service Plans (ISP)
  • Hands on training on different other modules including Therap GERs (incident reports), Time Tracking, Secure Communications and Training Management
  • Therap electronic billingservice authorizations and claim tracking

Please check back on our website for updates.

We look forward to seeing you in Florida!


Future conferences

In the coming months, we will be hosting conferences in many other states including Colorado, New York, Texas and Iowa. Details regarding these events can be found here.

 


Therap’s HIPAA compliant documentation, reporting and communications solutions are widely used by organizations, working with people with developmental disabilities in home and community-based services (HCBS) and other settings. Direct Support Professionals, nurses, supervisors, executive directors and CEO’s in 1000+ agencies, in over 47 states, are using Therap’s paperless solutions to improve quality of care. To learn more about Therap please visit www.TherapServices.net.
Date & Time
October 22-23, 2013
8 am – 5 pm everyday
Location
1301 Belvedere Road
West Palm Beach, Florida
Important Links
Register now for an early bird discount
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Please share this event with anyone you think might be interested.
Therap Services, LLC.
562 Watertown Avenue
Suite 3, Waterbury
CT 06708-2240, USA
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© Copyright Therap Services, LLC. 2003 – 2013, All Rights Reserved.
This message was sent to barry.pollack@therapservices.net from:Therap Services LLC. | 562 Watertown Avenue, Suite 3 | Waterbury, CT 06708-2240

Therap 2013.2 Release Preview

Check out this You Tube Video of our upcoming Release expected in July!

Video on Therap 2013.2 Release Preview

 

Florida IBudget Handbook – Change in “Service Logs”

The following is a response from Kristin Allen, Delmarva Regional Manager, regarding changes in the new IBudget Handbook for monitoring HCBS Waiver providers for Service Logs:

The iBudget Handbook deleted Service Logs as “required” for Life Skills 3 however providers will still be bound by whatever is identified in the IPs as the data collection method, which historically has included service logs.  It was a requirement, and “logical” in tracking progress. In terms of what should continue vs. what reviewers will be evaluating, the answer is more two-fold. Until the iBudget Handbook is promulgated as an organization continue to follow the November 2010 Handbook as per memo from Denise Arnold. However, our reviewers are using the new iBudget tools (but not citing providers for anything new) which means they will only be looking for a Daily Attendance Log which must include (for Life Skills 3) the name of the provider, name of the recipient, each date of service and the time period which means total time in attendance each day. It can be time in/out or just 4 hrs, 6 hrs, etc. For Residential Habilitation time in/out or time period is not required. One last note about service logs, although maybe not “required” they are useful in evaluating other standards.

The time period means total time in attendance each day. It can be time in/out or just 4 hrs, 6 hrs, etc. For Residential Habilitation time in/out or time period is not required.

 

DD Awareness Month in Florida

Florida ARF Logo

Press Conference Photo.jpgFlorida ARF Recognizes DD Awareness Month – Tallahassee, FL (March 28, 2013) March is National Developmental Disabilities Awareness Month (NDDAM) and is a time when many of you are joining with others to raise awareness about developmental disability issues and the challenges faced by individuals with all types of disabilities.  We agree wholeheartedly with the statement released by the national UCP organization which reads as follows:  “During NDDAM, there are many accomplishments to celebrate. Advances in technology continue to enable greater participation in all kinds of activities, from video games to voting.  Landmark legislation like the Patient Protection and Affordable Care Act has expanded access to services like healthcare and housing.  Individuals with disabilities participated in the London Olympic games and the Miss America pageant last year, and the disability community was even mentioned in President Obama’s second inaugural address in January.  But the challenges for people with disabilities continue despite these important advances. While the number of people in the United States with disabilities continues to grow, state and federal budget cuts threaten funding for vital government programs and services.”  
Earlier this week, we were pleased to see Florida’s House and Senate Appropriations Committees recognized the need to appropriate additional funding to expand services to individuals with developmental disabilities who have been on a waitlist for services for many years.  Also, The Arc of Florida’s legislative proposal to remove use of the “R” word from state legislation is receiving strong support.  Within our member agencies, we see so many of you addressing the needs of individuals with developmental disabilities in such positive ways, often with limited resources and restrictions, and we celebrate your efforts and accomplishments.  While we still have much work to do to assist you in achieving your missions, it is rewarding to find so many things to celebrate!

Therap National Conference Coming Soon ! January 29-31, 2013

Here it is, the time has come…The annual Therap National Conference is back again this month.  Don’t miss out this year, take advantage of the Early Bird Discount and Register by January 7th!  

 

*This is the best and most comprehensive training opportunity to get the most out of Therap for your organization.  I hope to see may of you there!

Therap National Conference, Ramada East Hanover, New Jersey, January 29-31, 2013

Therap would like to welcome everyone involved in providing support and services to the people with Intellectual and Developmental Disabilities (ID/DD).

Therap has been focused on developing software that can be used to document and track progress of individuals, and this conference will provide an opportunity for the agencies and State officials to get a comprehensive, hands-on view of the system. Here, you can meet the Therap staff and also network with people from other parts of the country who are also using the applications to manage their data. Therap also is a platform that improves the communication regarding services provided within the organization, which in turn raise the quality of services! This will be the place to hear all about it.

Event highlights include:Therap's National Conference Graphic
* Hands-on training on Therap modules including Individual Service Plans, Health Tracking and Billing
* Sessions for advanced level users and certified trainers
* User presentations on implementation and usage (Interested in presenting?)
* Focused sessions for states, counties and multi-state providers
* Brainstorming and requirement analysis for future upgrades
* Presentations by other vendors

The details of the sessions and timings are available in our schedule (Download Schedule).

If you have questions, please contact us.

Registration:
Registration Packages:
$220 – 3 Day Conference
$245 – 3 Day Conference + Bus to NYC and back on 30th evening with free time to explore on your own.
$265 – 3 Day Conference + Guided tour of NYC and pizza dinner on 30th evening.
Online Registration
Note: Register by January 7 for an Early Bird Discount
and pay only $180/$205/$225 per attendee for the respective packages.
All price includes lunch and snacks during the day.


Venue & Accommodations:
Ramada Hotel & Conference Center
130 Route 10 West, East Hanover, NJ, 07936.
Call (973) 386-5622 to reserve rooms.

You can ask for the Therap Block Rate of $94(plus tax) if you book you stay by December 27, 2012.

You can book rooms at the Holiday Inn Parsippany(just beside the Ramada Hotel & Conference Center) also at the same rate (Call (888) 465 4329 to reserve rooms).

Free Shuttle to/from the Hotel:
Therap will be chartering a bus for pickup from the AirTrain Monorail atNewark Airport on Monday, January 28, 2013 which is the day before the National Conference starts on January 29.

Exact monorail stops will be announced. The charter bus will have a 50 person limit. Our plan is to have the bus for airport pickups at 2pm, 4pm, 6pm and 8pm. People taking Amtrak trains can also meet the bus.

There will be two buses on the last day of the conference, Thursday, January 31, 2013, for taking attendees back to the airport. These buses will start from the hotel at 3:30pm and 5:30pm. If we are allowed we will drop people directly at each terminal. Or else, the will drop will be at a Newark Airport Monorail station.

The times may vary due to traffic and other conditions. We will announce specific times and a pickup location closer to the event.

We are not guaranteeing space on the bus, although we think there should be availability for people to get on the bus of their choice. This is the first year we are attempting this, so please let us know if this is useful or if there are any questions.