Contracted and Newly Hired Speech and/or Hearing Therapist Professional Development

1. Contracted and Newly Hired Speech and/or Hearing Therapist Professional Development ACCESS Claiming Information and Electronic Service Documentation Tuesday, September 9, 2014

2. Agenda • Review the requirements for the ACCESS Program • Introduce the Service Documentation Screens • Tips for Service Documentation • Review Collateral Service Documentation • Review Progress Note Documentation – Qualitative vs. Quantitative • Review the Error Reports • Review the EasyTrac History Screen and tracking of Medicaid Parental Consent • Review the 150 day cycle – no more retroactive submissions • Review how claims are submitted and the 15 minute increment • Review Group vs. Individual service documentation • Questions and Answers

3. ACCESS Program Claiming Requirements • The student must be identified as Chapter 14. • The student must be Medicaid Eligible. • The Medicaid Parental Consent must be signed Yes and on file. The One Time Consent form if signed Yes will cover services moving forward. • The service provider must be registered with the ACCESS office and meet the criteria to be credentialed with an ACCESS Provider number. • The services must be provided by the service provider submitting the claim. Absolutely No Intern services are to be claimed. • There must be Medical Authorization on file to cover the dates of services. • There must be an IEP in place recommending the service and covering the date of service to be claimable. Note: The EasySystem is a Full Electronic Documentation system and all services should be documented regardless of claiming status.

4. Medical Authorization Form

5. Sample Medical Authorization Tracking Screen

6. Selecting the Month Of Service

7. Service Specific Information

8. Collateral Service Documentation

9. Direct Service Documentation

10. Tips for Recording Speech and/or Hearing Services • Make daily entries of the services provided to assure the accuracy of the data. Be sure to be as timely as possible so that the student record is always current. • Pay close attention to the type of service and the time required to perform the activity. Enter accordingly. • Separate services into correct categories. Be careful not to duplicate or overlap services. Do not combine everything into one date if a report was written over the course of several days. Testing should always come before the final written report is documented and the dates should match the test forms. • At the end of the month, review all services to assure your service entries have been recorded correctly. • Maintain a caseload of students for whom you are currently part of the team. Once all services have been completed and the monthly summary recorded, a student may be removed from your caseload. • Utilize the Green Checkmark/Yellow Yield Sign/Red Stop Sign to review actual IEP dates. and Medicaid Parental Consent. Only use the dates that have a final document attached to them. • If you are not sure how to document a particular item, contact the ACCESS team for assistance. • A written report should be available for presentation to an auditor for all evaluations/re-evaluations claimed under ACCESS.

11. Changes in Collateral Service Documentation • Collateral services are no longer claimable under the School Based ACCESS Program. • Several services that were formerly collateral services have been reclassified as direct service for the purpose of evaluation/re-evaluation. These include, but are not limited to, classroom observation, consult with medical personnel and writing the evaluation report.

12. What is a Progress Note? • The written record that supplies the details of how the student utilized their treatment plan.

13. Why Do We Use Progress Notes? • Progress notes are vital to good clinical treatment. • Charts the students’ journey through the continuum of care. • Improve and enhance the treatment process by helping the direct service provider track the students’ progress in treatment while staying focused on the treatment plan. • Good progress notes also assist other program staff to participate intelligently in the students’ treatment process. • Review of progress notes is the best way to refresh ones memory when sitting with the IEP team to discuss the students’ progress. • If the primary direct service provider is not available to provide support to the student, the chance that another direct service provider will be able to provide meaningful assistance may be dependent on the quality of documentation in the progress notes

14. How? • Essential that the direct service provider is able to give a complete picture of the student’s progress and/or lack of progress. • Progress note should always include documentation of development with the use of suggested activities or strategies during daily routines. • Notes should explain everything that happened with the student

15. WARNINGS: • A series of notes that only reports the student’s attendance and indicating that they had “good participation” are clinically useless. • Additionally, if notes consistently say that service provider worked on the exact same activity for service after service, it may seem like they are not individualizing services to the student’s needs

16. Qualitative Data vs. Quantitative Data • Quantitative data is information about quantities. It is information that can be measured and written down with numbers. Goals should be measurable and therefore notes regarding services should in turn provide data that is measureable. • Qualitative data is information about qualities. It is information that can't actually be measured.

17. Error Reports – What Do They Mean? • Invalid IEP - This report notifies the service provider that the dates of service recorded are not within the date range of the IEP and are not claimable. • Missing Essential Data – This report notifies the service provider that the service entry was finalized before all of the required data was recorded. • No Parental Authorization – This report notifies the service provider that the parent has not given permission for claiming to be submitted. • Missing Parental Authorization – This report notifies the service provider that the parental consent form has not been submitted to the ACCESS office for programming in the EasySystem to allow claiming to occur. • Expired Parental Authorization – This report advises the service provider that the Medicaid Parental Consent on file has expired and does not cover the date of service for claiming. The correct version of the Medicaid Parental Consent must be submitted for the error to be corrected. • No Monthly Summary – This report notifies the service provider that the monthly summary has not been entered to allow the student’s record to be completed and the claiming cycle to begin.

18. Easy Trac History Screen and Tracking of Medicaid Parental Consent

19. Overview of the Claiming Process Begin Here

20. 15 minute increments • Services eligible for reimbursement under the school based ACCESS program are reimbursed in 15 minute increments. • Services under the 15 minute increment, round down to 0 and are not claimed. • Services over 15 minutes are claimed in 15, 30, 45 or 60 minute intervals. • If a service is over one interval, but under the next, i.e. 40 minutes, the service is rounded down to 30 minutes and the remaining minutes are left unclaimed.

21. Individual vs. Group • Services are to be logged as listed in the IEP. If the IEP lists that the student is to receive 30 minutes of group therapy, then the session is to be recorded as group for the ACCESS program. A note should be made in the Description of Service/Daily Note box indicating if the session was not a group session and why.

22. Why is the ACCESS team here today? • To review the ACCESS program. • To provide instruction in the documentation of services and to reiterate how important timely and accurate documentation is for the student record and the successful claiming of services under the School Based ACCESS Program. • To offer assistance to staff in need of 1:1 training. Contact Information: Michelle Ovington - movington@philasd.org Martina Boardley – mboardley@philasd.org • To review the types of error reports so that staff understand what needs to be done when the reports are received.