An Oregon Medicaid Agency Supporting Individuals with Intellectual and Developmental Disabilities

Section 6

Fees, Billing, and Financial Systems

Fees

The Company is required to maintain an updated schedule of fees for its services when services are not delivered through a service agreement through ODDS. If services are delivered under a service agreement through ODDS, rates are determined by current ODDS expenditure guidelines.

Payments received from CDDP will be considered as full payment for those services. the Company is not allowed to demand or accept additional payment from the customer, customer’s family, or any other source.

Billing

The Company is required to bill any appropriate third-party resource before billing the customer’s brokerage for state support service funds, unless another arrangement has been agreed upon with the customer’s brokerage agency and is included in the customer’s ISP.

The Company will prepare and send invoices for customers to their respective CDDP no more twice a month, in accordance with the CDDP’s requested dates. The
invoice form will provide the following information:

  • The customer’s name
  • Time period covered by the invoice
  • The type of services provided and location where they were provided
  • The rate charged for each service
  • A copy of the customer’s progress notes and progress reports will be sent with the invoice.

Progress notes are daily notes that provide accountability for how time with an individual is spent, what activities, appointments, and tasks were supported by employees.

Progress notes are a narrative accounting of how the individual’s specific goals were addressed and the progress made towards meeting those goals.

Accounting System

The Company maintains a financial accounting system (Quickbooks) and a billing System (IVP Billing). Its financial records are available for public inspection, and an independent audit of its financial reporting system is conducted annually.

The Company policies contain internal controls and practices aimed at preventing fraud and embezzlement. Policies require that an employee who knows about or suspects that other employees are engaging in theft, fraud or embezzlement must report the information to the Executive Directors.

Cost of Services

The cost of activities done while delivering services to customers is the customer’s responsibility. This includes entrance fees, equipment rental, and transportation costs other than non-medical transportation that is part of a service agreement.

Customers will often want to participate in activities they cannot afford. Employees should not encourage customers to engage in activities that are beyond their means or find funding sources for those activities so as not to negatively impact a customer’s budget.

The Company does not reimburse employees for activity-related fees except under the following conditions:

  • Public transportation costs no greater than $5.
  • Parking fees no greater than $5.

Employees should determine if the customer is eligible to have an attendant on public transportation where the attendant is not required to pay a fare.

Many venues for activities allow personal attendants to enter for free. Employees should seek out such venues or make requests to venue operators for such an accommodation.

No employee is expected to pay for activities that requires a fee. The employee may choose to pay the fee, but will not be reimbursed by the Company.

 

 

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