fiscal officers training manual - New York State Conference of Local ...

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1. To Sign up for Electronic Payments - http://www.osc.state.ny.us/epay/index.htm2. Track a payment: NYS Comptroller Office – Payment Information Inquiry -https://wwe1.osc.state.ny.us/ach3/achpaf.cfmDate: May 1, 2010OMH Review: 1/4/11OASAS Review: (none)OPWDD Review: (none)
Business Process: (what is it?)FISCAL OFFICER TRAINING MANUALMEDICAIDMedicaid is a federal health insurance program for low income individuals and families. Medicaid is administered at thestate level and managed at the county level in NYS. Eligibility is based on federal poverty guidelines. Covered benefitsinclude minimum federal requirements and optional benefits identified in state medicaid plans. In NYS, Medicaid isfunded by federal, state and local shares.Medicaid is largest share of revenues for Behavioral Health services. In NYS, Medicaid is paid directly to licensed serviceproviders on a fee-for-service basis and through the Medicaid managed care program. Most individuals in NYSparticipate in managed care (HMO styled plans) on a mandatory basis. However, many behavioral health services areprovided outside the managed care benefit plan.Rules defining Medicaid covered services, payment rates and billing guidelines are set forth in NYS regulations (add link).Brief Description of Process: (how does it work?)Medicaid regulations outline the minimum requirements which mustbe met in order for a licensed provider to be able to bill Medicaid for a covered service to a Medicaid eligible individual.The Billing section summarizes the basic billing rules and limitations. The Documentation section summarizes therequirements which, when met, provide supporting documentation that the eligibility and billing requirements have beenmet. Even when there is not a specific documentation requirement included in the regulations, providers are advised toensure that they have sufficient documentation to verify compliance with other standards.Medicaid claims are auditable by federal and state agencies. (See NYS Office of Medicaid Inspector General websitebelow)Frequency:Medicaid covered services are billed according to rules set forth in regulation. For example, the frequency could be pervisit,hour, day of service or month of service. Medicaid covered services and payment rates are periodically updates inNYS regulations. Significant changes may require federal approval of Medicaid state plans.Instructions:Medicaid has various components; please refer to the websites listed below for additional subject matter.Resources:1. Medicaid Program – General Information: http://www.cms.gov/medicaidgeninfo/01_overview.asp2. Administrative Practices and Medicaid Requirements: http://www.omh.ny.gov/omhweb/012104letter/3. Medicaid Compliance Program: http://www.omh.ny.gov/omhweb/guidance/MFA/MedicaidCompliance.html4. Medicaid Self-Disclosure Guidance: http://www.omh.ny.gov/omhweb/guidance/medicaid_self_disclosure/5. Use of Electronic Records by Medicaid Providers:http://www.omh.ny.gov/omhweb/guidance/esra/attachment.html6. EMedNY electronic claiming: http://www.emedny.org/HIPAA/SupportDocs/ePACES.html
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2. NYS Uncompensated Care:https://w
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Funding expectancies cannot exceed
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• Lodging/Respite/Hotel: Money us
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