Simple Billing

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Simple Billing Quick Reference Guide

How do I change my password?.............................................................................................4

How do I build my caseload?.................................................................................................5

How do I keep my caseload accurate?...................................................................................6

How do I delete a student on my caseload?...........................................................................7

How do I change minutes?.....................................................................................................8

How do I change IEP dates?..................................................................................................9

How do I know who is Medicaid eligible?...........................................................................10

How do I add, view and access uploaded file(s)?...........................................................11-12

How do I generate an electronic One-Time Parental Consent…………………………13-14

How do I create a billing record for Medicaid eligible students?...................................15-16

Evaluation and Re-evaluations Information………………………………...………….….17

How do I enter evaluations and re-evaluations?...................................................................18

Diagnosis and Service Code Information………………………………………………….19

How do I check the billing record for accuracy?.............................................................20-22

How do I correct the billing record?................................................................................23-24

Documentation of Simple Billing………………………………………………………25-27

Documentation Rubric……………………………………………………………………..282

Training Objectives:

1. Learn how to create a caseload.

2. Learn how to keep your caseload

accurate and up to date.

3. Learn how to enter information accurately

and steps to correct mistakes.

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How do I change my password?

3. Click change my password.

4. Enter new password.

5. Click

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1.Click

2. Click

How do I build my caseload?

1.3 Type the last

and first name of

a student on your

caseload.*

*Student names are submitted on a student roster from your administrator.

Contact_______________________, if you cannot find a student on your

caseload.5

1.1 Click

under Therapist Tools tab.

1.2 Click

1.4 Record actual minutes as documented

on the IEP for your specific service.

Defaults to week but you have other

choices in drop down menu.

1.5 Click When searching for a student with a common last name you may have to enter the full last name, followed by a comma and a space, before typing the student’s first name. You may also search for a name by using

the Student ID, this may be helpful when a student has a hyphenated name or uses a nickname.

How do I keep my caseload

accurate?

• By adding and deleting students as your

caseload changes.

• By changing minutes to reflect the current

IEP.

• By updating IEP date.

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How do I delete a student on my

caseload?

If you delete a student from

your caseload, the student’s

information remains archived in

the system. If necessary to

reinstate the student, the student

record will be available when

you add them to your caseload.

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1. From the Caseload

page, select the student

and Click Delete.

2. Click

How do I change IEP service

minutes ?

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1. From the Caseload

page, Select student and

Click Edit.

2. Enter minutes.

3. Click

How do I change IEP dates?

Re-Eval Date is not required for Medicaid billing. This information may be

required by your district’s administrator. Notes:

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1. From the Caseload

page, Click IEPs/Goals.

2. Click 2. Click

4. Click

This will display a listing of IEP

dates entered by therapists and

administrators.

3. Enter month, day and

year OR use calendar to

select date.

How do I know who is Medicaid

eligible?

➢Students highlighted in yellow and green are Medicaid eligible.

➢You should enter data for all students highlighted in yellow or green.

➢If administrator has entered the One-Time parental consent information,

student will be highlighted in green.

➢Therapylog automatically runs student Medicaid eligibility with MO

HealthNet (MHD) weekly to determine eligibility.

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Students highlighted in

green are Medicaid

eligible

and One-Time consent has

been signed.

Students highlighted

in yellow are

Medicaid eligible.

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All folders and uploaded files can be viewed and accessed from

under the Therapist Tools tab. Uploaded files will display on the My

Attachments screen and can be downloaded, viewed and printed as needed by

clicking the download icon.

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How do I add, view and access

uploaded file(s)?

How do I add, view and access

uploaded file(s)? [cont.]Create new Folders for Files

2.1 Folders for individual student worksheets, parent

notes, notices etc. can be created and added to My

Attachments. Type name of folder in box and click

to create a new folder.

2.4 Click Upload File. Find the document to upload

from your computer and click Open.

2.2 Click on

the name of

folder where

you want to

upload the

file.

2.3 Select the student name from the drop down. All

students on your caseload will be available for

selection.

How do I generate a One-Time

Parental Consent? Step 1: Locate electronic One-Time Parental Consent form

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1. 1 From the

Caseload page,

Select student and

Click Edit.

1.2 Click Generate

Parental Consent.

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How do I generate a One-Time

Parental Consent? Step 2: Select options and complete information

2. 1 Click drop down arrow to select

form option.

2. 2 Type parent name, confirm

default dates or change as

appropriate Consent Start Date and

Consent Signed Date, Have parent

sign. Select Preview, Save or

Cancel.

How do I create a billing record for Medicaid eligible students?Step 1: Select a Billing Month

▪This page will show the number of students on your caseload that are

Medicaid eligible each month.

▪Double click on a month and it will show the names of students that are

Medicaid eligible for that month.

1.3 Use the drop down menu to select

the month and year for which you want

to enter data and click

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1.1 Click

under Therapist Tools tab.

1.2 Click on

Online Billing Data Entry Form.

How do I create a billing record for Medicaid eligible students?

Step 2: Enter Student Specific Information

2.1 Select student from drop down box.

2.2 Select Diagnosis from drop down box.

2.3 Enter start and end time of service.

2.4 Select location from drop down box.

2.5 Select Service Code from drop down box.

2.6 Select date of therapy (automatically populates to current date).

2.7 Click 16

Only students that

are Medicaid

eligible for the

selected month

will appear in the

drop down box.

Evaluation and Re-evaluation BillingTherapist should follow the steps below to create a billing record for evaluations.

Initial Evaluation Billing

In order to create a billing record for an initial evaluation, the following rules must be met:

The Initial Evaluation must result in an IEP

The student must be Medicaid (MO HealthNet) eligible

The student must be entered on therapist’s caseload

*Only time spent evaluating students may be billed. Time spent scoring evaluation, writing evaluation report, or discussing evaluation

results are not billable activities.

Recommended process for entering Initial Evaluations in Therapylog.com:

Keep a record of Initial Evaluations. This record should contain the following information:

Name of student, Start Time, Stop Time, Notes

Keep a record of students evaluated that resulted in IEPs.

At the end of the month, therapist should add students that received initial IEPs to their caseload and enter the evaluation time.

Re-Evaluation Billing

In order to create a billing record for a re-evaluation, the following rules must be met:

The student must have a current IEP documenting service in the area being assessed.

The student must be Medicaid (MO HealthNet) eligible.

The student must be entered on therapist’s caseload.

*Only time spent evaluating students may be billed. Time spent scoring re-evaluation, writing re-evaluation report, or discussing re-

evaluation results are not billable activities.

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How do I enter evaluations and re-evaluations?To create a billing record for evaluations using Simple Billing:

Therapist should:

• select student from drop down box

• select relevant Diagnosis code

• enter start and end time of testing, according to evaluation record

• select location from drop down box

• select Service code, i.e.,

– PT Evaluation (High) (Moderate) (Low)

– PT Re-eval

– OT Evaluation (High) (Moderate) (Low)

– OT Re-eval

– Behavioral and Qualitative Analysis of Voice & Resonance

– Eval of Speech Sound Production

– Eval of Speech Sound Production w/ Eval of Lang Comprehension and Expression

– Eval of Lang Comprehension and Expression ONLY

– Evaluation of Fluency

- Evaluation for Prescription of Speech-Generating AAC Device, 30 Additional Minutes

- Evaluation for Prescription of Speech-Generating AAC Device, First Hour

- Evaluation for use and/or fitting of voice prosthetic device to supplement oral speech

• select date of testing, according to evaluation record.18

Diagnosis and Service CodesDiagnosis Codes in drop down box are

specific for each discipline. The codes in

Therapylog are codes most commonly used.

If you need a code added, please contact a

member of the MSBA Medicaid Consortium

Team.

Service Codes in drop down box are also

discipline specific. See below for complete

list of Service Codes.

Physical Therapy Service Codes

-Gait Training- Manual Training

-Neuromuscular Re-Education

-Orthotic Training

-Prosthetic Training

-PT Evaluation (High/Mod/Low)

-PT Re-Evaluation

-Self Care Management Training

-Wheelchair management/

propulsion training

-Therapeutic Activities

-Therapeutic Exercises

-These codes apply to individual

treatment

.

Occupational Therapy Service Codes

-Dev of Cognitive Skills to Improve

Attention, Memory

-Neuromuscular Re-Education

-OT Evaluation (High/Mod/Low)

-OT Re-Evaluation

-Self Care Management Training

-Sensory Integration

-Wheelchair management/propulsion

training

-Therapeutic Activities

-Therapeutic Exercises

These codes apply to individual

treatment.

Speech/Language Service Codes

-Speech/Language Therapy-Group-Speech/Language Therapy-Individual

-Behavioral and Qualitative Analysis of Voice & Resonance

-Eval of Speech Sound Production

-Eval of Speech Sound Production w/ Eval of Lang

Comprehension and Expression

-Eval of Lang Comprehension and Expression ONLY

-Evaluation of Fluency

-Evaluation for Prescription of Speech-Generating AAC

Device, 30 Additional Minutes

-Evaluation for Prescription of Speech-Generating AAC

Device, First Hour

-Evaluation for use and/or fitting of voice prosthetic device

to supplement oral speech

These codes apply to group and individual treatment.

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How do I check the billing record for accuracy?Step 1: Go to My Reports

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1.1 From the Simple Billing

page, click Home.

1.2 Click

under Therapist Tools on the Home page.

How do I check the billing record for accuracy?Step 2: Select and Create a Customizable Report

2.1 Click

Customizable Report.

2.2 Use the controls to customize your report and Click

Information entered by therapists remains in Therapylog

for 72 hours. Run The Customizable Report within 72

hours to correct mistakes before your therapy

transactions are bundled for claim submission to MHD.

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If the therapy transaction has been paid, the district will need to request that the transaction

by voided. Please send email to your District’s Direct Service Administrator with service

date, service time, therapist name, and student’s name of the transaction(s) to be voided.

How do I check the billing record for accuracy?Step 3: Use Weekly Notes to Review Report for Accuracy

3.1 Check your report to make sure that all information is accurate.

Your report will look like this:

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How do I correct the billing record?Step 1: Go to Your Calendar

• If you see an error on The Customizable Report, you can

correct the error through your calendar.

• You can access your calendar page two ways:

From The Customizable Report page click on

Calendar at the top, right side of the screen.

or From your home page, click

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2.1 Click on the gray box

that contains the date you

want to correct.

2.2 Click

2.3 Click to delete the

session.

2.4. After you delete a session, you re-enter

the correct billing information for the

session.

How do I correct the billing record?Step 2: Locate and Delete the Error

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Documentation of Simple Billing

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2.3.A Adequate Documentation

All services provided must be adequately documented in the medical record. 13 CSR 70-3.030, Section (2)(A) defines

“adequate documentation” and “adequate medical records” as follows:

• Adequate documentation means documentation from which services rendered and the amount of reimbursement

received by a provider can be readily discerned and verified with reasonable certainty.

• Adequate medical records are records which are of the type and in a form from which symptoms, conditions, diagnoses,

treatments, prognosis and the identity of the patient to which these things relate can be readily discerned and verified with

reasonable certainty. All documentation must be made available at the same site at which the service was rendered.

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13.4 Special Documentation Requirements

For physical, occupational and speech therapy services, the MO HealthNet Division requires that the following

documentation be included in the recipient’s medical record:

• Participant’s complete name;

• Participant’s date of birth;

• Date service was provided;

• actual treatment provided for the participant (more than “treatment given”) on the specific date of service;

• individual or group therapy;

• the setting in which the service was rendered;

• time service was delivered (e.g., 4:00-4:15 p.m.);

• The name, title, and signature of the therapist who provided the service;

• the plan of care must include treatment, evaluation(s), test(s), findings, results, and prescription(s)/referrals;

• documentation for the need of the service(s) in relationship to the participant's treatment plan;

• The participant's progress toward the goals stated in the treatment plan; and

• official Individualized Education Plan (IEP) or Individual Family Service Plan (IFSP) when billing therapy services

documented in an IEP or IFSP.

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Documentation Rubric

Adequate documentation requirements state that services must be readily discerned and verified with reasonable certainty. According to MHD, therapists

must state level of progress toward the goal relative to the completed therapy session each time.

_____participant’s complete name;

_____participant’s date of birth;

_____date service was provided;

_____individual or group therapy;

_____the setting in which the service was rendered;

_____time service was delivered (e.g., 4:00-4:15 p.m.);

_____the name, title, and signature of the therapist who provided the service;

_____Actual treatment provided for the participant (more than “treatment given”) on the specific date of service.

1. Defined activity such as:

-flash cards to elicit target sounds

-Q and A ‘wh’ questions with therapist initiating the questions

2.Progress relative to therapy session:

-Every session requires an indication of progress relative to that day’s therapy session (progress, minimal progress, etc.)

3. Student response:

-Notes to include how the student responded (ex. student responded without hesitation; or, student struggled with answering “when” questions; or.

student’s behavior was disruptive during therapy) or conditions of response (responded with cues; responded following peer modeling; responded

with assistance or without assistance, etc.).

4. Periodically provide quantitative data (not required every time).

5. State any use of assistive technology in notes.

The student’s complete [medical] record must also include:

_____the plan of care, which must include treatment, evaluation(s), test(s), findings, results, and prescription(s)/referrals;

_____documentation for the need of the service(s) in relationship to the participant's treatment plan;

_____the participant's progress toward the goals stated in the treatment plan; and

_____official Individualized Education Plan (IEP) or Individual Family Service Plan (IFSP) when billing therapy services documented in an IEP or IFSP.

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