Medicaid Plus for Frontline IEP-NY
Medicaid Plus for Frontline IEP-NY (formerly IEP Direct) is an enhanced Medicaid Processing service for Frontline IEP-NY districts participating in the School Supportive Health Services Program (SSHSP) and using Frontline IEP-NY and Frontline Medicaid.
The goal of the Medicaid Plus for IEP Direct is to assist school districts in maximizing the reimbursement of Medicaid funds available through the SSHSP (School Supportive Health Services Program). Data entry is the responsibility of the school districts providers and clerks as described. Districts will check the data entered for accuracy and verify it is in compliance. WNYRIC will review the necessary information and communicate missing information.
Administrative PC/LAN Service Base (Service 650.650.00)
Requirements and Recommendations
Desktop/Laptop Computer (PC)
Operating System: Microsoft Windows 7, 8, 8.1 or 10.
Hardware: 2 gigahertz (GHz) or faster 32-bit (x86) or 64-bit (x64) processor and 2 gigabyte (GB) RAM minimum (4 GB RAM or more recommended)
Other Software: Microsoft Word 2007 or higher to generate and print letters. Acrobat Reader XI or higher to read PDF files.
Browser: Microsoft Internet Explorer 10.0 or higher (128-bit Encryption support required) Google Chrome Version 36.0 or higher
Macintosh (Mac)
Operating System: OS X 10.9 or higher
Other Software: Microsoft Word 2008 or higher to generate and print letters. Acrobat Reader XI or higher to read PDF files.
Browser: Safari 7.1.7 or higher
iPad
Operating System: iOS 8 or higher
Hardware: Apple A5 SoC (iPad 2) or Newer
Other Software: Microsoft Word Reader App and PDF Reader App
Browser: Safari or Chrome
Chromebook / Chromebox
Operating System: Most Recent Version
Hardware: Intel dual-core Celeron or faster processor
Browser: Chrome
Other Software: Microsoft Word Reader App and PDF Reader App
Connection: High Speed Internet connection
Considerations
- “Save Password” features should be disabled in the browser
- Web TCP port 80 and 443 is required to be open for general web and secured SSL connections from client workstations
- Screen resolution should be set to at least 1024x768
- Browser history settings should be set to check for newer versions of stored pages on every visit
- Pop-up Blockers should be turned off when using any of the Frontline IEP-NY products
- Assess the effects of any Content Filtering devices on the speed of the connection
- Assess the Internet bandwidth available for additional usage during peak times
- Assess the effects of a Proxy Server on access and speed of the connection
Notes
- Internet Explorer within Windows 8 and 8.1 must be launched from the Desktop. Integrated Internet Explorer in Metro is currently unsupported.
- In order to use any Frontline IEP-NY products, the iPad must be connected to a WiFi source.
District Responsibilities:
- Verify any data entered is accurate and is in compliance with NYSED SSHSP Compliance Policy and Confidential Disclosure Policy including documentation that supports the validity of all Medicaid claims.
- Annually acknowledge in writing the school district responsibilities.
- Designate a Medicaid Module coordinator.
- Annually renew Medicaid Direct.
- Participate and attend scheduled training sessions with WNYRIC staff.
- Ensure that related service providers are trained on how to enter session notes and claiming information into the RS Log in Frontline IEP-NY.
- Enter written orders to Frontline IEP-NY.
- Send copy of written orders to WNYRIC via fax, BOCES courier, or US Mail.
- Keep all original written orders on file.
- Enter parental consent dates into Frontline IEP-NY.
- Enter special transportation claims into Frontline IEP-NY.
- Enter any claims received on paper log into Frontline IEP-NY.
- Verify provider license and NPI numbers are entered correctly into Frontline IEP-NY.
- Link/unlink orders/referrals in Frontline-IEP-NY as necessary.
- Have a secure e-mail system and provide appropriate addresses to RIC.
- Notify WNYRIC of need for training of related service providers.
- Assign appropriate personnel to enter the above information into Frontline IEP-NY.
- Receive and review all relevant announcements, directions, and documentation from vendor (Frontline IEP-NY) and WNYRIC, NYSED, Office of Health Insurance programs, and NYS Office of Medicaid Inspector General.
- Retain all records as required by the Medicaid Guidelines, including parental consents and written orders/scripts, and referrals.
- Checks to ensure session notes are signed contemporaneously.
- Obtain the CIN number for students eligible for Medicaid.
WNYRIC agrees to:
- Review entered claims and verify supporting information has been entered into Frontline IEP-NY; check services being billed are consistent with the IEP; check written orders have been entered into Frontline IEP-NY; check that parental consent has been entered into Frontline
- IEP-NY; review claims for proper provider and UDO signatures.
- Notify district office of any missing documentation required for a claim in a confidential manner via a phone call or other secure means.
- Review related service provider’s license and NPI numbers are entered into Frontline IEP-NY.
- Update eMEDNY with license and NPI numbers and communicate any inaccuracies to the district.
- Check NYS and Federal exclusion lists for individuals or entities excluded, restricted, terminated or censured from participating in the
- Medicaid Program.
- Upload claim files using Frontline IEP-NY, either quarterly or monthly depending on the service being used.
- Notify providers in a confidential manner via a phone call or other secure means, if claims have not been electronically signed.
- Analyze rejections and denials to determine reason for rejection and whether they can be resubmitted; provide district with monthly or quarterly remittance amount via email to the Medicaid Module Coordinator, if applicable.
- Perform on site documentation compliance reviews up to four times annually as requested by district.
- Create reports of claims, eligibility, filed documents and others in PDF format via secure FTP site or remote support application upon request.
- Provide relevant group trainings at WNYRIC sites and/or online throughout the year.
- Maintain strict confidentiality.
- Be available for consultation during an audit.
- Provide ongoing telephone support.
- Provide district with support contact phone numbers and email address.
- Provide the number of Medicaid encounters of billable services annually to the business office (for the Medicaid Cost Report)
- Provide the number of one way trips for Medicaid eligible transportation annually to the business office (for the Medicaid Cost Report).
The WNYRIC utilizes cost effective best practices determined by research that allows our experienced and trained technical staff to perform robust testing and support of the WNYRIC network in the areas of security, infrastructure, energy management, virtualization strategies, disaster recovery and business continuity. Therefore, we are able to be a district advocate for vendor contract issues and aggressively negotiate contract pricing and performance terms.
Staff follows best practices in order to provide necessary security as it relates to the most recent student, teacher and principal data security and privacy regulations.
Service Desk can be reached Monday – Friday from 7:00 a.m. – 4:30 p.m. by calling (716) 821-7171, 1-800-872-0780, by email at servicedesk@e1b.org, or via live chat by clicking here. A representative will be available from 4:30 p.m. through 11:00 p.m. to assist you with calls regarding emergency situations. During all other hours and holidays, a caller will receive important information regarding coverage.