Payment Process and Provider Billing Forms

Accessing Provider Billing Forms

The DCC-97, Provider Billing Forms (PBF) are available on the first day of each month to cover the prior month’s CCAP enrollments.

Providers who use the KICCS Provider Portal can access and submit their billing electronically.

Providers who do not use the Provider Portal access will receive their paper PBF in the mail. Paper PBFs are mailed out on the first business day of each month. Paper PBFs may be returned to DCC via email at CCAPProviderPayments@ky.gov, mailed using the address on the form, or faxed to (502) 564-3464.

A KICCS User Guide and a guide to process and print a PBF can be found on the Kentucky Integrated Child Care System Provider Portal Launch Site.

Blank Paper PBF

The form below is a blank paper DCC-97 form. Once generated and ready to mail, the form would include the children’s names and care schedule from the current certificate prefilled on the ‘Scheduled’ line.

Provider Portal PBF

The portal PBF below is filled out for May 2022 and is available to be submitted by the provider on June 1, 2022. The child’s care schedule from the DCC-94 certificate is prefilled on the ‘Scheduled’ line. The PBF shows the Care Level for the child which is determined by the child’s age and may change during the month if the birthday falls during that month. The Codes being paid either from the prefilled schedule, the provider exception line or both. The count which is the number of days being paid for each code. The Rate the provider charges per day for that care level and the copay rate. The form also has the daily calendar for billing for each day the child is scheduled to attend in the month of May with lines for Provider Exceptions and Worker (DCC staff) Exceptions. The exception codes are under the calendar boxes. Last, the Provider’s note box (for the provider to leave explanations of the exceptions) and the EAV Note box (for DCC staff to communicate with the provider).

Once a provider submits the PBF, either by mail or online, it goes into the KICCS portal for DCC staff to process. The system puts the PBFs in the portal according to the order in which they are received. This can be affected by the speed of the internet being used or the server processing the information-both of which are out of human control.

Once the provider has submitted the PBF, Kentucky Administrative Regulations and DCC CCAP Policy require that provider billing forms are processed by DCC staff within ten (10) business days of receipt.

within 10

Business Days of Receipt

Questions about Payment Timeframes

Providers that have inquiries about the timeframe for payment should reference KRS Chapter 45.453. Providers shall receive a payment within thirty (30) working days of processing the PBF, except when there are payment discrepancies in the payment amount billed and the amount owed to the provider. In these instances, the Cabinet is not held to the thirty (30) day period for payment.

within 30 days

Unless there are payment discrepancies

Issuing Payments

Provider payments are issued in the form of a check unless the provider chooses to receive the payment as an electronic direct deposit. To set up direct deposit a provider must submit a DCC-93, Authorization for Electronic Deposit and a W9.

A DCC-93 and W9 can be requested by contacting CCAPProviderPayments@ky.gov. If the DCC-93 is incomplete, it will be returned to the provider for completion.

DCC-93

Authorization for Electronic Deposit

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How often can payment options be changed?

3 times per calendar year

Unless there is a change in provider type or license number.

How to fill out a Provider Billing Form

When a DCC-97 Provider Billing Form is received, either in the portal or in paper form, it will have the expected attendance/care schedule (found on the DCC-94 Licensed and Certified Enrollment Agreement Enrollment Certificate) prefilled on the Scheduled line.

The next line, for Provider Exceptions, is left blank. Providers use the exception line to make needed changes to the prefilled schedule. If a child’s attendance is different from the expected prefilled schedule, the provider must enter the correct billing code to make the exception (change).

PBFs with a Flex Schedule do not have a prefilled care schedule but have an allotted number of days the child may attend. For example, the child may be allowed to attend 5 full days per week. If the provider is open 7 days a week these 5 full days may be any of the 7 days in the week and may change each week.
The CCAP email inbox frequently receives emails stating that the PBF is giving an error message that says, “Exceptions cannot be made….”. This happens when a provider is filling in the same code in the Provider Exception box that is prefilled on the PBF. The provider exception line is to make CHANGES to the prefilled code, not to add the same code.
If the care schedule is incorrect, it is the parent’s responsibility to contact DCBS Family Support (855-306-8959) for a care schedule correction. CCAP payment staff cannot make changes to certificate schedules.

Find a tip sheet for Exception Codes and Flex Schedules here:
https://chfs.ky.gov/agencies/dcbs/dcc/Pages/kiccsportal.aspx

The billing codes are as follows:

Codes 43, 45, 55 and 65 are based on the provider’s circumstance.
Codes 40, 45, 50, and 60 are based on the child‘s circumstance.

The exception codes for each provider type are as follows: $=payable code

Licensed Provider Codes ($ = payable code)

01 –$ Full day-payable code for attendance of five (5) or more hours per day
02 –$ Part day-payable code for attendance less than five (5) hours per day
40 –$ Excused absence (five (5) per month permitted without documentation of the reason)
NOTE: This code is only used for the purpose of the child being absent from the center on a day that the center was open, and the child was scheduled to be in attendance. It is not used if the provider was not open for business.
43 –$ Holiday, closed but payment requested
NOTE: Limit of ten (10) days per year. If the provider is closed for holidays more than ten (10) days per year, a code 55 must be used for any days over the first 10 days. If this code is used on even one child in error the system automatically uses one of the 10 holidays for the year.
45 –$ Extraordinary absence (For absences which exceed five (5) days, written documentation of illness, (except for maternity leave), natural disaster (declared by nation, county or state), or death in the family must be on file and retained with the provider’s daily attendance sign-in sheets)
50 – Unexcused absence – any absence which exceeds five (5) per month and is not documented by one of the three (3) reasons shown for code 45
55 – Closed, no payment requested
60 –$ Last day attended –payable code-follow with code 55 to prevent overpayment
65 – Non-payable code used to end enrollment-follow with code 55 to prevent overpayment. Codes 60 and 65 were designed to give the provider a method of ending an enrollment for a child that is no longer attending the child care center.

Use the following for flex schedules:

401 –$ Flex excused absence (five (5) per month permitted) full day
402 –$ Flex excused absence (five (5) per month permitted) part day
431 –$ Flex closed but payment requested (scheduled holiday) full day
432 –$ Flex closed but payment requested (scheduled holiday) part day
451 –$ Flex extraordinary absence full day
452 –$ Flex extraordinary absence part day
601–$Flex last day attended – payable full day, follow with code 55
602 –$ Flex last day attended – payable part day, follow with code 55
651 – Flex day to end enrollment – non-payable full day, follow with code 55
652 – Flex day to end enrollment – non-payable part day, follow with code 55

Certified Provider Codes ($ = payable code)

01 –$ Full day- payable code for attendance of five (5) or more hours per day
02 –$ Part day-payable code for attendance less than five (5) hours per day
40 –$ Excused absence (five (5) per month permitted)
43 –$ Holiday, closed but payment requested
NOTE: Limit of ten (10) days per year. If the provider is closed for holidays for more than ten (10) days per year, they must be shown as code 55. If this code is used on even one child in error the system automatically uses one of the 10 holidays for the year
50 – Unexcused absence – any absence in excess of five (5) per month
55 – Closed, no payment requested
60 – $ Last day attended –payable day, follow with code 55
65 – Non-payable day used to end enrollment, follow with code 55

Use the following for flex schedules:

401 –$ Flex excused absence (five (5) per month permitted) full day
402 – $ Flex excused absence (five (5) per month permitted) part day
431 – $ Flex closed but payment requested (scheduled holiday) full day
432 –$ Flex closed but payment requested (scheduled holiday) part day
601 –$ Flex last day attended – payable full day, follow with code 55
602 –$ Flex last day attended – payable part day, follow with code 55
651 – Flex day to end enrollment – non-payable full day, follow with code 55
652 – Flex day to end enrollment – non-payable part day, follow with code 55

Registered Provider Codes ($ = payable code)

01 – $ Full day
02 –$ Part-day
50 – Absence
60 – $ Last day attended –payable day, follow with code 55
65 – Non-payable day used to end enrollment, follow with code 55

Use the following for flex schedules:

601 –$ Flex last day attended – payable full day, follow with code 55
602 –$ Flex last day attended – payable part-day, follow with code 55
651 – Flex day to end enrollment – non-payable full day, follow with code 55
652 – Flex day to end enrollment – non-payable part-day, follow with code 55

Enrollment vs Attendance PBF Coding

CCAP has been paying based on enrollment and not attendance since 12/1/22. There is currently a tentative end date for this initiative of 12/31/23.

This means that payments are based on the care schedule from the CCAP certificate. The care schedule is the hours and days per week a child is expected be in a child care program. Child absences using codes 40, 45, or 50 will NOT be recorded. The customary 5 absences per month do not apply when paying based on enrollment.

Providers will only need to use codes that affect the entire center’s attendance, such as code 43 (holiday) or 55 (to follow a code 60/65 or center is closed more than the allotted ten (10) holiday code 43s). Weather related closures will not be coded.

Exceptions to this rule are when the care schedule is incorrect on the certificate. In these cases, codes 1 and 2 can be used to correct an incorrect prefilled code.

The parent should also be advised to contact Family Support to have the care schedule corrected. This is a frequent issue with School Schedule enrollments. For example, the prefilled schedule is a 1 but the child’s actual schedule is part day. The provider will enter a 2 in the Provider Exception box.

Flex schedules will remain the same as if payment was based on attendance because the nature of the Flex schedule is that the provider fills in the child’s actual attendance.

Important Reminders:

Provider Billing Forms (PBF) are ready for providers beginning the first day of the month.
PBFs are processed by DCC Staff during normal business hours M-F 8am-4:30pm. If the first falls on a weekend or a holiday processing will begin the first business day of the month.
PBFs are processed by billing staff within ten (10) business days of receipt or being submitted in the portal.
Providers shall receive payment within thirty (30) calendar days.
If there is a claim, the PBF may be signed monthly to have the claim payment taken out of your payment.
No payments or adjustments will be made ninety (90) or more days after the month care is provided.
Using correct billing codes helps prevent overpayments.
A provider may end an enrollment on a PBF using a code 60 or 65 followed by code 55. A code 60 will pay for the last day the child attended, and a code 65 will end an enrollment without payment.
A code 43 is for HOLIDAY pay only. If code 43 used even on one child during a billing cycle, the system picks it up and uses one of the center’s 10 holidays for the calendar year. During the December billing cycle, providers frequently question why they are out of holidays and it is often because a child was coded incorrectly in a previous month.
Never submit a blank PBF and leave a provider note with directions on how to code the PBF. Coding the PBF is the provider’s responsibility. If you have questions, contact CCAPProviderPayments@ky.gov.