“The Fiduciary Branch shall utilize facility invoices to process timely payments when an individual under guardianship has available funds to make payments and to provide personal needs funds. Let’s review how these payments are processed.”
Processing Non-recurring Payments:
To process non-recurring payments, Fiduciary staff review facility statements of charges to ensure proper billing and payment for each individual under guardianship.
Fiduciary staff also verify that individuals have sufficient funds to cover the billed expenses. If funds are found to be insufficient, Fiduciary staff should consult their supervisor.
State Psychiatric Hospital bills are processed and paid within 3 business days of receipt.
Room and board and any personal needs expenses itemized on the statement of charges are paid and verified. Fiduciary staff must select the correct vendor in KYGFIS for payment.
It is important to note that facility payments are not processed by payment requests. If a payment request is submitted to Fiduciary, payment is denied and forwarded to designated Fiduciary staff for payment processing.
Private Pay
For individuals under guardianship who have the financial resources to private pay, monthly statements of charges are processed and scheduled for payment according to the itemized monthly billing statement.
Prorated Billing will be used for payments made for individuals who reside in a facility for a specified number of days in a month. In these cases, payment is made according to the exact number of days at the facility that are less than a full calendar month.
Example: If an individual is admitted to a nursing facility on the 10th of the month, Fiduciary will calculate and issue payment to cover the 10th through the last day of the month.
”In this lesson, we will explore the procedures followed by Fiduciary staff to manage and ensure the accuracy and timeliness of payments to facilities and service providers for individuals under guardianship. This process is critical to maintaining the health, safety, and well-being of those we serve. Watch the video below to review this information. Note that you must watch the video in it’s entirety to continue in the course.”
Note: You must watch the entire video to continue through the course.
“As part of its duties as an appointed Conservator or Limited Conservator, the Fiduciary Branch will set up payments in accordance with state and federal regulations for residential facility, personal needs, and other expenses when an individual under guardianship has available assets and/or financial resources.”
Residential facilities submit itemized statements of charges to the Fiduciary Branch, which documents monthly expenses for individuals under guardianship.
Recurring expenses may be set up in processing batches as automatic payments when possible.
An exception is a facility that submits bills to Fiduciary a month behind. These bills must be paid upon receipt by the due date.
“Hello and welcome to this Fiduciary Training on Establishing Payments to Facilities and Service Providers. In this course, you will be working with Hanna to review payments to facilities, resident trust accounts, medical and pharmacy payments, and bed holds.”
“Hi, I’m Hanna. I’ll be working through this course with you to help you get a better understanding of the process for payments to facilities and service providers. This course is part of a required set of training courses for new Fiduciary Branch employees. In this course, we will:
Course Objectives:
Describe facility payment procedures.
Identify requirements for resident trust accounts and receipts.
Explain the requirements and procedures for medical and pharmacy payments.
The website can assist families and providers with finding all things related to DCC and its programs. Specifically, click on Child Care Assistance Program for Providers then click on the KICCS Provider Portal link. Under the Additional Information section, you will find many useful guides and tip sheets.
The Division of Child Care (DCC), Child Care Assistance Program (CCAP), Claims Section is responsible for childcare provider claims. All references to the claims policies and procedures are found in 922 KAR 2:020.
Explanation of a Claim
Claims result from an improper payment. The purpose of a claim is to collect the amount that was overpaid. Overpayment results from an action or inaction on the part of the child care provider; this includes failure to report a change in circumstance in accordance with 922 KAR 2:160, Section 11, or an agency error that provided the child care provider with an overpayment. (922 KAR 2:020, Section 2).
The Division of Child Care, Claims Section
The Division of Child Care Claims Section is responsible for using advanced skill sets to investigate potentially fraudulent activities and interview providers to determine if a child care provider claim exists, establish the claim, negotiate repayment agreements, and maintain the claim file.
Division of Family Support
Responsible for establishing and collecting a child care client claim.
Reasons for claim establishment
Falsification of information on DCC-94E Child Care Daily Attendance Record shall lead to a claim. All child care providers (licensed, certified and registered) are responsible for reporting the attendance of each child who receives CCAP. The attendance is reported on the regulated DCC-94E form (922 KAR 2:160).
Falsification of information reported on the DCC-97 Child Care Provider Billing Form (PBF) shall result in a claim. Child care providers submit payment for CCAP using the Provider Billing Form; DCC-97.
Claim Determination can be made by, but not limited to:
Auditing of the DCC-94E for fraudulent activity or erroneous errors.
Attendance reported on the 94E form that should be recorded legibly each time the child arrives and each time the child departs the provider’s care and signed by the parent or applicant for the child served by CCAP (922 KAR 2:160). The 94E forms should be consistent with the billing forms/KICCS.
DCC-94E inconsistencies such as:
Days billed, but not reflected on the 94E,
Arrival and departure times for each child not recorded on the State approved the regulated DCC-94E, Child Care Daily Attendance Record, and
Missing legible parent weekly signatures and/or no provider signature at the bottom of the DCC-94E.
Notification from the Billing Team
The CCAP Billing section notifies the claims section of payment errors.
Child Care providers may contact the billing section when they discover inadvertent payment errors. “Inadvertent error claim” means an overpayment resulting from misunderstanding or unintended error on the part of a recipient or a child care provider (922 KAR 2:020).
Random selection of Child Care Providers’ Attendance Report
Every month, a CCAP attendance report is generated through the state-approved child care eligibility system, which generates lists of active child care providers requesting payment for CCAP children’s attendance. A random audit of attendance records is completed for child care providers from this report.
OIG Referral Line
If the cabinet has sufficient documentary evidence to confirm that a recipient or child care provider has committed an IPV, the cabinet shall refer the case to the cabinet’s Office of Inspector General (OIG) for investigation or referral for prosecution if warranted by the facts of the case (922 KAR 2:020).
Intentional Program Violation (IVP)
Intentional Program Violation (IVP) means a CCAP recipient or child care provider has intentionally: (a) Made a false or misleading statement; or (b) Misrepresented, concealed, or withheld facts”.
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 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.
Once in the New PBF status, a PBF will remain open for submission for 90 days.
After 90 days, the PBF will void, and payments will not be able to be processed.
If the child’s enrollment is being discontinued for any reason during the twelve (12)-month certification period (before the end date on the certificate), a DCC-94C, Provider Notification Letter, will be generated.
A DCC-94C will be sent to the provider if a CCAP case ends because of a change in the case, making the family ineligible.
If an enrollment does not have any changes, then the end date on the certificate serves as the notice and a DCC-94C will not be sent.
Click image to view in larger detail.
The effective date on the DCC-94C is the first day of non-payment.
Process
A DCC-94C is sent to the child care provider ten (10) calendar days prior to the effective date on the letter.
If during ten (10) calendar days the parent contacts the Family Support office to resolve the case issue a DCC-94.1, Child Care Change Notice, will be sent to the parent and the child care provider.
As a provider, if you receive a DCC-94C and do NOT receive a DCC-94.1 after the DCC-94C, then the case has discontinued and CCAP payments have ended.
Frequently parents will tell providers that the issue has been resolved but unless a DCC 94.1 Notice of Change certificate has been received it is best to contactCCAPProviderPayments@ky.gov to double check.
If the CCAP case does not have any changes that affect the end date of the twelve (12)-month eligibility period, the end date on the certificate serves as the provider’s notice of discontinuance.
Have questions?
Parents will need to contact DCBS Family Support at 855-306-8959 to discuss the specifics of their case.
Providers will need to contact DCC with questions concerning payments or certificates at CCAPProviderPayments@ky.gov or 844-209-2657.
Due to confidentiality, Family Support and DCC staff are not able to communicate the reason for the discontinuance with providers. Staff may only discuss the information that is on the certificate and the status of the case. Any other concerns or questions will require the parent to contact DCBS Family Support.
The DCC-300: Kentucky Child Care Maximum Payment Rate Chart, details by county the max rate the state can pay per child based upon license type and age of child. Rates are based on a full day, which is defined as care five (5) to eighteen (18) hours per day, or a part day, which is defined as less than five (5) hours of care per day.
The state of Kentucky does not mandate the rates a provider can charge. Each provider can consult the DCC-300 when setting their rates but ultimately, may charge more or less than these rates. Providers are encouraged to complete a DCC-94B, Licensed or Certified Provider Agreement Form, yearly. The DCC- 94B allows providers to make any billing changes that may affect their CCAP payments.
When child care enrollment is added to an approved CCAP case a DCC-94, Child Care Service Agreement and Certificate, will be sent to the parent and the provider through the provider portal if the parent granted Provider Portal access during the interview process. The DCC-94 (Certificate) shows the child’s pending enrollment, along with other valuable information.
Please complete the form below. If you mark “no” credit for completion of this course WILL NOT be added to your ECE-TRIS professional development record.
Your individual training record in ECE-TRIS will be updated within 10 days with the course credit. ECE-TRIS is a training registry for early care and education providers and gives you 24/7 access to your professional learning record: https://tris.eku.edu/ece.
The website can assist families and providers with finding all things related to DCC and its programs. Specifically, click on Child Care Assistance Program for Providers then click on the KICCS Provider Portal link. Under the Additional Information section, you will find many useful guides and tip sheets.
