Lesson 4: Facility Payment Procedures

Facility Payment Procedures

Hanna

”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.

[ld_video]

Lesson 3: Payments to Facilities with Established Rates

Payments to Facilities with Established Rates

Hanna

“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.

Lesson 2: Welcome

“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.”

Hanna

“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.
  • Describe the process and criteria for bed holds.”

Lesson 1: Start Here- Contact Us

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Resources and Glossary

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For More Information

DCC Listserv

Join the DCClistserv message system by sending your first and last name and email address to DCCListServ@ky.gov

DCC Website

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.

KYNECT

The Commonwealth of Kentucky’s space to connect residents with state resources including Medicaid, SNAP, KTAP, KHIP, and CCAP.

KY Childcare Regulations

Kentucky Administrative Regulations for Childcare, including those for CCAP.

Wrap Up

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Congratulations, you have made it through all of the content in Provider CCAP Billing Basics (July 2024)!

Upon successful completion of the final quiz, you will receive 1 clock hour of credit in ECE-TRIS within 10 days of the completion of this course.

Course Evaluation

ECE 080: Provider CCAP Billing Basics

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Please rate the following items related to the course layout.

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Claims

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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”.

Statements, Adjustments, Enrollment Fees, & Questions

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Click the first topic below to learn more about statements, adjustments, enrollment fees, and questions.

Payment Process and Provider Billing Forms

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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.  

The KICCS User Guide Print a PBF’s Guide can help answer questions you might have about the PBF.

Attendance Records

A DCC-94E, Child Care Daily Attendance Record, is required for all providers (licensed, certified, and registered).   

Sample completed PBF.
Click image to view in larger detail.
  • Each child’s name needs to be listed legibly on the DCC-94E exactly as listed on the PBF and certificate. 
  • The parent, guardian, authorized representative, or program staff need to record the actual time the child arrives and departs daily and initial.  
  • DO NOT record this information in advance. 
  • To verify accuracy of attendance, the parent/guardian, or authorized representative must sign the form at the end of each week. 
  • If the DCC-94E is not signed at the end of each week the CCAP funds may be recouped by DCC. 
  • The PBF and sign in and out sheets should be compared to ensure the child’s attendance, absences and holidays have been recorded and billed correctly. 
  • The DCC-94E must be kept for five (5) years for each child. 

DCC has partnered with Brightwheel to add an electronic attendance option for all providers.  For more information contact kentucky@mybrightwheel.com

Discontinued Enrollment Notification

Notification

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.

Provider notification of payment termination.
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 contact CCAPProviderPayments@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.

Rates and Schedules

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. 

DCC-94 – Child Care Service Agreement and Certificate

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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.

DCC-94C Provider Notification Letter

DCC-94 Child Care Service Agreement and Certificate

Receiving Payments

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Click the first topic below to learn more about receiving payments.

Verify your ECE-TRIS Information for Course Credit

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.

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Resources and Glossary

User Guides and Tip Sheets

DCC Listserv

Join the DCClistserv message system by sending your first and last name and email address to DCCListServ@ky.gov

DCC Website

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.

KYNECT

The Commonwealth of Kentucky’s space to connect residents with state resources including Medicaid, SNAP, KTAP, KHIP, and CCAP.

KY Childcare Regulations

Kentucky Administrative Regulations for Childcare, including those for CCAP.

Glossary

What’s that abbreviation stand for again? Here’s a list for you.

  • CCAP – Child Care Assistance Program
  • DCC – Division of Child Care 
  • DRCC – Division of Regulated Child Care
  • FPG – Federal Poverty Guidelines
  • IEES – Integrated Electronic Eligibility System
  • IPV – Intentional Program Violation
  • KICCS – Kentucky Integrated Child Care System
  • KOG – Kentucky Online Gateway
  • KTAP – Kentucky Transitional Assistance Program
  • PBF – Provider Billing Form
  • PPA – Pay Period Adjustments
  • SMI –  State Median Income

Lions and Tigers and Forms, Oh My!

(List of all the mentioned forms in the course)

  • DCC-93 Authorization for Electronic Deposit form
  • DCC-94 Child Care Service Agreement and Certificate
  • DCC-94.1 Child Care Change Notice
  • DCC-94B Licensed or Certified Provider Agreement Form
  • DCC-94C Provider Notification Letter
  • DCC-94E Child Care Daily Attendance Record
  • DCC-97 Provider Billing Form
  • DCC-97 Remittance Report
  • DCC-300 Kentucky Child Care Maximum Payment Rate Chart

Course Evaluation

ECE 080: Provider CCAP Billing Basics

Please choose the agency you represent.

Please rate the following items related to the course layout.

PoorBelow AverageAverageExcellent
PoorBelow AverageAverageExcellent
PoorBelow AverageAverageExcellent
PoorBelow AverageAverageExcellent
PoorBelow AverageAverageExcellent
PoorBelow AverageAverageExcellent

At the end of the course I am able to:

Not at AllVery LittleSomewhatCompletely
Not at AllVery LittleSomewhatCompletely
Not at AllVery LittleSomewhatCompletely

Please rate the following items related to course knowledge and satisfaction.

Strongly disagreeDisagreeAgreeStrongly agree
Strongly disagreeDisagreeAgreeStrongly agree

Complete the Course Evaluation

Are you new to CCAP Billing?(Required)
What type of provider are you?(Required)
As a result of this training, my knowledge about CCAP Billing has increased…(Required)
How likely are you to apply this knowledge?(Required)
Which of the following reflects your level of satisfaction with the training?(Required)

Wrap Up

Congratulations, you have made it through all of the content in Provider CCAP Billing Basics (July 2022)!

You will receive 1 clock hour of credit in ECE-TRIS within 10 days of the completion of this course.

Don’t forget to print the course certificate for your records, and check your email for a Quick Reference Sheet!

Congratulations!

Claims

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.

What is 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, including 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

DCC Claims 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 Intentional Program Violation (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” or “IPV” means a CCAP recipient or child care provider has intentionally: (a) Made a false or misleading statement; or (b) Misrepresented, concealed, or withheld facts”).