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Authorized
Representative Payee
Billing
Services
Legal Fund
Payment
Processing
Special
Enterprise Investment Fund
Waiver
Management
Authorized
Representative Payee
Value Added Benefits: Authorized
Representative Payee Benefits
AUTHORIZED REPRESENTATIVE PAYEE
– COMPREHENSIVE PRODUCT DESCRIPTION:
CORE PRODUCT / AUTHORIZED REPRESENTATIVE
PAYEE:
The Authorized Representative Payee
Service is designed to help adults with
Mental Retardation and Developmental
Disabilities who receive Social Security
benefits to pay their bills; to meet
basic living needs and all personal
financial obligations.
As described by
the Social Security Administration, an
Authorized Representative Payee is an
individual or organization that receives
Social Security payments for someone who
cannot manage or direct someone else to
manage his or her money.
Authorized Representative Payee
The main responsibility of an Authorized
Representative Payee is to use the
Social Security funds to pay for the
current and foreseeable needs of the
individual.
Qualifying individuals are
referred by the county board and enroll
in this service. As the Authorized
Representative Payee, MEORC receives the
Social Security checks directly and
ensures that basic needs such as rent,
utilities, food and clothing are paid as
a priority. Individuals are then
assisted to designate spending money for
other items.
This service will not
involve providing skill development
plans or developing money skills.
VALUE ADDED BENEFITS /
AUTHORIZED REPRESENTATIVE PAYEE
BENEFITS:
Stability of Income for Individuals
Provides assurance that rent, food, and
other necessary expenses will be paid
regularly.
Improves individuals’ credit
and prevents late fees or duplication of
services.
Provides opportunity for increased
savings for larger, special purchases.
Ensures that financial entitlements do
not lapse, and that money is spent
appropriately.
Increases the chance of
achieving future life goals, such as
sustained independent living.
Help to Protect from Financial
Exploitation and Abuse
MEORC participates in the following
reviews with the Social Security
Administration:
(1) 6- month site visits, (2) Site
reviews-at least once every 3 years, (3)
Face-to-face interviews and
(4) Sample random records reviews.
MEORC will provide to participating
members, guardians when applicable, and
County Boards an accounting record of
activities on a routine basis.
MEORC will be responsible to notify the
Social Security Administration and the
local Department of Job and Family
Service office of changes in fiscal
circumstances.
When individuals require annual income
tax filing MEORC will complete the
Internal Revenue Service (IRS) forms.
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Billing Services
Core Product:
Billing Uploads to ODMRDD
Value Added
Benefits
BILLING SERVICES
– COMPREHENSIVE PRODUCT DESCRIPTION:
CORE PRODUCT / BILLING UP-LOADS TO
ODRMDD:
On an as needed or requested basis,
MEORC will provide, through the member
collaborative database, upload billing
functions for county board direct
services.
Day Habilitation
MEORC creates billing files based on
electronic or hard copy documentation
submitted by the member and validates
billing files through use of the
collaborative database software. MEORC
works with the billing contact person
from the county board to resolve
documentation questions and invalid
billing records. MEORC will upload all
properly documented and validated
billing files to the, ODMRDD web based,
Medicaid Billing System. ODMRDD payments
are made directly to the county boards.
Targeted Case
Management (TCM)
MEORC creates billing files based on
electronic or hard copy documentation,
submitted by the member and validates
the billing files through use of the
collaborative database software. MEORC
works with the billing contact person
from the county board to resolve
documentation questions and invalid
billing records. MEORC uploads all
properly documented and validated
billing files to the, ODMRDD web based,
Medicaid Billing System. ODMRDD payments
are made directly to the county boards.
VALUE ADDED BENEFITS:
Technical Assistance
Stakeholders receive the benefits of
MEORC staff specialization and expertise
through assistance in regards to diverse
perspectives of other members.
Availability of technical assistance is
on a daily basis. Stakeholders receive
updated information regarding changes
that occur in the system and assistance
in making changes in processes in
accordance with mandates.
Training
MEORC coordinates and conducts training
in to assist members to connect with
neighboring county boards to share
information in regarding successful
procedures. MEORC coordinates and
conducts training to assist members with
successful administration of billed
services.
Liaison
With current participation of members,
MEORC represents over 20% of the 88
counties in the State which provides a
combined voice to assist with change at
the State level.
MEORC, as an entity, is involved with 18
County Boards with varying opportunities
and resources. Through this long-term
involvement with County Boards, MEORC is
able to share diverse options and
perspectives.
MEORC leadership staff serves as
representatives on State level
workgroups.
MEORC communicates on behalf of the
membership with providers, ODMRDD, ODJFS
and OACBMRDD.
Quality Outcomes and Statistical
Analysis
Provides routine updated information and
statistical analysis, via a
collaborative database system, related
to county board billed services to
assist stakeholders with the monitoring
and measuring of outcomes based services
and the improvement of the delivery of
services.
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Legal Fund
Core Product: Legal Fund
Products
Value Added Benefits:
LEGAL FUND – COMPREHENSIVE
PRODUCT DESCRIPTION:
CORE PRODUCT /
LEGAL FUND:
MEORC works
collaboratively with stakeholders to
ensure compliance with rules and
regulations that pertain to the core,
bundled or a la carte products purchased
by stakeholders.
Access to Legal Services
Stakeholders receive the benefit of
legal services to address common issues
facing the industry.
VALUE ADDED BENEFITS:
Liaison
MEORC develops successful and positive
relationship with contracted legal
counsel and, in many instances, serves
as liaison for stakeholders.
MEORC communicates with member county
boards regarding interactions with legal
professionals and any predicted impact
on the local delivery system.
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Payment Processing
Core Product:
Payment Processing
Value Added Benefits:
-
Liaison
-
Staff Specialization and Expertise
-
Specialized Debit Card System
-
Supporting Documentation
-
Voucher Preparation
-
Vendor Communications
-
W-9s and 1099s
-
File
Management
-
Accountant Communications
-
Documentation Reviews
PAYMENT PROCESSING –
COMPERHENSIVE PRODUCT DESCRIPTION:
CORE PRODUCT / PAYMENT OF
NON-WAIVER FUNDS:
MEORC processes payment of supported
living allocations in accordance with
5123:2- 12-04 and 5126.40 to 5126.45. In
addition, MEORC processes payment of
other state and local funding as
authorized by the members.
Distribute Funds
MEORC distributes funds provided by or
on behalf of County Boards, in
accordance with ISPs, for: Supported
Living, Homemaker Personal Care,
Non-waiver subsidies, Room and Board in
licensed setting, one time or General
Revenue Funds. MEORC mails checks and
remittance advices for the payments
processed under this description. MEORC
maintains a tax exemption certificate.
Contract Development and
Management
MEORC staff members prepare Supported
Living, Non-Waiver contracts and
addendums based on ISPs, negotiations or
other relevant information. MEORC
maintains a systematic process for
mailing, tracking and distribution of
prepared contracts to providers. The
systematic process ensures proper
contract signatures and coordination
with payments. MEORC efficiently and
effectively communicates contract
attachments by way the agency web site.
VALUE ADDED BENEFITS:
Liaison
MEORC staff members communicate on
behalf of the member counties with:
providers, vendors, individuals,
families, guardians, ODMRDD, ODJFS and
OACBMRDD.
Staff Specialization and
Expertise
MEORC fiscal staff focuses on providing
professional, quality and consistent
service to member counties. This
specific focus on fiscal functions
results in specialization and enhanced
expertise in the financial arena.
Specialized Debit Card System
MEORC establishes specialized debit
cards in accordance with ISPs.
Specialized debit cards are available
for cost of living subsidies, as
identified in the ISPs. The debit cards
have specialized restrictions on usage
and dollar limitations.
Supporting Documentation
MEORC is responsible for the maintenance
of supporting documents on all payments
processed under this product
description.
Voucher Preparation
MEORC prepares and distributes vouchers
to members, providers, vendors or
individuals, as applicable, for approval
of purchases prior to payment.
Vendor Communications
MEORC works with vendors (providers and
merchants) to coordinate payments and to
settle any payment issues that may
arise.
W-9s and 1099s
MEORC gathers W-9s from vendors for tax
identification purposes. MEORC contracts
with an outside accounting firm to
prepare the year-end 1099’s. As
required, MEORC annually distributes
1099s to vendors.
File Management
MEORC manages files to ensure timely
availability of payment and invoice data
and compliance with governmental
auditing standards.
Accountant Communications
MEORC transfers fiscal data monthly to
an outside contractor accounting firm.
MEORC communicates effectively with the
accounting firm to ensure accurate and
timely preparation of financial
statements.
Documentation Reviews
MEORC conducts monthly random reviews of
Supported Living provider documentation
to ensure that payment for services is
in accordance with documentation of
services.
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Special Enterprise Investment
Fund
Core Product: Special
Enterprise Investments
Value Added Benefits:
SPECIAL ENTERPRISE INVESTMENT
FUND – COMPREHENSIVE PRODUCT
DESCRIPTION:
CORE PRODUCT/SPECIAL ENTERPRISE
INVESTMENTS:
MEORC establishes investments on behalf
of member boards to enhance the
authorization by ORC 5126.05 of county
boards to coordinate, monitor, and
evaluate existing services and
facilities available to individuals.
Member boards pursuant to various ORC
sections have responsibilities and
authority concerning the development of
supported living, and other services.
Investment Services
MEORC invests county board funds in
accordance with MEORC policies and
applicable laws. Minimum participation
is $10,000.00 for the initial
establishment of the enterprise
investment. Interest earnings on such
investments are available for use at the
discretion of the member board. MEORC
provides investment status reports to
members. MEORC will work with Merrill
Lynch to invest within parameters of
public funds laws.
MEORC employs a certified public funds
investment manager as required for
current investment opportunities.
VALUE ADDED BENEFITS:
Interest Retention
Enterprise funds provided by a member
board, including any interest earned on
such funds, shall be obligated and
expended by MEORC with the prior
approval of that member board.
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Waiver Management (See Diagram
#1)
Core Product:
Waiver Management
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Packet Review
-
ISP Fiscal Analysis
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PAWS Development
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PAWS Upload to ODMRDD
-
Utilization Review
Value Added Benefits:
-
File Management
-
Provider Selection Assistance
-
Technology Support
-
Website Updates
-
Countywide Fiscal Analysis
-
Patient Liability Administration
-
External Reviewers
-
Policy and Procedure Development
-
County Contact Meetings
-
Liaison
-
Training and Technical Assistance
WAIVER MANAGEMENT -
COMPREHENSIVE PRODUCT DESCRIPTION:
CORE PRODUCT/WAIVER MANAGEMENT CYCLE:
MEORC implements a system of waiver
management services to assist member
boards with the administration and
coordination of Medicaid local
administrative authority in accordance
with 5126.05.5 (ORC).
Packet Review
MEORC staff members conduct external
quality reviews of every referral packet
submitted by member boards. MEORC staff
members work with member board staff to
resolve issues uncovered during the
packet review. This quality review
ensures consistency of assessments,
plans and service levels, as well as,
compliance with rules and regulations.
Upon completion of the review on
referral packets, MEORC staff members
submit, track and monitor the required
documents to ODMRDD for eligibility
processing.
ISP Fiscal Analysis
MEORC staff members conduct external
fiscal analysis on every referral packet
submitted by member boards. MEORC staff
members work with member board staff to
resolve issues uncovered during the
fiscal analysis. The fiscal review
ensures ISP service levels, cost
information and Payment for
Authorization of Waivers Services
(PAWS), as well as, compliance with
rules and regulations.
Upon completion
of the fiscal analysis on referral
packets, MEORC staff members communicate
with certified providers to confirm
rates, service levels (i.e. ratios), and
terms of service contracts.
PAWS Development
MEORC staff members perform data entry
of PAWS for referral packets submitted
by member boards.
MEORC prepares PAWS
and notification of change in status
forms (NICS), to ODMRDD and as
applicable ODJFS, when the following
circumstances affect individual
services: (a) suspension of waiver
services due to institutionalization,
(b) change of address, (c) change in
waiver type and (d) transfer out of
county.
PAWS Management
MEORC staff members submit PAWS to
ODMRDD for referral packets from member
boards. MEORC staff members coordinate
and track the receipt of PAWS
confirmations from ODMRDD.
In accordance
with rules and regulations requirements,
MEORC maintains a routine and systematic
approach for tracking, preparing and
distributing of PAWS confirmations to
providers and individuals receiving
services.
MEORC maintains a routine and systematic
approach to ensure consistency between
ODMRDD confirmations and PAWS
submissions.
MEORC serves as the waiver contact for
member boards in relations with the PAWS
and waiver units at ODMRDD. Aligned with
this function are the follow-up,
communication and analysis of PAWS
issues and discrepancies to ensure the
expedited processing of PAWS for
individual receiving services.
Utilization Review
MEORC reviews utilization reports from
the database and alerts SSA of
discrepancies. This review does not
involve an examination of provider
documentation. The reviews are conducted
through the use of the collaborative
member boards and MEORC database.
The
technology review process compares
units, rates and ratios billed to ISP
authorized services.
MEORC coordinates
Gatekeeper training, initial and
ongoing, for SSAs relative to printing
utilization reports and interpretation
of reports.
MEORC imports waiver
provider billing information from the
ODMRDD on-line Medicaid billing system.
MEORC updates the utilization details
from waiver providers in the
collaborative database for easy access
from member board locations.
VALUE ADDED BENEFITS:
File Management
MEORC maintains case files, provider
files and fiscal files for member
boards. The file development and
maintenance is coordinated by MEORC in
order to retain supporting documents for
external review of member boards.
Provider Selection Assistance
MEORC communicates with member board
staff to coordinate provider selection
needs upon receipt of non-renewal
contract notices from the providers or
the individuals that are receiving
services. When requested, MEORC updates
the individual profile section of the
agency web site to solicit needed
providers.
Technology Support
MEORC reviews and grants access to
OhioMRDD.com which is a communication
vehicle for the service providers and
the individuals that receive services.
Upon request, MEORC reviews and grants
security to the collaborative database
applications for member boards.
MEORC maintains aspects of the
collaborative database of vendors,
member board staffs and service
providers. In order to facilitate a
current and accurate collaborative
database, MEORC monitors replication
between county boards and MEORC.
The consistent integration of member
board and MEORC information is a core
value that drives the need for effective
technology. MEORC maintains financial
responsibility for the annual database
license agreement for residential
modules of the collaborative database
software.
MEORC utilizes technology for surveying
as a method to ensure timely
coordination of meetings, services, new
product developments and feedback loops.
MEORC utilizes and is financially
responsible for a conference line that
facilitates effective and efficient
alternatives for meetings.
Web site Updates
MEORC
develops and maintains an agency web
site to facilitate information sharing
among stakeholders. The following areas
are updated as necessary to ensure the
availability of timely information:
announcements and notices of trainings,
meetings; Frequently Asked Questions
(FAQs); relevant information for
individuals, guardians, and families;
County Board links; and ODMRDD and other
agency links.
Countywide Fiscal Analysis
MEORC successfully ensures compliance
with audit (Federal and State)
requirements. MEORC verifies the receipt
and deposits of funds received on behalf
of county boards.
MEORC assists member
boards in the accurate tracking of
residential funding allocations. MEORC
assists member boards in assuring the
accurate calculation of match funds for
waiver services and local commitment
analysis. The development and
maintenance of residential projections
aligns with this function.
MEORC contracts with an external CPA
firm to ensure the effectiveness of
internal controls.
MEORC conducts analysis of financial
statements as prepared by external firms
to ensure consistency with communicated
information.
MEORC represents over 20% of the 88
counties in the State which provides
access to and influence in the fiscal
analysis impact from rule changes. The
fiscal analysis involves various tiers
of information, countywide, MEORC-wide
and statewide.
Patient Liability Administration
MEORC manages the Medicaid
administrative functions related to
patient liability for applicable waiver
individuals. This function involves
database updates, analysis and
distribution of ODMRDD monthly patient
liability updates to county boards and
providers.
External Reviewers
MEORC serves as an external control
mechanism for member boards. MEORC
maintains the ability to remain one-step
removed from the member boards to ensure
that quality, impartial information is
available in the management of waiver
administration.
Policy and Procedure Development
Assist with the development of updated
policy and procedures related to member
board’s waiver administration in the
residential service arena.
Advise member
boards regarding pending rules and their
predicted impact on local delivery
systems and on applicable policy and
procedures.
County Contact Meetings
Coordinates and facilitates routine,
update, and training meetings for
stakeholders to assist with the
successful administration of residential
waiver management. These meetings also
provide an avenue for networking with
other MEORC member boards. MEORC
arranges for CEU availability for staff
attendance to assist in maintaining
certification as ODMRDD approved growth
credits.
Liaison
With current participation of members,
MEORC represents over 20% of the 88
counties in the State, which
additionally provides a combined voice
to assist with change at the State
level. MEORC leadership staff serves as
representatives on State level
workgroups.
MEORC communicates on behalf
of the members with providers, ODMRDD,
ODJFS and OACBMRDD.
Training and Technical
Assistance
MEORC coordinates and conducts training
for stakeholders in an effort to assist
members with the successful management
of residential waiver administration.
Some areas of training include, but are
not limited to, billing, provider
requirements, documentation, waivers,
fiscal impacts and rule changes.
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