Providers are responsible for many tasks; including but not limited to personal care, medication administration, transportation, documentation, billing, incident reporting, and ongoing training.
The County Board is available to answer questions and to ensure that all Providers are empowered to provide high quality services and supports to all individuals served.
We have a variety of resources and information available to assist you.
Electronic Visit Verification (EVV)
Providers of routine Homemaker Personal Care (HPC), Participant Directed Homemaker Personal Care (PD-HPC), and/or IO waiver nursing are required to use Electronic Visit Verification (EVV). Information about EVV can be found here.
Forms and Documentation
All services provided must be documented, and each service has its own documentation requirements. These requirements can be found in the Rule specific to the service being provided. Rules can be found here.
DODD does not require Providers to use one specific form to document services. Your forms can appear any way you would like but must contain all required elements.
The County Board has created sample templates for common services:
Invoices submitted for payment or billing records are not considered documentation. Providers must maintain their documentation for six years from the date of payment or until an initiated audit is completed, whichever is longer.
Billing and Submitting Claims
Providers must submit claims for services provided in order to be reimbursed. In order for a provider to be able to submit claims;
The provider must be certified to provide the service
The services are identified in an approved individual service plan (ISP) and the PAWS (payment authorization for waiver services) has been processed
The service has been provided and documented; and the claim is being submitted within 350 days of the service being provided
Each service is associated with its own billing codes and rate of payment, which can be found in the appendix to the service rule. It is the provider’s responsibility to ensure the accuracy of their billing. If you are not comfortable or able to submit your own claims, you can associate with a billing agent to submit claims on your behalf.
There are two methods to bill: single claim entry through eMBS or Monthly Rate Calculator (MRC) through MSS.
Independent providers will only bill through eMBS. Agency providers may use either eMBS or MRC depending on the service being claimed.
Billing agent information as well as additional information regarding claims and billing can be found through DODD.
Invoices submitted for payment or billing are not considered documentation. You must maintain your documentation for a minimum of 6 years or until an initiated audit is completed, whichever is longer.
Provider certification is valid for 3 years. In the 90 days prior to your certification expiring, you will begin to receive communication from DODD via email regarding your renewal. It is very important to submit your application for recertification in a timely manner so that there is no lapse in your certification that would prevent you from providing services or submitting claims for reimbursement.
The typical documents required for submission with your recertification may include but are not limited to the following:
BCII if not enrolled in Rapback
FBI if not a resident of Ohio for the last five years
Valid “American Red Cross” or equivalent CPR/First Aid Certification
Certificate or Transcript verifying completion of required training
As required by Rule
Car Insurance (only if certified in NMT and/or HPC Transportation)
Driver’s Abstract (only if certified in NMT and/or HPC Transportation)
Other documentation may be required depending on service certification renewals and/or additions and changes in demographic information
The instructions to complete the recertification application can be found on this document.