I completed a client intake packet when we started services, am I required to update this paperwork?
Yes, as standard of care across all medical facilities, client paperwork is required to be updated annually.
What happens if I over-utilize my authorized hours?
The client or guardian assumes all financial responsibility for hours exceeding authorization. As such, it is critical that both the provider and the parent monitor authorization usage.
What do I do when my authorizations expire?
You should contact the insurance carrier responsible for funding services immediately. While some payment sources like DDD may backdate authorizations, many private insurance carriers will not not.
How many hours per day can I bill of habilitation?
The maximum number of hours a provider can bill for habilitation is 8 hours. There should, however, be breaks in the services for both the client and the provider. Timesheets exceeding 6 hours without a break will be flagged for review and may not be processed.
How many hours per day can I bill of respite?
The maximum number of hours a provider can bill for respite is 11.75 hours in one calendar day.
If I need a respite provider for extended periods, can I request a respite day authorization?
Respite day authorizations (or RSD) can be requested if you intend on exceeding 11.75 hours in a single respite session. Please contact the office for more information.
I am looking for a habilitation and/or respite provider. What can I do to facilitate the process?
I was notified that my insurance company was changing, who do I need to contact?
Because most benefit plans require pre-authorization, you should contact our Insurance billing department, immediately to discuss a transition plan. Failure to do so may result in denials which in turn will be patient responsibility.