Frequently Asked Questions

Funds - Receiving / Spending

• Where does Third Party Billing money come from? The Third Party Billing Program is designed to recover health care costs from Medicaid for health care services rendered to Special Education students eligible for Medicaid. We bill Medicaid for the service coordination of all activities outlined in the IEP. A portion of these funds is returned to the schools and is directly proportional to the number of case management encounter forms submitted to Third Party Billing during the previous school year.
• What type of items can we buy with Third Party Billing funds? Third Party Billing funds must be utilized for Special Education and Health Related Services. This can include hiring contractual staff, or purchasing supplies, materials, and equipment that will enhance the special education program.
• When will we be notified to how much money our school will have to spend? Your school will be able to access your Third Party Billing funds during the month of September. A letter and a copy of The Administrator's Guide to Accessing Third Party Billing Case Management Funds will be sent to your Principal. Please keep in mind that the action plan and purchase orders must be submitted on or prior to April 5, 2007.
• How do you determine the amount of reimbursement that is returned to each school? The amount of reimbursement that is returned to each school is directionally proportional to the number of case management encounter data forms submitted to Third Party Billing during the previous school year.
• Will our action plan be submitted to the Area Assistant Superintendents of Schools? No, your completed action plan will be submitted to the Office of Third Party Billing for approval. An approved plan is required before making any purchases or hiring contractual staff.
• What is the deadline for using our Third Party Billing funds? All purchase orders must be received in the Office of Third Party Billing by the close of business, April 5, 2007.
• Does this money go into our local budget? No. Medicaid regulations will not allow this money to be co-mingled with the local budget. All funds recovered from Medicaid must be spent according to Medicaid guidelines. Therefore, there is a separate budget for all funds recovered from Medicaid.
• Can our school get reimbursed for purchases already made? An approved action plan is required before making any purchases. Third Party Billing will not reimburse for items previously purchased using another funding source. This includes procurement card purchases.
• Can we access this money using a procurement card? No, Third Party Billing will not reimburse for items previously purchased using another funding source. This includes procurement card purchases.
• Can we use our Third Party Billing funds to pay for a conference for a special education teacher? Yes, Third Party Billing funds may be utilized to pay for a conference for a special education teacher, if the conference is designed to improve the delivery of special education services in the school.
• Can we use our Third Party Billing funds in order to pay for mailings to parents of special education students? You may use your Third Party Billing funds to pay for mailings to parents; however, this is a tedious and cumbersome process. It is suggested that you use these funds for hiring contractual staff, or purchasing supplies, materials, and equipment that will enhance the special education program.
• Last year, we did not spend all of our Third Party Billing funds. Do these funds carryover? Third Party Billing funds do not carry over from year to year. For the 2006-2007 school year, all action plans and purchase orders must be forwarded to the Office of Third Party Billing on or before April 5, 2007.
• When will we be able to spend our Third Party Billing Funds? Your school will be able to access your Third Party Billing funds on or about September 29, 2006. A letter and a copy of The Administrator's Guide to Accessing Third Party Billing Case Management Funds has been sent to your Principal. Please keep in mind that the action plan and purchase orders must be submitted on or prior to April 5, 2007. If you need additional help, please call the Office of Third Party Billing at 4130.
• Can we use our Third Party Billing funds for additional clerical support for IEP team information? Yes, many schools choose to use Third Party Billing funds to hire contractual staff to support the special education or health services program.
• We want to set aside a certain amount of funds for subs for IEP Team meetings. Let us suppose that in March we determine that the estimated expenditures are too high. Can we make adjustments? Yes, you may make adjustments to your funds. Just remember to send a new action plan to the Office of Third Party Billing explaining the change of use for your funds, and also remember to complete the new plan for your funds and attach purchase orders to your action plan. Please keep in mind that all action plans and purchase orders must be forwarded to the Office of Third Party Billing on or before April 5, 2007.