Medicaid Messenger

Open Service reports for the end of the 2025-2026 school year will be sent out to districts the week of September 7th.

Services from the 2025-26 school year that are still 'Open' in MISTAR will need to be marked Ready to Bill no later than October 9, 2026. Completing this important step, will allow the Medicaid Team to submit your billing to the state, which benefits your district's reimbursement percentage.

Follow these steps to make your 'Open' services Ready to Bill:

• Sign into MISTAR Q and click All for the Track to access your 2025-26 Service Tracker Caseload.

• Billings with the non-billable service code must also be made Ready to Bill.

You are required to complete this form and include it with every Medical Plan of Care and Amendment that is completed for each of your students, regardless of Medicaid eligibility.

When completing the Authorization for Medicaid Services form, refer to this guidance as you develop a draft.

Medicaid Details Section:

At the time of this meeting, was the student's age 0-20 years old?

• When you answer Yes, continue to the next question.
• When you answer No, Validate, print then sign and date the form for filing. Students age out of the Medicaid School Services Program on their 21st birthday.

• When the student receives one or more direct or direct/consult ancillary support service and/or Personal Care services, you must answer Yes.
• When the student has no direct or direct/consult ancillary support service, you must answer No.

• When the student's IEPT indicates Yes, for the question: Is the severity of the student's impairment such that it requires hands-on assistance with daily living skills, redirection and behavior, or health related (not academic) monitoring or cueing by a paraprofessional aide, you must click the Yes check box on the Authorization form.
• You will then include the specific service(s) that the student needs by selecting options from the drop down under the Personal Care Services heading. The student's aide will need to be informed of what service(s) they will be providing and tracking on their Personal Care Services Monthly Activity Log and billing for in Service Tracker.
• When the No box is checked on the IEP, you must also check the No box on the Authorization for Medicaid Services form.

Medical Plan of Care Details

Check the box next to the Type of Meeting that was held, and the date of the meeting.

The Annual Notification and One-Time Consent to Bill Medicaid

Continue to complete the form by providing the parents with the Annual Notification Regarding Parental Consent form, which is for their records, and check the box indicating that the form was presented to the parent/guardian.

Medicaid Consent to Bill Status

Verify if the student has a One-Time Consent to Bill Medicaid by checking the student's Service Tracker screen. Check the appropriate box regarding whether the student has the One-Time Consent in MISTAR, or if they do not. If the student does not have the One-Time Consent on file, work with the Case Manager (Special Education Teacher) to ask the parents to provide their Consent to bill Medicaid.

Qualified Medicaid Provider

The list of LARA licensed staff who meet the requirement of a Qualified Medicaid Provider depends on whether Personal Care Services are ordered in their Plan of Care, or not. The full list is included below in a side-by-side comparison of who is considered qualified without and with Personal Care Services listed on the Authorization form.

Students who receive Direct Nursing Care, OT, PT and/or Orientation and Mobility Services require signed written orders or a signed prescription for your services. The orders/prescription must include the signature, date, signing practitioner's address and their NPI number (National Provider Identification number). Signing practitioners include: physician, physician's assistant, nurse practitioner or clinical nurse specialist.

All written orders and prescriptions must be forwarded to the Medicaid Team via secure email. To access the secure email, simply email a member of the Medicaid Team to request a secure email link.

Details from the written orders and prescription are entered on our end of the billing system. When, your billings marked as "Ready to Bill" in Service Tracker, they are linked to the authorizing signer's NPI number, which is what allows your monthly submissions to flow through to the State.

Tips for written orders and prescriptions:

1. Combine needed services onto one prescription form. Students who need OT/PT and or Orientation and Mobility services can have any combination of these listed on a single prescription form.
2. Students who have medical and health conditions that require nursing services have medical directions/orders for the student's treatment, testing, or care. Forward a copy of your orders via the secure email process.
3. Physical Therapists must obtain a prescription prior to providing services. Forward a copy of your prescriptions via the secure email process.
4. Occupational Therapists and Orientation and Mobility Specialists can request help from the Medicaid Team in obtaining the required prescription when having difficulty obtaining from the family.
5. Students on your caseload, who have the One-Time Consent and are Medicaid eligible should also have a visible prescription or referral in the Student NPI section for your Service Tracker.

*Speech and hearing services require a referral, which the Medicaid Team obtains for Wayne County.

1. 48 hours before your assigned survey moment, you will receive an email from

MIAOP@PCGUS.COM.

2. You will then have 48 hours to complete and submit your survey, which is now a hard deadline.

• If you do not submit your survey within the required 48 hours, your survey will count against the reimbursement funding that flows back to the district or academy for your services.

A link to quick tips and a training video on how you can successfully complete and submit your survey responses for RMTS is included below.

If you need assistance, have questions or would like to schedule training, please contact a member of the Wayne RESA, Medicaid School Services Program Team.

Feel free to contact us with any questions.

We're here to help!

Michelle Maxfield - (734) 334-1461 ~maxfiem@resa.net

Leanne Smith - (734) 334-1464 ~smithle@resa.net

Tia Williams - (734) 334-1397 ~williat@resa.net