Ohio Admin. Code 3701-8-09 - Criteria for reimbursement of home visiting services
(A) Home visiting
services shall be reimbursed per the terms and rate set forth in the provider
agreement. Minutes of service provided to an eligible individual will be
aggregated by covered services in accordance with paragraph (B) of this rule,
within each day. The number of units of covered services is the total minutes
divided by fifteen plus one additional unit if the remaining number of minutes
is at least eight minutes, for each covered service.
(B) Provider shall accept reimbursement for
all reimbursable services as payment in full. Services shall be reimbursed
when:
(1) The provider is qualified in
accordance with rule
3701-8-03
of the Administrative Code;
(2) The
home visitor delivering the service meets requirements for education and
training set forth in rule
3701-8-04
of the Administrative Code;
(3) All
required data prescribed by the Administrative Code is entered into the
statewide data system and approved by the assigned supervisor of the individual
delivering the service. The supervisor shall serve concurrently as the billing
approver to ensure accuracy and quality of services delivered;
(4) The service for which reimbursement is
sought is allowable under paragraph (C) of this rule and are clearly identified
in the family goal plan or record.
(C) Reimbursable home visiting services
include:
(1) Preparing materials and
information for a completed home visit;
(2) Conducting assessments, including the
administration of approved screening tools, monitoring, and follow-up with
families during a home visit, in accordance with timeframes specified within
provider agreements;
(3) Developing
and managing a family goal plan during home visits, when such goals are related
to the program goals;
(4)
Department approved parenting education curriculum provided to families during
home visits;
(5) Referral and
referral follow-up activities facilitated by the assigned home visitor to link
families and caregivers to services that address identified goals or needs in
the family goal plan or record;
(6)
Traveling to and from the home visit; when the home
visit is successfully completed;
(7) Documentation and data entry into the
statewide data system.
(D) Providers may be reimbursed up to the
department caps set forth in the provider agreement.
(E) Activities not reimbursable for
home visiting services include, but are not limited to:
(1) Time spent in
training;
(2) Time spent in
supervision;
(3) Time spent on activities for a
home visit that was not successfully completed;
(4) Time spent on administrative
task or duties;
(5) Vacation leave, sick leave or
other related benefits.
(1) The
activity
service that was provided;
(2) The date inclusive of day, month, and
year that the activity was provided;
(3) The first and last name of the individual
for whom the activity was provided;
(4) The duration in minutes or time in and
time out of the activity provided; and
(5) The signature or initials of the person
delivering the service on each entry of service delivery.
Notes
Promulgated Under: 119.03
Statutory Authority: 3701.61
Rule Amplifies: 3701.61
Prior Effective Dates: 09/03/2012, 07/01/2018
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