health & human services local health department/district medicaid administrative claiming (mac)
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Welcome to the. Health & Human Services Local Health Department/District Medicaid Administrative Claiming (MAC) Overview. The Purpose of MAC. - PowerPoint PPT PresentationTRANSCRIPT
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Health & Human Services
Local Health Department/District
Medicaid Administrative Claiming (MAC)
Overview
Welcome to the
The Purpose of MACTo provide Local Health Department (LHD’s)
the opportunity to submit reimbursement claims for administrative activities that support the Medicaid program such as: Medicaid Outreach Medicaid Referral, Coordination, and Monitoring Medicaid Transportation and Translation Medicaid Provider Relations
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The Benefits of MACGenerate Revenue from MAC claim
submission
Dedicated to the provision of health services
May be used to enhance services at the LHD’s by improving and/or expand the level and quality of
health/medical services provided to clients within the community
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MAC Process
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Determine who performs MAC
activities
Determine who performs MAC
activities
Determine how much
reimbursable activity is performed
Determine how much
reimbursable activity is performed
Determine actual costs
associated with these activities
Determine actual costs
associated with these activities
Apply reimbursement rates (TS, MER,
IDCR) to calculate a claim
Apply reimbursement rates (TS, MER,
IDCR) to calculate a claim
Participant ListParticipant
Identification
Participant ListParticipant
Identification
Random Moment Time Study
Random Moment Time Study
MAC Financial Data CollectionMAC Financial Data Collection
MAC Claim CalculationMAC Claim Calculation
How to get started in MACInteragency Agreement
Direct Deposit Form
Vendor Information Form
Payee Number Application
http://www.hhsc.state.tx.us/rad/mac/mac-contracting.shtml
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MAC Financial Contact Responsibilities
Serve as financial liaison between HHSC & Fairbanks LLC Must attend MAC Financial Training at a minimum
annually Enter, verify and certify the MAC financial data on the
system Certify, notarize and submit quarterly MAC financial
reports Maintain financial documentation and supporting materials Must be listed as the primary MAC Financial Contact Trained Financial Contacts must maintain the accuracy of
ALL Contacts in the cost reporting system
What Cost can I report?• Compensation
Entity Employee Salaries Payroll Taxes & Benefits
Only Report “True” Expenditures If your entity sets funds aside for future Workers
Comp claims then these “set aside” funds are not true expenditures.
Contracted staff
• Revenues (Federal Revenues offset expenditures)
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Mr. Higgins, CPA
Functional Reporting
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There are two options to enter financial data:
1. Participant Detail (Preferred) • Detailed basis by individual position
2. Group Summary• Provider category summary
• Categories as entered on the participant list
• If your entities enters at this level, they must keep the detail by position/individual in the audit documentation file.
Detailed Worksheet
Psychologists and Interns
Bob Employee
Joe Employee
Mary Contract Staff
Registered Nurse (RN)
Salaries 30,000
Benefits 6,000
Purchased Svcs. 8,000
Category Summary
MAC Financial Reporting MAC financial quarters will not be opened
unless the following requirement are met:
Active contract with HHSC Appropriate MAC & RMTS training for the FFY RMTS Requirements are met
If you are unable to access the quarter, please contact the MAC team via email at:
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Important Notice LHDs participating in MAC
Please be aware that costs associated with MAC activity and claimed on the MAC claim may not be included as part of the cost report submitted for reimbursement under the Texas Healthcare Transformation and Quality Improvement 1115 Waiver Program.
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Time Study PeriodsFederal Fiscal Quarters
1st Quarter - October, November, December
2nd Quarter - January, February, March3rd Quarter - April, May, June4th Quarter - July, August, September
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Important Dates for MAC Claim Submission
Date Event Description Open Date Close Date1st Quarter MAC Financials 02/18/2013 04/05/20132nd Quarter MAC Financials 05/27/2013 07/12/2013
3rd Quarter MAC Financials 08/19/2013 10/04/2013
4th Quarter MAC Financials 11/25/2013 01/10/2014
All important information, notices, claim due dates, etc can be found on the
following website: http://www.hhsc.state.tx.us/rad/mac/mac-lhd.shtml
This information along with additional updates may also be found on the Dashboard page of STAIRS web system.
Contacts Medicaid Administrative Claiming – (512) 491-
1802 – [email protected] (MAC Email Box) http://www.hhsc.state.tx.us/rad/mac/index.shtml (MAC Website)
Yvonne Moorad - Team LeadSandra Brabandt - LHDs
STAIRS (State of Texas Automated Reporting System) & Website Questions – [email protected]
Fairbanks Hotline: (888) 321-1225
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