Date Revised: November 3, 2015Connecticut Birth to Three System
BIRTH TO THREE SYSTEM INVOICE SUBMISSION AND RECONCILIATION PROCESS
Programs must sign off in SPIDER by the 15th of each month and send an email to to notify the fiscal office that this was completed. For your records, save copies of the invoice and related reports before sending the email and anytime changes are made. After the 15th of the month, the fiscal office will contact programs that have not sent an email indicating they have signed off.Invoices not signed off by the 15th of the month delays the billing of insurance and the issuance of the Family Cost Participation invoice.
Include in or attach to the email other supporting documentation including Birth to Three case numbers. Examples of supporting documentation include reasons for supplemental hours over those authorized, Team Meeting hours if a child received 20 hours or less of direct services, assistive technology form 3-12 and backup and explanations for "Other". Any child specific information can be securely right faxed to 860-920-3156.
Programs should make sure that the amountentered on line K. Insurance Receiptsmatches the number BPS/Summit lists in SPIDER see the Payment Procedure for more information.
Upon receipt of the signoff email the fiscal staff will, as quickly as possible, take a snapshot of the data by saving pdfs of the invoice, units report, and supplemental summary report as needed. Note that emails received after 3:00 p.m. will not be processed until the next business day. Once the reports have been saved, the fiscal staff will email the program that the pdfs were saved.
To avoid confusion, programs should wait to enter any billing related data for the month being reviewed until they receive an email from the State Comptroller’s Office, “Apd, Osc ”,confirming that an invoice has been entered into CORE for payment. Programs can enter data for the current month without impacting the month being reviewed.
Communication with Birth to Three Fiscal Staff
The reconciliation process described on the pages that follow must be completed by the program prior to saving and signing off the invoice in SPIDER. The fiscal office will follow this process as well, using their saved reports. If any discrepancies are found during their review, the program will be notified via email using the Birth to Three Reconciliation Memo on page 10.Processing of the invoice will stop until the data has been corrected.
Once changes are made, programs andthe fiscal office will save updated versions of the invoice and report(s). Any questions about where an invoice is in the process should be emailed to . Once an invoice has been entered into CORE for payment, an email from “Apd, Osc <>” isautomatically sent to programs. This may not be to the Birth to Three program office if there is another email address in CORE.
RECONCILIATION PROCESS
In SPIDER on the Invoice Processing Screenselect the correct YR/Month and click the first three buttons at the bottom of the screen in order Left to Right.
Remember to save reports and invoice. Compare the Units Report (a.k.a. Attendance Count / ProgramMonthlyUnitsBreakout.rdl) against the Invoice as follows:
Continued
For each case, data must exist in each column except for the exit date. If an exit date exists, it must be after the current billing month. If the exit date is in the current billing month, the program must change the attendance status to Discontinued before signing off and rerun reports.
If you find a 1st service date is in the billing month the attendance status must be changed to New before signing off and rerunning reports. This is important for families paying Family Cost Participation fees that the attendance status of Continued not be used if the 1st service date is in the current billing month.
New
For each case, data must exist in each column except the exit date. The 1st service date must be in the current billing month and after the Physician’s signature date. If the 1st service date is not in the current billing month the attendance status cannot be New and must be corrected on the attendance grid before signing off. There should be no cases with 0 units. For further guidance on attendance status codes, please see the table on page 9 of the Payments to Programs procedure.
Discontinued
For each case, there must be an exit date in the current billing month and it must be before the child’s 3rd birthday. If the family exited and the date is missing it must be entered before signing off the invoice. If the exit date is in a month other than the current billing month the attendance status must be changed to the correct option before signing off so the record does not show up as Discontinued in the current billing month. If this doesn’t fix the error, check the exit tab in the child’s file, and update.
At the SPIDER home screen there’s a link labeled Show Over 3 and Missing Transition ConferenceThat will give you alist of children over 3 that need to be exited in the current month.
Eligibility (Evaluation Only)
For each case, the evaluation column needs to be completed with a date from the current billing month. If the date is missing or from another month, the data must be corrected on child’s tab within the child’s file and/or attendance grid before signing off so the record does not show on the Evaluation Only page. It is important to check that evaluations and assessments have been entered on the EVL line with either an X or A (or setting code - not an I).
Autism-Specific Programs(Assessment Only)
If a child has already had an eligibility evaluation, the date in the evaluation column will be the date the evaluation was completed and will not reflect the date an autism assessment was completed. Check to be sure only one evaluation unit has been calculated for the child. If there is a record with 0 units contact to explore the reason.
Transfer In and Transfer Out
A child with a status of Transfer In must have an IFSP review “R” before direct services begin.
For each case, all columns except the exit date should be completed. Check that the totals match the invoice. If you are transferring a child to a different program, do not select Transfer Out unless there has been a month were the attendance status was New. A record cannot have an attendance status of Transfer In or Transfer Out until AFTER a month in which the attendance status was New. If SPIDER is not working, confirm that the Initial IFSP, MD signature and a New attendance status have all been correctly entered. Submit questions to with SPIDER in the subject line. If enrollment was reactivated and transferred to another program, you may need to use Transfer Out even if the record was previously Discontinued.
Services at No Cost + Services at No Cost – Exit
This unit will only be paid for children whose family is responsible for a family cost participation fee and have chosen to only receive those services available to them at no cost or children that have been suspended due to nonpayment of family cost participation fees.
The number of children and units on both pages should be added together to come up with the total number of units billed by the program for Services at No Cost.
Pending / NA
The unit reports may include this data but it does not impact billing.
Pending will include determinations completed during the month that were not made based on an actual evaluation (Cannot locate, Parent refused, Turned three, etc.)
NA is for children that have been found eligible during a previous month. It is also used when only the initial IFSP meeting is held and no direct services are provided or when no initial IFSP meeting is held during this month (between Eval Only and New). The eligibility information must indicate that the child is “eligible”. This does not impact billing except that the record will appear on the IFSP Meeting page if the initial IFSP was held during the month. Please review this report to ensure children are listed here correctly.
Initial IFSP
First, check that there is an INITIAL IFSP date in the current billing month. If there is no date or the date is in a different month, correct the IFSP data on the IFSP tab before signing off.
NOTE: Programs can enter and save an IFSP without a Physician’s signature. The Physician’s signature is not required to be paid for an IFSP it is only required for an attendance status of New.
Then look for the following Issues:
- If the IFSP date and the Evaluation date are the same and the child has a diagnosed condition there must be a “Y” in the “D" column to indicate a Diagnosed condition. If the IFSP and Evaluation occurred on the same day, the IFSP should be entered on the IFSP tab and a service line added to the attendance so the “I” for the meeting can be entered on the same day while the “X” is entered on the EVL line
- If the IFSP date is after 45 days from Enrollmentand there is a documented Family reason for the delay in the record there must be a “Y” in the “F” column.
- If the IFSP date is after 45 days from Enrollment and there is no documented Family reason for the delay in the record and a unit appears on the report, then an adjustment should be made under “Other”. Please indicate the Birth to Three case number in the signoff email to .
If either is true and the “Y” is not present on the report, correct the data as appropriate before signing off. If there is no “I” in attendance, the child’s name will not appear. Use IFSP report to check this.
The current version of this report may not consistently show records when the data does not support receiving a unit for the initial IFSP meeting. If the number of children on the invoice does not match the number of units, please double check the data for all the children who had initial IFSP meetings in the month. That list can be found by using the IFSP report named “IFSP Entered for A Date Range”
Supplemental Reimbursement for Intensive Services
Under the Invoice Processing Screen click the button labeled Supplemental Summary Rpt
For any child that receives 20 hours or less of direct services for the month, please indicate in the invoice signoff email to if a team meeting was provided and if so, how many hours. This will help fiscal determine if the threshold hours were met and the supplemental hours were calculated correctly.
For General & Hearing Specialty Programs
There must be an approved contract supplement request on fileat the lead agency prior to the submission of the invoice for the month in which the intensive services are provided. This process has been automated in SPIDER and pulls the data that already exists regarding the child. Please check whether the total number of hours provided exceed those in the IFSP as listed on the report. If they do, submit the reason (make-up visits, etc.) in the invoice signoff email to .
If a Contract Supplement Request is in place and 13 hours of service have been provided then hours added due to missed visits can be submitted in the invoice with a note indicating the reason for the additional hours. Conversely, if 13 hours of service were provided not including makeup time, then any hours added for missed visits would not be payable unless a Contract Supplement Request is in place.Additional hours being added for missed visits can be noted in the IFSP but should not be entered into Section 8 of the IFSP.
Occasionally a family may receive more than 13 hours of direct services in a long month and there is not an approved contract supplemental request on file, this explanation should also be included in the invoice sign off email .
For Autism-Specific Programs
Check the report to be sure the total hours reported, minus team meeting hours does not exceed 80 hours. If the 80 hours are exceeded, there must be an approved contract supplement request on file at the lead agency for the period being billed or the explanation for hours over 80 must be included in the invoice signoff email sent to . Please see below for further information regarding valid explanations for hours over 80 and for IFSP’s written for more than 80 hours.
The Birth to Three Payment Procedure states that:All autism-specific programs must submit a Contract Supplement Request via SPIDER for children receiving more than 80 hours of direct service per month in order to submit an invoice for payment of these hours. Hours for team meetings will not be counted toward the 80 hours.
In order to assure timely payment of your invoice and to reduce confusion around supplemental hours we are requiring that when an IFSP is written for over 80 hours of direct service that the program submit a supplemental request through SPIDER and receive approval prior to submitting the invoice for that child’s services. No matter how many hours are provided. The supplemental request should be submitted with enough time to complete the approval process if there is a need for additional information.
If a Contract Supplement Request is in place and 80 hours of service have been provided then hours added due to missed visits can be submitted in the invoice with a note indicating the reason for the additional hours. Conversely, if 80 hours of service were provided not including makeup time, then any hours added for missed visits would not be payable unless a Contract Supplement Request is in place. Additional hours being added for missed visits can be noted in the IFSP but should not be entered into Section 8 of the IFSP.
Issues with SPIDER
In some cases the discrepancy may be related to an issue with SPIDER. Programs should
a)check that all the related data are accurate,
b)check the month prior to assure a correct status flow, it’s possible that the previous month’s status was incorrect and is contributing to the problem in the current month,
c)save any Attendance changes,
d)reprocess the units and
e)save the invoice.
If the problem did not resolve, any questions about the data system should be submitted to . with “SPIDER” in the subject line.
Please contact the fiscal staff if you have any questions:
Mary Coyle 860-418-8714
Kathy Granata 860-418-6146
Secure right fax 860-920-3156
Please see the following for further information:
-Birth to Three System’s website for information regarding SPIDER, click For Providers, click SPIDER Video Manual, and click SPIDER Overview video.
-Program Procedures: Payments to Programs, Transfer Between Programs and Assistive Technology
-Contract in general and specifically Section 1-8a for fiscal obligations if attendance is not signed off by the 15th of the month.
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