Important Update for Service Providers: Billing for April 2020

April 30, 2020

Dear Service Providers,

On March 4, 2020, Governor Gavin Newsom declared a State of Emergency for California, as a result of the global COVID‐19 outbreak (otherwise being referred to as Coronavirus).  This memo will provide guidance to service providers for State of Emergency (SOE) billing for Los Angeles County.

When billing for the month of April 2020, providers may bill for nonresidential services and/or appointments that were not provided due to the precautionary measures for COVID‐19 or a direct relation to COVID‐19. We highly recommend that our providers keep clear documentation that supports the closure of your agency, cancelation of service, and SOE billing in the event of a future audit.  If your services have been impacted by COVID‐19 for the month of April 2020, please follow the billing guidance below. If you were not impacted by COVID‐19, bill as you normally would.

Residential Care Facility Providers

  • Bill for services and report scheduled absences as you normally

Day Programs, Supported Employment, Community Integration and Work Activity Programs

Follow these steps to bill for SOE related absences:

  1. Calculate the actual attendance for April
  2. Calculate the absences in April due to COVID‐19.
  3. Calculate the total absences during the 12‐month period prior to March
  4. Divide the 12‐month total absences (from Step 3) by 12. This provides the average monthly absences for this 12‐month period
  5. Take the absences due to COVID‐19 (from Step 2) and subtract the average monthly absences (from Step 4). The difference is the absence amount that you may bill for (it must be rounded to the nearest whole number and cannot be negative).
  6. Bill for the actual attendance during April (from Step 1) plus the difference between the absences due to COVID‐19 and the average monthly absences (Step 5).

Transportation Providers

  • Please follow the same procedure as above. If you have any questions, please contact Stancey Deluca. Her contact information is StanceyD@westsiderc.org.

Early Start Vendors, including Behavioral Services, Physical Therapy, Speech Therapy, and/or Occupational Therapy

  • You may bill for visits that were canceled due to COVID-19.
  • Bill the average monthly billable number of hours per client. Calculate the average monthly billable number of hours during the 12-month period prior to March 1, 2020 by calculating the total number of billable hours for that period and dividing by 12.
  • For service codes 025, 048, 077, 612, 613, 615, 616, 620, 625 and 680, the Parental Verification Form should include the statement “Billing average monthly billable hours as outlined in State of Emergency declaration.”

Supported Living Services and Independent Living Services

  • Bill the average monthly billable number of hours per client. Calculate the average monthly billable number of hours during the 12-month period prior to March 1, 2020 by calculating the total number of billable hours during that period and dividing by 12.

Additional Program Support

  • In the event that additional hours were needed to assist clients in residential care facilities, day programs or other services that were displaced and/or needed additional assistance, please contact the Service Coordinator for authorization.

ALL OTHER PROVIDERS INCLUDING RESPITE

  • If client services were canceled due to COVID-19, bill the average monthly billable number of hours per client. Calculate the average monthly billable number of hours during the 12-month period prior to March 1, 2020 by calculating the total number of billable hours during that period and dividing by 12.
  • If additional services were provided due to COVID-19, bill for the actual service hours provided.

For all providers billing services under this State of Emergency declaration, please enter a comment under the first billed line that states “Billing as outlined in State of Emergency”. If the State of Emergency related to COVID‐19 continues into April, we will issue a similar billing notice for that month.

Thank you for taking precautionary measures and assisting our persons served to remain safe and healthy during this critical time. If you have any SOE billing questions, please direct them to Stancey Deluca, at StanceyD@westsiderc.org or Nick Adolfo, at NickA@westsiderc.org.

Best Regards,

Danny Franco

Director de Finanzas

dannyf@westsiderc.org