5
E xam le 1: ,,. .'..,jj =~:,: CJ Hfr,.,,://f'<I\W V ~ Go L,-lc » "I: U'"'"""'- .. Tennessee Early 1ntervention Data System 8 r1e,-r11 '.l'-11',i 9 , ........ e ri.,ii,, , 8 i;,.,, r 11'h-.-h"I,, 8 " rlobt1cor: ~I e ,IMJ'(-.4 t..u®ll-11. 8 Ir'"¥ e Ac:t-~'lt ~ ~,-ontc Q 8 ~Clt'.. fli llj 4} r,nlo1111 "- • 1 ,, ~, 8 'l"uu~ ~• , ,., . 8 l-'o::iltl-v'IIT1'TI1 . .m,~:bcn; 8 t(,U.IOOon 8 1•f1:11ri r:,td~f'l\UI 8 Lflilil i\c.--..ten sorvlco Loq lnlormatlon i (6.i0:Y2C07 .. S-:-1 , ,.,,. "':ll;MM c.·h1ld IIJ: J¾5tl lhlld Name/DUB: De·,ap \ 1 opfapt- Ll/'t•':S/£01:<l. Chlld !,tatu!i: ilctive- 1-'has:,e,: lfSI-' 5elect an JFSl•to Add service Loq (If It is not current IFSll) Llfole; (r lh111 ,;;urienl JfSP i:: 1,H:r,di'l'-l Q,-J 'f<Ju.- ~0:11,ice i~ ir, lh., .:,.1111::,-,~ IF:SP, 11ou ·1,ill ,, ~l te -11ble to 1m\e; ::11,1co log, tr-, th•~ c~:o pi4::.~ i:i oor,t:ct s;o,, ell! c::::o,dlr ~,;ot t~ fio~l1zca th Ill Jl's; ) Actr:I Gcrvir::n I og: "Scn,icc Providc1· Plnnncd Period Pl.rinncd SettinQ 'A,tu•I c;.-,muu "Sc,rviceNoto (--:: 10:0 ch.:Jr,)c\:e;1!: l (M,,1DD1'i'l'f',') fJ.;;.111~1~.1 ~ •Af:,~Pv· Du-::~,, Fdo11ili ,m ,I ,·;-,ii J ~ 1 AbBnc.e Du!:: b )-::1v l 1;1J Provi,Jr:r ~• uc,ShOI' (~ )Cl1clcunc0Dnl·r! Sf:lri.tlco Log t a . Jntcmtl:: Welcome to TEIDS Tennessee's Early Intervention Data System bttps://www. t ids.org/teid Vendor Accounts Payable Instructions Below are step by step instructions on "How to bill TEIS" for services rendered. At least one person will need to be designated at each agency to be responsible for the input of all requests for payment to the Central Reimbursement Office (CRO). In order to bill TEIS through TEIDS there must be a service log entered. Service logs are created and entered by the therapists/teachers that are administering the authorized individual or group services for our children. Each service log entry will create a corresponding accounts payable entry. Below is an example of what the service log entry may look like (Example 1). Page 1

Vendor Accounts Payable Instructions · The billing person from your agency will login in with user name and password into the TEIDS system. On the home screen (Example 3) a child

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Page 1: Vendor Accounts Payable Instructions · The billing person from your agency will login in with user name and password into the TEIDS system. On the home screen (Example 3) a child

E xam le 1: ,,.

.'..,jj =~:,: CJ Hfr,.,,://f'<I\W V ~ Go L,-lc » "I: •

U'"'"""'-.. Tennessee Early 1ntervention Data System 8 • r1e,-r11 '.l'-11',i 9 , ........ ~ e ri.,ii,,, 8 i;,.,, r 11'h-.-h"I,,

8 " rlobt1cor: or✓ Rcten ~I e ,IMJ'(-.4 t..u®ll-11. 8 Ir'"¥ e Ac:t-~'lt ~~,-ontc Q 8 ~Clt'.. fli llj 4} r,nlo1111 "- • 1,,~, 8 'l"uu~ ~•

,,., . 8 l-'o::iltl-v'IIT1'TI1 . .m,~:bcn; 8 t(,U.IOOon 8 1•f1:11 ri r:,td~f'l\UI 8 Lflilil i\c.--..ten

sorvlco Loq lnlormatlon

i(6.i0:Y2C07 ~ .. S-:-1 , ,.,,. "':ll;MM

c.·h1ld IIJ: J¾5tl lhlld Name/DUB: De·,ap \ 1 opfapt- Ll/'t•':S/£01:<l. Chlld !,tatu!i: ilctive- 1-'has:,e,: lfSI-'

5elect an JFSl•to Add service Loq (If It is not current IFSll) Llfole; (r lh111 ,;;urienl JfSP i:: 1,H:r,di'l'-l Q,-J 'f<Ju.- ~0:11,ice i~ ir, lh., .:,.1111::,-,~ IF:SP, 11ou ·1,ill ,, ~l te -11ble to 1m\e; ::11,1co log, tr-, th•~ c~:o pi4::.~ i:i oor,t:ct s;o,, ell! c::::o,dlr ~,;ot t~ fio~l1zca th Ill Jl's; )

Actr:I Gcrvir::n I og:

"Scn,icc Providc1· Plnnncd Period Pl.rinncd SettinQ

'A,tu•I c;.-,muu "Sc,rviceNoto (--:: 10:0 ch.:Jr,)c\:e;1!:

l

(M,,1DD1'i'l'f',') fJ.;;.111~1~.1

~ •Af:,~Pv· Du-::~,, Fdo11ili ,m ,I ,·;-,ii J

~ 1 AbBnc.e Du!:: b )-::1v l1;1J Provi,Jr:r

~• uc,ShOI'

(~ )Cl1clcunc0Dnl·r!

Sf:lri.tlco Log t

a . Jntcmtl::

Welcome to TEIDS Tennessee's Early Intervention Data System

bttps://www. t ids.org/teid

Vendor Accounts Payable Instructions

Below are step by step instructions on "How to bill TEIS" for services rendered.

At least one person will need to be designated at each agency to be responsible for the input of all requests for payment to the Central Reimbursement Office (CRO).

In order to bill TEIS through TEIDS there must be a service log entered. Service logs are created and entered by the therapists/teachers that are administering the authorized individual or group services for our children. Each service log entry will create a corresponding accounts payable entry. Below is an example of what the service log entry may look like (Example 1).

Page 1

Page 2: Vendor Accounts Payable Instructions · The billing person from your agency will login in with user name and password into the TEIDS system. On the home screen (Example 3) a child

,ii )·¥ tu,, ,:. • • ,o ....... • · ~ Uome PHge - hHHll':ll~H!12 Eml lntorv1:1nt1un 06h) t:v~lcm TUDS)

... . 111,... ,t1t•t• r,.,.,. n

I O!lf'IQII My Pul'IIOfd j

Al: l ,l,._I )I/Upd,1\ !

..... la/l',/lOO', tl/l'J.'00', 1/l'J:OOt, • 11."tllJe. :./llllO!. f/01.~ f/~ ...l , OC16 ll'U'l/.'1C.... l_!),1/."<.0t. ovr~ll'OJ! °""'~"'l.!001 IWl 'J.cxr

After the entry is saved by clicking the large arrow at the bottom it will look like this on the lower portion of your screen. (Example 2)

Example 2 Set"Yice Log:

The billing person from your agency will login in with user name and password into the TEIDS system. On the home screen (Example 3) a child will be selected in the drop down box that says Service Logged Awaiting Payment. This will immediately take you to the accounts payable screen .

Select the service to add accounts payable. The accounts payable will show up below. See Example 4. In this example TEIS is the only payer source. The amount expected from TEIS is entered in the field "Payor 1 Amount" next to the payer source "TEIS". Save the entry. See Examples 5 and 6 for those entries that might involve other payer sources.

Page2

Page 3: Vendor Accounts Payable Instructions · The billing person from your agency will login in with user name and password into the TEIDS system. On the home screen (Example 3) a child

.. 8 • ocmo.:m~f!h1c e Porent 8 Eho,bl<, 8 Service loo

e • Noti ti,:.itiorvlt~ferral • f'irMnt:ii,I Supp,irt 8 JFSP • Ai::count P.il'l.tbli!

0 8 Screaning 8 Contact Log e coals e Transition - 8 ttedlth/rrnmUfl •l<1'10,,, • Ev,,h.1Gliw1 8 Pl<IN"e,j Servio=, 8 Le1J nl Acfon

Arrn11nt II,, 1 ' it'llr. lnlntm-,1 inn

Child JD: 1:¥158 Child N•me/D00: Dsvop './opfept 11)0512004 Child Status: Acb-..e

JFSP: lNlTJAL • 04/17/2007

Select a Prev1ou.- JF,w (lf 1t IJ not current IFSP): INnIAL - 17-AF'P.-07

select th!!' Ser\.llCI!- to Add Account Payable: I~vdluation. sPeed, (Individual) - -- -- - - --- -- -vi Pmvldlll" and Ag•ncy j'lanned Pel"lod =~~i~~d fNq/WHk ~:::'~'~miles)

Nannill Brook-Heiilllh Serv;cvli 10,4/17/20)7 - lame o0t9ll07692JL l

J11JOS121D7

Enlcr ~r.rvirr. Ac:cnuot P~y.,blr. Or.lo!'I;

, .UOl

&erYIC.e ALCDUQt PIIJ11t11Wl HI U UI'," {A

Permit Jn!ll1nance'? ~IU

9 Ooc/rorms

• Shrctict-,ild

e rr.ansf•r

• LOIJ•JU~

Ph,i1159l lFSP

Pavor source

PrN!'ll~ ln $U ll) l'lf, ft, 'TEl3

Exam le 4

;i.,j:,o::: C) tttt,1:J'r,VM-1

Cu<

vJ r:J Q:I :..n·s • ~ • -· Tennessee Eady Inte1vent1011 Data System ['"61.. 9 " Dernc~raphic If Pu-erit 9 'Eiig,b,l1t~ . Sen:~LOIJ • Do~ra1nn

. .. NotifiOlltiOn..'Refeml 8 ~inancial support 8 1FSP e RocauntPavible • se.ircn Chi Id

9 9 Scre,n11ny • Con!-.tJct LJg 8 Gu.111 e rren,t•on e Tro111f~r

a.:11 • Health/lmmuni.!a'tlOOS e Ew;;luation 8 r1an~ee1ser1rioes . LGilillAotior, e l.Caout

Child ID: lJ.158 Child Neme/1>00: Oi!V,:,P V,)pfept · 11JOS/20(M

lf!IP : lNtTtAL • 0>1/17/2007

Select~ rre1tJC>IIS JfiP (JI It IS not c:urrelK IF5P): lNITIAL • 17-APA.-O7 '¥

lEIS

iervlc:e Account P•vment Hli:lory (Auount payable hai, bi!!'en ilpproved):

In the above scenario the child has private insurance that paid a portion of the service. Since the amount is under the contracted rate of TEIS, TEIS is billed for the remainder of the contracted rate. Enter that portion insurance paid in the Payor 1 Amount field and then that portion expected from TEIS in Payor 2 Amount field. Save the entry.

Page 3

Page 4: Vendor Accounts Payable Instructions · The billing person from your agency will login in with user name and password into the TEIDS system. On the home screen (Example 3) a child

Exam 7

chlld ID1 13156 Child N~ma/Dallll: Oavop Vopftpl ll./05/2004 thlld Status: Aci:i\116

Provider and Agency Pl.inned Pertod :~~~d rraQ/Week i[~!~~s~rymile~) !Permtt 1In•ur11111::e1 ,.,r.....'if)I}, 1,,1111

, iv ilr! l:r,,,_,... OAl17hOJ7 Home

1

1) 01921(176923'1. !

1

1

11,05/d):)7

App r� 'ile 6erv1ce "ccount Pilyablo Below:

I

,P.ivor source

TEIS

Save

Snv•

10/l~tOOI ~---~

O•-· · o L-l ,.;'l ,r.i y, ....,, <1•-... e ;.;> ~ .'!I · J a a ,'lo.J.lt",.,, [iihua;:(l ~~iw -·- - I~ •• '·"'. ,ijl•

,;..H,...,...

Tennessee Early Intervention Data System ~ 8 "Dtm09raphk 8 P:Hlilnt 8 Eligib i1ity 8 Si!r-. Oi ~ 8 Oo.:/F.J nTI~8 e I t.Jotil1~atkuV~~f,rr~I e f1M,,t:'ial <;uppott • lf 'i~ • Am,unt P~y~bh • Se,trc:t, C.h •'d

0 • Sc:r~~nm9 • Cout•.:1 Log 9 .:,,..1, 9 f,-,.n, l•on 9 Tran,lrr ,a • Huldl(Jnvnu nrl -U.otl S l:valu.ltion 8 P l.lMt d sen·icu l81;1al Aooon • Looout

',cl~rt tflr. Ser'Virc to Add Ar.count Porablc: E'ta"-iation - s~ tech ([ndi.,.,idual)

otiaterl rate and TEIS second fjle t,dl ~"l'I fatOII:~ IP:-;H tii,b

Q om!<· (i} ~ l!J t.J ; :~rch ·~ F•--• e) (j · •';.; _!!i •

"'Oemocr~ph1c 8 Porcnt 9 E~c,b1llr\' 8 Service Loo e Doc/Form,.. 9 • " Notifo:.a1iorv'Aeferr11I • financi;;I Siupp,111 • TFSP e Acc-ouot?<1 y able e suri:chr.:t-,ild

H e Scr••n no e Contact Log 8 G,ah 8 l r.ans1t1on 8 Trans1or

Sidi 8 tleolth'Ttnmun 1zol:J1lr,5 • f ... C,uotion 8 Plon11t1d S"r..-i ce, 8 Lef,Jal ildinn • Lovout:

Arrn11nt l'i'l\' 'lhll"' lnfotnhll '°" Child ID; 13458 Child Name/000: Oe'lop Vopfepc · lli OS/2004 Child Status: Active Ph~sa: Jf'SP

lF'liP: li"IJTlAL • C'd/l7/?..001

!ielect a Previous JFSP (If It Is not current lF'!iiP): TfJ[TlAL - 17-APP.-07

!ielecl the Se Nice lo Add Acc ount Pdyable : c ,., � !11.-lb1 • Spnch (Jnclividual)

Proulder- and Aiency !Planned Period Planned Prwq/Wwek Jnlenilly Permit Payor tource I li:lellino (Hour,- or mil~s) lm1urcmu,1 ().t'l/1 ?!20)7 _ lome Cl 0l9230'692JL 1 No PrMl1e lri!\uraru:e, TEISN11111 1111Ei1ullk- 1i1111 ..l'h 5:..¥ rt' tli:"li

lI1J05/2CIJ7

Enler ctervitr. At c ount PnYl'lblr. Del u"" ;

-

In the above example the negotiated rate with the insurance company was $50.00. Enter the payment from the insurance company in Payor 1 Amount field and the portion due from TEIS in the Payor 2 Amount field.

Upon receipt of the billing memorandum the CRO will validate your request for payment. See Example 7

I

Page4

Page 5: Vendor Accounts Payable Instructions · The billing person from your agency will login in with user name and password into the TEIDS system. On the home screen (Example 3) a child

Exam le 8 f.11Ut-.f':91G'h1Jpdi~

o...,•o -~ iii ; ,tJ- ,_ e (I;)• ii. Mil • • a •& , ,~ 'JIiii•...

w.,fr • • • .. Cl . ..... Involor R.tport

JIWonl Pcriot 'lll'ldllOl7'- '11/16/lOO'l' J (I t !J P

Hclldl ScCW:e, 1111 Nor!bem Way .Aqwbe,c. TM 3?214

Scnah.CratralTEtsOf'&te 74~S c:bYrth SL,~ 101 Mw-ii:csharo.. TN ~131

Cbld N•t scmcc Snvic:tDC 'JEIS Dnnp Vaplept EvMlltim · SpHcb 0Sill2'2DIJ'J

T"""--~~ __H9,!IO

Once all payments have been approved/disapproved the CRO will create an invoice report for your agency and submit it to the Finance and Administration Office for payment. See Example 8.

Page5