This article discusses the rare situation where a child's residence was mixed up, and services for them were billed to the wrong county. Whether you're the county that shouldn't have paid for the child or the county that should, you just need to review the general process and follow the steps that are relevant to you.
For simplicity, the county that shouldn't have paid for the child will be called "the wrong county", and the county that should have paid will be called "the correct county".
The process to resolve this is as follows:
1. If the wrong county has already submitted STACs for the child, they will need to withdraw their STAC.
2. The wrong county will then need to process payment recoups to take back everything that's paid on the child.
3. The correct county will need to send up new STACs for the child.
4. The correct county will need to pay the provider for all the services.
The idea in general should be straightforward enough, but there are specific notes for different parties involved.
For the wrong county:
If you've claimed any payment for the child on an AVL after you withdraw their STACs, SED will hit you with AVL adjustments in the next AVL. You will need to have your recoup processed by then to reconcile those adjustments. If you're unfamiliar with the AVL adjustment process, feel free to contact your support rep when you see adjustments in the AVL adjustment report or the Process Adjustments window.
For the right county & the provider:
The tricky part for you is that the provider will need to make up possibly months of billing in one go, depending on how late this is discovered and how many notes they need to move:
-Dozens of notes:
If the notes they need to move are a reasonable amount to redo by hand, the provider will need to delete their notes in the wrong county and manually re-enter everything in the correct county.
-Hundreds of notes:
If the notes they need to move are too many for them to handle, you can send in a request to see if our technical team is able to mass-transfer them to the correct county.
-Hundreds of notes, and the provider did not enter any Portal notes in the wrong county because the wrong county doesn't use the CPSE Portal:
In this very specific case, you (the right county) can consider taking the provider's paper notes and paying them manually.
And of course, there may be other factors in play, or concerns about the Medicaid status in relation to the signing dates of the notes for re-entering them. Feel free to reach out to your support rep if you have any.