OAR 416-335-0090
Billing and Payment for Services and Placement Related Activities
(1)
Billable Care Days(a) The BRS Contractor is compensated for a Billable Care Day (Service and Placement Related Activities rates) on a fee-for-service basis in accordance with OAR 410-170-0110 (Billing and Payment for Services and Placement-Related Activities) and this rule.
(b) The BRS Contractor may include overnight Home Visits and Transitional Visits by the BRS Client to a Hosting Placement in its Billable Care Days. The BRS Contractor must:
(A) Receive prior approval from OYA for a Home Visit or Transitional Visit to a Hosting Placement; and
(B) Ensure that the Home Visit or Transitional Visit is in support of the BRS Client’s most current service plan goals related to transition.
(c) The Agency will pay the Sending Placement at the Billable Care Day rate.
(d) If the Hosting Placement is an OYA Foster Home, the Agency will pay the foster care rate specified by the foster care agreement for Transitional Visits.
(2) Absent Days
(a) The BRS Contractor is compensated for an Absent Day at the Absent Day rate in order to hold a BRS Program placement for a BRS Client with the prior approval of the BRS Client’s JPPO and the Contract Administrator.
(b) The BRS Contractor is compensated at an Absent Day rate when the BRS Contractor is a Hosting Placement for a Transitional Visit, unless the Hosting Placement is an OYA Foster Home.
(c) Notwithstanding OAR 410-170-0110 (Billing and Payment for Services and Placement-Related Activities)(4), the BRS Contractor may request prior approval from OYA to be reimbursed for more than a maximum of eight calendar days total of any combination of Home Visits and Transitional Visits in a month for a BRS Client. However, for any additional days of Home Visits and Transitional Visits approved under this rule, Sending and Hosting Placements will be paid at the Absent Day rate.
(3) The BRS Contractor may be reimbursed only for the BRS Type of Care authorized in the contract with OYA.
(4) Invoice Form
(a) The BRS Contractor must submit a monthly billing form to OYA in a format acceptable to the Agency, on or after the first day of the month following the month in which it provided Services and Placement Related Activities to the BRS Client. The billing form must specify the number of Billable Care Days and Absent Days for each BRS Client in that month.
(b) The BRS Contractor must provide upon request, in a format that meets OYA’s approval, written documentation of each BRS Client’s location for each day claimed as a Billable Care Day and an Absent Day.
(c) The BRS Contractor may only submit a claim for a Billable Care Day and an Absent Day consistent with the Agency’s prior authorization or approval.
(5) Billable Care Day and Absent Day rates are provided in the “BRS Rates Table,” dated July 1, 2020, which is adopted as Exhibit 1 and incorporated by reference into this rule. A printed copy may be obtained from OYA.
Source:
Rule 416-335-0090 — Billing and Payment for Services and Placement Related Activities, https://secure.sos.state.or.us/oard/view.action?ruleNumber=416-335-0090.