Agency and Independent Providers have the choice of billing the Ohio Department of Developmental Disabilities (DODD) for Waiver funded services directly, or by utilizing the services of a DODD authorized billing agent. All direct billing must be transmitted electronically, as invoices submitted on paper are not processed by DODD.
Providers are reimbursed for services when
the services are identified on an approved individual service plan (ISP),
the service is recommended for payment through Payment Authorization for Waiver Services, or PAWS,
you have been certified by DODD to provide services,
you have provided the service,
and you submit claims within 350 days of service.
The Union County Board of Developmental Disabilities, does not present training on DODD billing procedures.
How Do I Bill For Medicaid Funded Services That I Provide?
Provider PAWS MSS Registration Link Information
MSS is the system that projects the Waiver cost for each individual and also is where the Daily Rate Application (DRA) for congregate settings lives.
Every provider is given access to the MSS application when being certified and it should appear in your applications drop down menu. Agency access is given to the CEO or person responsible for updating information in the Provider Certification Wizard (PCW) online application.
Any agency staff that do not have access to view MSS and were responsible for accessing PAWS in the current stand-alone application will need to submit a security affidavit to the Department to get access to MSS to view PAWS.
Billing for I/O and Level 1 Waiver services is submitted online at http://www.dodd.ohio.gov through the eMBS system. You will need your user name and password, PAWS information and service documentation in order to bill.
A provider cannot bill for services until he/she has received a final approval letter from the DODD. The final approval letter indicates your Medicaid Provider number issued by the Ohio Department of Job and Family services (ODJFS). You may only submit claims after you and/or your billing agent have completed and returned to DODD a Security Affidavit. Once received, you will be assigned a log-in and temporary password. The DODD Security Affidavit Form is located on the DODD main website in the forms section. Complete this form and fax to DODD at 614-752-4673 or mail the original to:
Providers that deliver non-Medicaid funded Supported Living services are reimbursed directly by the County Board of Developmental Disabilities with whom you are contracting. It is recommended that you contact them directly to obtain reimbursement information.
A contract number is a 7-digit number assigned by the DODD. It is placed on a Payment Authorization for Waiver Services (PAWS) form to identify the various providers of service. A Medicaid Billing number is a 7-digit number issued by ODJFS. A Medicaid Billing Number indicates that the provider is officially enrolled as a Medicaid Provider, and may receive federal reimbursement through the waiver.