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Low Income Home Energy Assistance Program Division 10 Service 415 Program 415 Chapters 05 - 65 North Dakota Department of Health and Human Services

Case Management Billing Process 415-10-15-20 (Revised 10/02 ML #2812) View Archives

SFN 339 "Monthly Case Management Billing and Reporting Form" will be completed by the case manager. One form for each county is completed for services provided to a household.

The billing form should be submitted to the referral source by the case manager by the 10th of the month after the service was provided and forwarded to the state office by the 15th. Payment will not be made for any services provided three or more months prior to the receipt of the billing form by the referral source.

The form is self explanatory. The referral form (SFN 98) provides most of the necessary identifying information. A uniform system to calculate each case manager's cost per hour per county has been adopted. The signature of the director of the community action agency will certify that the billing is accurate and that the services were delivered. When completed by the case manager, the billing form is submitted to the referral source. The monthly data report will be attached and should be referenced to the Action Plan Summary.

Eligible household billing forms are sent by the case manager to the LIHEAP worker who referred the household. The county worker receives the form for accuracy and LIHEAP eligibility.

If someone is not eligible for LIHEAP, the community action agency must be notified so that they may bill those costs elsewhere. County Social Service Representative • Review the form for accuracy and that LIHEAP eligibility is checked appropriately. LIHEAP Households . . . Billing is sent directly to the county social service office that made the referral.