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Section 5: Financial Matters 31 Authorization Forms While some of the information provided on authorization forms is self-explanatory, it is important to be aware of what needs to be on each form and to ensure all details are provided. Some information requires coding that you will need to learn. This step may be unclear if you have not familiarized yourself with all the authorization details. Note: Some forms may use the word client, which is represented below as parent/caregiver. Parent/Caregiver Details The first section of the authorization form provides important details related to the parent/caregiver(s) for whom services are provided, including: • Name(s) of parent/caregiver authorized to receive care. • ID number(s) assigned by DHHS for each parent/ caregiver listed on authorization form. • Authorization number. • Authorized child’s name, ID number and provider authorization number. Note: The Provider Authorization authorizes the family to receive child care services from you, however, ONLY those children listed on the form are eligible. DHHS will not be responsible for payment for children NOT authorized on this form. Service Codes Service codes indicate the age category under which fees will be charged and the other types of fees that might be charged. *Note: Transportation will only be authorized to and from the child’s home and child care, and for providers licensed with the department. Authorized Units Authorized units refer to the time intervals listed on the authorization. • Partial day unit: Up to 4 hours and 59 min. • Full day unit: 5 hours to 9 hours and 59 min. • Full day unit, plus partial day unit: 10 hours to 18 hours • Hourly units are used only by in-home providers Authorized Rates Rates on the Provider Authorization are based on the rates on your Child Care Provider Enrollment and the child(ren) authorized. • Frequency is the type of billing occurring for the family, such as hourly or daily. • Frequency codes include: Hour (HR), Partial Day (PD), Full Day (DY), Occurrence (OC) and One-Way Trip (OW). Special Needs Authorizations Nebraska policy defines special needs as: “Requirement for extra care because of an acute or chronic physical or mental condition. Acute special needs include temporary conditions that require special medical attention and isolation from other children (e.g., recovery from surgery).” Chronic special needs include long-standing medical or behavioral problems that require, at all times, medical, behavioral or other services (e.g., medically fragile, attention deficit, etc.). If a parent/caregiver has a child with special needs, they need to call ACCESSNebraska to request special needs child care. A Documentation of Special Needs for Child Care (CC-6) form can be provided, but it is not required. Billing Process Claims are completed using information found on the Provider Authorization. The RD will provide training on how to complete billing in the Provider Portal. If you are on paper billing, reach out to your RD for information on how to complete and submit your billing document. Note: If you provide child care to a family who is responsible for paying a portion of the cost, you must collect the family fee and deduct it from your billing document. Infant – 8903 Toddler – 6679 Preschool – 9946 School Age – 3580 Family In-Home Care – 8775 In-Home CC Special Needs – 4907 Transportation* – 5641 Activity Fee – 7964 Enrollment Fee – 6529 QUICK TIP A convenient way to keep track of how many units you have billed, either partial or full day, is to visualize your Provider Authorization as a checkbook with a beginning and ending balance. Start with the units authorized and subtract the units billed each month from the total.