Rate Changes for Medicaid in Florida

Important Update: Rate Changes for Medicaid in Florida

As you may have heard, the State of Florida is implementing changes to the Medicaid health plan rates effective October 1st, 2024. While we received this news with less than 3 days’ notice, let’s look on the bright side—after all, higher rates mean more funding to support our vital services! It’s almost like getting a surprise party, but instead of cake, we get… rates!

At Office Puzzle, we want to make sure you have the tools you need to navigate this transition smoothly.

We recommend a straightforward approach: only change the rates once you have finalized billing for the previous month, which includes everything up until September 30th.

And if you’re thinking about updating the rates early, here’s the funny part: even if you do it today, Medicaid won’t pay you the higher rate just yet! So if you want, you can update the rates right now and you will be fine. They will adjust to the correct rates.

To avoid any issues, check out our step-by-step guide on how to manually update your rates by following the instructions below or the quick video tutorial we’ll be providing. This will ensure everything runs smoothly without any surprises!

Go to the Agency Dashboard
Click Configuration
Click Billing
Click Payers
Click on the Payer Name (STATE OF FLORIDA, MEDICAID, FLORIDA MEDICAID, etc)
Look for the Health Plan, it's on the right. Click on the green pencil right next to the name of the Health Plan (Default, Medicaid, etc)
Click the Rates Tab
Find the Billing code you would like to update the rate and enter the new amount (find the changes below)
Repeat step #8 three times since we have 3 rate changes (97153, 97155, 97155-HN)

The video instruction is here:

In case you missed the changes here is a quick summary of them:

Service Description	Procedure Code	2022 Rate (Per Unit)	2022 Rate (Per Hour)	2024 Rate (Per Unit)	2024 Rate (Per Hour)	Fee Change (Per Unit)	Fee Change (Per Hour)
Behavior identification - assessment	97151	$19.05	$76.20	$19.05	$76.20	No change	No change
Behavior identification - supporting assessment	97152	$12.19	$48.76	$12.19	$48.76	No change	No change
Behavior reassessment	97151 TS	$12.19	$76.20	$12.19	$48.76	No change	No change
Behavior treatment with protocol modification (Lead)	97155	$19.05	$76.20	$19.17	$76.68	+$0.12	+$0.48
Behavior treatment with protocol modification (Assistant)	97155 HN	$15.24	$60.96	$15.37	$61.48	+$0.13	+$0.52
Behavior treatment by protocol (RBT/BCaBA/Lead)	97153	$12.19	$48.76	$12.26	$49.04	+$0.07	+$0.28
Family training by Lead Analyst	97156	$19.05	$76.20	$19.05	$76.20	No change	No change
Family training via telemedicine (Lead Analyst)	97156 GT	$19.05	$76.20	$19.05	$76.68	No change	No change
Family training by assistant	97156 HN	$15.24	$60.96	$15.24	$60.96	No change	No change

Thank you for your continued partnership as we work together through these changes!

by Editor

Payments & Invoice Efficient Integration

Name: Creating and Managing Invoices on the Agency’s Payment section at Office Puzzle
Description: How to create an invoice on the Agency’s Payment section.
Difficulty: Middle
Duration: Less than 10 minutes

Invoices

Summary:
Step 1- From the Agency Dashboard, access Payments shortcut.
Step 2- Click on Invoices.
Step 3- Click on +New invoice.
Step 4- Select Source: Events, Billed Events or Manual.
Step 5- If selected Events/Billed events, then choose the Range of dates and click on Submit. Also, there are Optional filters: Providers, Clients and Event types.
Step 6- Select the events to be included and hit Continue. (There you can check if there are any error on the events)
Step 7- Select Strategy: Merge all Events, Split by Provider or Split by Event Type.
Step 8- Select the Invoices to be created.
Step 9- Click on Create.

Create Invoices on the Agency’s Payments section

Invoices

Step 1: Navigate to the Agency Dashboard and access the Payments shortcut.

Step 2: Click on the "Invoices" box.

Step 3: Initiate a new invoice by clicking on "+New Invoice."

Step 4: Choose the source of the invoice: Events, Billed Events, or Manual.

Step 5: If Events/Billed Events is selected, specify the date range and click "Submit." Optional filters such as Providers, Clients, and Event types can be applied.

Step 6: Select the events to be included in the invoice and proceed by clicking "Continue." This step also allows you to check for any errors in the selected events.

Step 7: Opt for a strategy to organize the invoice: Merge all Events, Split by Provider, or Split by Event Type.

Step 8: Choose the specific invoices you want to create.

Step 9: Finalize the process by clicking "Create."

by Editor

Mastering Billing' Standalone & Batch Claims

Name: Create Standalone & Batch claims on the Agency’s Billing section at Office Puzzle
Description: How to create a standalone / batch claim on the Agency’s Billing section.
Difficulty: Middle
Duration: Less than 7 minutes

Standalone claims

Summary:
Step 1- From the Agency Dashboard, access Billing shortcut.
Step 2- Click on Standalone Claims.
Step 3- Click on Actions.
Step 4- Select +New Claim.
Step 5- Select Source: Events or Manual.
Step 6- If selected Events, then select the Range of dates and click on Submit. Also, there are Optional filters: Providers, Credential types, Payers, Clients, Event types and Billing codes.
Step 7- Select the events to be included and hit Continue. (There you can check if there are any error on the events)
Step 8- Select Strategy: Merge all events, Split by Provider or Split by credential.
Step 9- Select the Claims to be created.
Step 10- Click on Create.

Batch claims

Summary:
Step 1- From the Agency Dashboard, access Billing.
Step 2- Click on Batch Claims.
Step 3- Click on +New Batch.
Step 4- Select Payer.
Step 5- Select Health Plan.
Step 6- Select Clearing House (if needed/required).
Step 7- Click on Create.
Step 8- Within the batch, click on + Add claim.
Step 9- Select Other Claims / Events / Manual.
Step 10- If selected Events, then choose the Range of dates and click on Submit. Also, there are Optional filters: Providers, Credential types, Payers, Clients, Event types and Billing codes.
Step 11- Select the events to be included and hit Continue. (There you can check if there are any error on the events)
Step 12- Select Strategy: Merge all events, Split by Provider or Split by credential.
Step 13- Select the Claims to be added.
Step 14- Click on Add.

Create Standalone & Batch claims on the Agency’s Billing section

Standalone claims

Step 1- From the Agency Dashboard, access Billing.

Step 2- Click on Standalone Claims.

Step 3- Click on Actions.

Step 4- Click on +New Claim.

Step 5- Select Source: Events or Manual.

Step 6- If selected Events, then select the Range of dates and click on Submit. Also, there are Optional filters: Providers, Credential types, Payers, Clients, Event types and Billing codes.

Step 7- Select the events to be included and hit Continue. (There you can check if there are any error on the events)

Step 8- Select Strategy: Merge all events, Split by Provider or Split by credential.

Step 9- Select the Claims to be created.

Step 10- Click on Create.

Batch claims

Step 1- From the Agency Dashboard, access Billing.

Step 2- Click on Batch Claims.

Step 3- Click on +New Batch.

Step 4- Select Payer.

Step 5- Select Health Plan.

Step 6- Select Clearing House (if needed/required).

Step 7- Click on Create.

Step 8- Within the batch, click on + Add claim.

Step 9- Select Other Claims / Events / Manual.

Step 10- If selected Events, then choose the Range of dates and click on Submit. Also, there are Optional filters: Providers, Credential types, Payers, Clients, Event types and Billing codes.

Step 11- Select the events to be included and hit Continue. (There you can check if there are any error on the events)

Step 12- Select Strategy: Merge all events, Split by Provider or Split by credential.

Step 13- Select the Claims to be added.

Step 14- Click on Add.

by Editor

A Step-by-Step Guide to Evaluate Objectives

Evaluating objectives is a crucial step in managing and organizing Short Term Objectives (STOs) within the Office Puzzle system. This tutorial will guide you through the process of adding mastered dates for STOs by utilizing the “Evaluate Objectives” functionality. By following these steps, you'll be able to efficiently set and manage key dates associated with your objectives.

Step 1: Navigate to the client's Dashboard.
Step 2: Locate and click on the “Data” shortcut.
Step 3: Within the Data section, find and click on the “Datasheets” option.
Step 4: On the Datasheets page, look for the prominently displayed “Bulk Actions” button. Click on this button to access a dropdown list containing several options for managing your objectives.
Step 5: From the dropdown list, choose the “Evaluate Objectives” option.
Step 6: Upon selecting Evaluate Objectives, a table will display various categories and items related to your objectives. This table includes information about the objectives, along with the proposed mastered dates.
Step 7: In the table, you will see the option to either “Accept” the suggested mastered date or “Edit” it as needed. Evaluate each objective and decide the appropriate action based on your requirements.

By following these steps, you can efficiently evaluate objectives and manage mastered dates for STOs in the Office Puzzle system. This functionality streamlines the process of setting key dates, ensuring that your objectives align with your client's progress. Make use of the Evaluate Objectives feature to enhance your workflow and keep your Objectives on track.

by Editor

Florida Medicaid Trading Partner ID & EDI Agreement

Name: Florida Medicaid Trading Partner ID and EDI Agreement
Description: Configuring Florida Medicaid portal for EDI files submission.
Difficulty: Medium
Duration: 15 minutes

Summary:
Step 1: Visit http://home.flmmis.com.

Step 2: Log into the secure Web Portal using your account credentials.

Step 3: Select Providers.

Step 4: Choose demographic maintenance.

Step 5: Select EDI Agreement.

Step 6: Select the transaction types.

Step 7: Add billing contact information.

Step 8: Read and Accept the agreement.

Step 9: Click “SAVE” at the end of the screen.

Step 10: Save the Trading Partner ID (TPID).

Florida Medicaid Trading Partner ID and EDI Agreement

Step 1: Visit http://home.flmmis.com

Step 2: Log into the secure Web Portal using your account credentials

Step 3: From the secure Web Portal landing page, select Providers

Step 4: Below the Providers option, choose demographic maintenance.

Step 5: From the Provider Informational panel, select EDI Agreement.

Providers without an existing Trading Partner ID (TPID) will see the message indicating that there is no TPID on file for the Provider ID. Users will indicate the transaction types they plan to send or receive under their TPID by selecting the checkbox next to the appropriate transaction.

If you already have a Trading Partner ID Steps 6 and 7 will not apply.

Step 6: Select the following transaction types:

270/271 270/271 Health Care Eligibility Benefit Inquiry and Response
276/277 Claim Status Request and Response
837 Professional Health Care Claim

Step 7: Add billing contact information (name, email, and phone)

Step 8: Read and Accept the agreement, basically accepting the process of submitting this type of file electronically.

Step 9: Click “SAVE” at the end of the screen.

Successful submission will produce the following message, which displays the user’s new TPID.

Step 10: Save the Trading Partner ID (TPID) as we will need this information.

by Editor

Restrict user due to missing HR documents.

Name: Restrict user due to missing HR documents.
Description: How to restrict user actions if they have missing or expired documents.
Difficulty: Easy
Duration: Less than 2 minutes
Summary:
1. Go to the Agency's Dashboard.
2. Click on Configuration.
3. Scroll down till HR Documents.
4. Click the Edit button of the document(s) you would like to restrict the user if it is missing or expired.
5. On the new window, enable the “Restricts” feature.
6. Finally, click on “Update”.

Important - These restrictions do not apply to Administrators of the Agency.

Restrict user actions due to missing or expired documents.

Step 1: Go to the Agency's Dashboard.

Step 2: Click on Configuration.

Step 3: Scroll down till HR Documents.

Step 4: Click the Edit button of the document(s) you would like to restrict the user if it is missing or expired.

Step 5: On the new window, enable the “Restricts” feature.

Step 6: Finally, click on “Update”.

by Editor

Exporting data from Behaviorsoft

Name: Exporting data from Behaviorsoft to Office Puzzle
Description: How to export data from Behaviorsoft and import it to Office Puzzle
Difficulty: Middle
Duration: Less than 10 minutes
Summary:

Exporting from Behaviorsoft
1. On the Client’s screen, click the Maladaptives tab or the Replacements/Skills tab.
2. Select the specific maladaptive behavior or replacement, and then click on the EXPORT DATA button under the GRAPHS column.
3. The EXPORT DATA pop-up screen will then appear.
4. Lastly, you can specifically choose to export data on specific dates. There is an option to enter a From Date and a To Date.
5. Once you have selected the Collection type and choose the specific dates, click Download Data. The data will then be exported in an Excel file.

Importing to Office Puzzle
6: Go to Client's Dashboard.
7: Click on the Service Plan button.
8: Click on ABA Therapy Service Plan.
9: Choose the required Category tab: Maladaptive Behaviors, Replacements, etc.
10. Click on the Edit button on the right side of the desired item.
11. Click on Imported Data tab.
12. On the main box, you can paste the dates and values from the Excel file that you’ve exported from Behaviorsoft.
13. Once you’ve finished, click on Update.

Exporting client data from Behaviorsoft to Office Puzzle

Exporting from Behaviorsoft

Step 1: On the Client’s screen, click the Maladaptives tab or the Replacements/Skills tab.

Step 2: Select the specific maladaptive behavior or replacement, and then click on the EXPORT DATA button under the GRAPHS column.

Step 3: The EXPORT DATA pop-up screen will then appear.

Step 4: Lastly, you can specifically choose to export data on specific dates. There is an option to enter a From Date and a To Date.

Step 5: Once you have selected the Collection type and choose the specific dates, click Download Data. The data will then be exported in an Excel file.

Importing to Office Puzzle

Step 6: Go to Client's Dashboard.

Step 7: Click on the Service Plan button.

Step 8: Click on ABA Therapy Service Plan.

Step 9: Choose the required Category tab: Maladaptive Behaviors, Replacements, etc.

Step 10: Click on the Edit button on the right side of the item.

Step 11: Click on Imported Data tab.

Step 12: On the main box, you can paste the dates and values from the Excel file that you’ve exported from Behaviorsoft.

Step 13: Click on Update.

by Editor

Backup Client

Name: Backup Client
Description: How to create a full backup of a Client.
Difficulty: Easy
Duration: Less than 2 minutes
Summary:
1. Go to Client's Dashboard.
2. Click on Manage.
3. Click on the Backups tab.
4. Click on the Request Backup button.
5. Once the Backup is completed you will receive an email and the backup file will appear here for you to download.

Important Notes:

This will backup all Documents associated with the client.
You are responsible for the storage required for the data.

Backup Client

Step 1: Go to Client's Dashboard.

Step 2: Click on Manage.

Step 3: Click on the Backups tab.

Step 4: Click on the Request Backup button.

Step 5: Once the Backup is completed you will receive an email and the backup file will appear here for you to download.

After is done:

by Editor

Create client event with EVV

Name: Create client event with EVV
Description: How to create an event/visit/session with EVV (Electronic Visit Verification)
Difficulty: Easy
Duration: Less than 2 minutes
Summary:
1. Go to Client's Dashboard.
2. Click on the Clock in button.
3. Fill in all the required fields.
4. Click on the Start Session button.
5. Now you can collect Data, capture Signatures, access linked Documents, etc.
6. Once the visit is over, click on the End button.
7. Fill in all the required fields. (including Signature if required)
8. Click on the End Session button.

Important Notes:

You are recommended to use our Mobile APP on your cellphone since GPS coordinates are more accurate.
If you don't see the Clock In button, your agency might have disabled this feature for you.
If GPS coordinates are required by the agency the device used (Phone, Tablet, Laptop) will need to have GPS capabilities and permission granted to Office Puzzle.
You can also create an event directly from the Calendar, but this will not include EVV information. Please click here for more details.

Create client event with EVV

Step 1: Go to Client's Dashboard.

Step 2: Click on the Clock in button.

Step 3: Fill in all the required fields.

Step 4: Click on the Start Session button.

Step 5: Now you can collect Data, capture Signatures, access linked Documents, etc.

You continue working for the duration of the session.

Step 6: Once the visit is over, click on the End button.

Step 7: Fill in all the required fields. (including Signature if required)

Step 8: Click on the End Session button.

by Editor

Link or Unlink events with documents

Name: Link or Unlink events with documents
Description: How to Link or Unlink events with documents.
Difficulty: Easy
Duration: Less than 2 minutes
Summary:
1. Go to Client's Dashboard.
2. Click on the Documents button.
3. Look for the document you would like to Link/Unlink events and open it
4. Click on the Linked Events tab.
5. Check/Uncheck, the event(s) that you want to Link/Unlink with the document.
6. Click on the Update Linked Events button.

*** If you are missing or have extra information in your documents that is generated directly from the events in the calendar most probably the document is not linked to the events. These steps will help you Link/Unlink these events.