Third Party Billing

What is it?

Federal and state law require all public Minnesota schools to request payment for Individualized Education Program (IEP) health-related services from public and private health insurers. Minnesota Health Care Programs (MHCP) pays the federal share of covered health-related services described on a child’s IEP or Individualized Family Service Plan (IFSP). Schools are reimbursed when a child has as a disability and an IEP or IFSP, requires health-related services in order to benefit from special education and is eligible for Minnesota Health Care Programs (MHCP) (which includes Medical Assistance (MA), MinnesotaCare and other public, government health programs). Reimbursable IEP health related services include assessments and services for:

Minnesota Health Care Programs (MHCP) Provider Manual



Parents

We are asking for your support

If your child is currently eligible for MA/MHCP, please consider signing the consent form to release records to the Minnesota Department of Human Services (DHS) for billing purposes. The records released may include your child's IEP, IEP health related services documentation, and medical orders. If you ask, we will send you copies of the records we share for billing.

While districts in the ASEC are required to seek payment from both private and public insurers, our districts will seek to bill only public insurance Medical Assistance (MA), TEFRA, and MinnesotaCare (MC). Billing public insurance has no impact on your child's or family's medical coverage. ASEC school will not bill private insurance, as doing so could cause your insurance rates to increase and/or have other negative effects on your child's and family's insurance coverage.

If your child was at one time determined eligible, but you decided not to participate due to financial feasibility with your private insurance or other reasons, please consider allowing MA/MHCP for IEP services only. A disparity agreement allows the school to bill for IEP services for students eligible for TEFRA without the family incurring any parental fees.


Assurances

Protections for Families and Children for other MHCP Health Care Services


Minnesotra Health Care Programs (MHCP)

Families may apply for MHCP online at www.MNsure.org or by completing a paper version of the application. A link to print the application is available at "How to apply for Minnesota Health Care Programs." Refer to the "MNsure and MHCP Member Help Desk Contact Information" for hours and contact information for help desks, as well as county and tribal offices contacts.


Parent Consent on MHCP Applications

DHS refers questions about parental consent to the Minnesota Department of Education (MDE), the state education authority on education law. Issues deal with the Family Educational Rights and Privacy Act (FERPA) and the Individuals with Disabilities Education Act (IDEA). Review MDE’s Third-party Billing web page for more information.

Both the initial MHCP application and the renewal application that the parent completes contain the language that is required under FERPA and IDEA regarding permission for school districts to access their child’s health information and to bill for services. Check the signature page of the most current version of the application to see the parent agreements and rights. Refer to the appendix for the Notice of Privacy Practices. The section on release and sharing of medical information contains information about how records may be released to several parties including schools.

Note: A parent must sign the MHCP application consent statement for Medical Assistance to cover heath care costs. However, a parent has the right under FERPA to deny consent to school districts to access information and to bill MHCP. A parent may stop consent for sharing records with school districts at any time. These two rights are covered in the MDE Notice of Procedural Safeguards.

Note from ASEC: we still seek a one-time parental consent to bill MHCP for any IEP related services. We currently don’t use the above described informed consent given on the MHCP application and renewal application.



What Happens to the Money

Minnesota laws are very specific about the use of money districts get from third party billing. There are several things you should know:

ASEC does not bill your district for the cost of billing or for training. All the dollars generated by your district go to your district to support special education services.