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Individual Budgets

Validate Budgets for Accuracy

Policy: 

Payment to a workers cannot be made without an active budget for the participant receiving service. The budget must cover the workers’s work date and the service type provided.  Any timesheets received that are not covered by a budget are denied.

F/EA receives budget data from the program administrator or counselors.  Each budget must be approved by <<X>> and <<Y>>.  Upon receipt, F/EA verifies that each budget is accurately calculated and includes appropriate start and end dates. Each valid budget is entered into F/EA’s Payroll System <<and billing system>>>.  A valid budget must be received by the F/EA for a participant before the participant is approved to receive service.
 
Budgets are processed by the <<Staff Title>> daily.
 
<<Insert how budgets are received by F/EA.  Are they paper forms?  Are they electronic submissions?>>
Procedure: 

Validate Each Individual Budget for Accuracy

F/EA receives individual budgets from Program Administrator or Counselors. Upon receipt, F/EA verifies that each budget is accurately calculated and includes appropriate start and end dates. Follow this process to validate the accuracy of a budget when it is received for a new participant, an existing participant or if the budget is an extension.
1.      Budgets are received daily via <<mail and fax>>
2.      When received, budgets are placed in assigned <<Staff Title>>’s inbox
3.      <<Staff Title>> collects budgets from inbox each day
4.      <<Staff Title>> identifies participant name on budget
5.      Open payroll system
6.      Press <<>> to find the participant in the system by last name.  Ensure the participant listed on the budget is in the system.
7.      Review the budget
8.      Identify the budget expiration date
9.      Verify that the budget expiration date is after the budget start date
10.  If the budget expiration date is not after the budget start date, the budget must be corrected (Go to Request Correction to Budgets as Needed below)
11.  Review the first line of the budget
12.  <<Insert what to check for>>
13. <<Insert everything that needs to be checked.  Pay special attention to make sure sufficient funds have been authorized to cover employer taxes and workers' compensation costs>>
14.  After verifying the budget for accuracy, <<Staff Title>> initials and dates the budget.

 

Request Correction to Individual Budgets As Needed
If there are any discrepancies found in the above process, Validate Each Individual Budget for Accuracy, a correction to the budget is requested of the <<the Program Administrator>>. Requests for corrections to budgets are made the same business day that the discrepancy is identified.
1.      After identifying a discrepancy on the budget, <<Staff Title>> requests a correction to the budget
2.      <<Staff Title>> logs in to Payroll System by double clicking on the icon on the computer desktop
3.      Enter user name and password
4.      Search for the participant by the participant number written on the budget
5.      Click on Notes tab
6.      Select “Add Note”
7.    Write “Waiting on budget correction”
8.    Select “Save”
9.      Prepare a Fax Cover sheet
10.  On fax cover, describe discrepancies on budget
11.  Request that budget be corrected as soon as possible
12.  Provide contact information for <<Staff Title>> in case Program Administrator has additional questions
13.  Fax Cover Sheet and budget to Program Administrator
Internal Controls: 

The internal controls used by F/EA to monitor this process establish responsibility, segregate duties, document procedures and ensure independent internal verification.

  1. All systems are password protected
    • Only staff with direct responsibility for certain Prior Authorization duties have password access to systems
  2. Each budget is verified for accuracy
    • The budget is verified for mathematical accuracy
    • The budget is verified for date accuracy
  3. After validating the budget, the <<Staff Title>> initials and date stamps the budget
  4. Program Administrator is notified in writing of budgets requiring corrections
  5. <<The budget is scanned to the participant file and saved for a minimum of 7 years>>

 

Process Budgets for Consumers Never Served by F/EA

Policy: 

F/EA ensures that consumers are not established in F/EA’s payroll system until a budget has been received. This is an internal control to ensure that payments are never made on a participant's behalf until the budget is received.  After a budget has been received for a participant and verified by the <<Staff Title>>, the <<Staff Title>> is notified to continue establishment of the participant with state tax agencies and in applicable payroll systems. Any timesheets received that are not covered by a budget are denied.

Budgets are processed by the <<Staff Title>> daily. Customer Service Unit is notified daily of consumers who do not yet have state tax ID numbers, but for whom a budget has been received.
 
Use this procedure for any consumers who are not yet in the payroll system when a budget is received.
Procedure: 
  1. Upon receipt of the budget, <<Staff Title>> looks for participant in payroll system.
  2. If participant is not found, <<Staff Title>> uses this process.
  3. Place budget in inbox called "Establish Consumer in Systems"
  4. Each day, <<Staff Title>> takes all budgets in "Establish Consumer in Systemss" inbox to process paperwork for the participant to obtain the appropriate Tax ID numbers
  5. <<Staff Title>> obtains quality checked paperwork for all consumers in the inbox
  6. <<Staff Title>> provides start-up paperwork and list to <<Payroll Department>> to set-up
  7. <<Payroll Department>> enters into the payroll systems all consumers who have an EIN and completed start-up paperwork
  8. After setting up all consumers in the payroll system, <<Staff Title>> uses applicable policy and procedure manual to enter budget in the systems and issue a welcome package to the participant.

 

Internal Controls: 

The internal controls used by F/EA to monitor this process establish responsibility, segregate duties, document procedures and ensure independent internal verification.

  1. All systems are password protected
  2. Only staff with direct responsibility for certain budget duties have password access to systems
  3. Budget information cannot be entered in to Payroll System to permit payment of timesheets unless participant has been entered in Payroll System
  4. Customer Service reviews when a participant has completed applicable paperwork to permit the participant to be entered in to Payroll System
    • This process ensures that payroll department does not add budget to F/EA systems until Customer Service has ensured that the participant has completed all necessary paperwork
    • By not entering the budget in the Payroll system, payment of timesheets is not possible
    • This ensures that timesheets are not paid for a participant until all required information has been received

Enter Budget Information in Applicable Systems

Policy: 

F/EA ensures that consumers are not established in F/EA’s payroll system until a budget has been received (See Policy and Procedure document 4.4). This is an internal control to ensure that payments are not made on a participant's behalf until an approved budget has been received.

After a budget has been received for a participant and verified by <<Staff Title>>, and the Customer Service Unit has verified that all requirements have been met for the participant to begin paying workers (See Policy and Procedures <<>>), the <<Staff Title>> enters budget in the Payroll System. The <<Staff Title>> performs these tasks daily. 
 
A separate process exists for entering budget information for complete budgets and for budget extensions. Both processes are described below.
Procedure: 

Enter Budgets (Not Extensions) in Payroll System

Use this process when a new budget for a participant has been received. Do not use the process when an extension of an existing budget has been received.
 
1.      <<Staff Title>> logs in to Payroll System by double clicking on the icon on the computer desktop
2.      Enter user name and password
3.      Search for the participant by the participant number written on the budget
4.      Select “Individual Budget” tab
  •  <<Insert Process to enter individual budget data into the payroll system and any checks or calculations that need to be made as part of the process.>>

 

 
Enter Budget Extensions or Amendments in Payroll System
In some cases, Program Administrator will issue a budget extension for a participant because their current budget has expired, but a new budget has not yet been issued. Extensions of budgets  are usually made for 1 month or less, but this is not a requirement. <<Staff Title>> enters extension information in the current budget portion of Payroll System.
 
Alternatively, an amendment to an existing budget may be submitted by Program Administrator.  Amendments are adjusted in the current budget portion of the Payroll System.
  1. Review PA extension
  2. <<Insert Process to enter Extensions/Amendments into Payroll System.  Include any necessary checks or calculations and/or people that should be notified of the change.>>
 
Internal Controls: 

The internal controls used by F/EA to monitor this process establish responsibility, segregate duties, document procedures and ensure independent internal verification.

  1. All systems are password protected
  2. Only staff with direct responsibility for certain budget duties have password access to systems
  3. Budget information cannot be entered in to Payroll System to permit payment of timesheets unless participant has been entered in Payroll System
  • Customer Service reviews when a participant has completed applicable paperwork to permit the participant to be entered in to Payroll System
    • This process ensures that <<Staff Title>> does not add budget to F/EA systems until Customer Service has ensured that the participant has completed all necessary paperwork
    • By not entering the budget in the Payroll system, payment of timesheets is not possible
    • This ensures that timesheets are not paid for a participant until all required information has been received
  1. <<Staff Title>> signs and dates each budget after entering in to Payroll System
  2. All Prior Authorization documents are stored for a minimum of 7 years, per F/EA file retention policy

 

Issue Welcome Package to Consumer

Policy: 

After a participant’s budget is received by F/EA, validated for accuracy and entered into Payroll System, a Welcome Package is sent to the participant. Welcome Packages are only sent to consumers after their first budget is received by F/EA. A Welcome Package is sent to the participant within 3 business days of entering the budget in the Payroll System. 

 

The Welcome Package is issued when the participant is totally ready to receive and direct service in the program.  This means that the Welcome Package is issued after all employer paperwork has been received by the F/EA and verified as correct and an authorized budget for the participant has been received by the F/EA.  The Welcome Package alerts the participant that they can now hire staff, purchase goods and receive services.  The Welcome Package also provides the participant with other information and documents that they will use in the management of their program.

Usually, the Welcome Package is only sent when the participant starts their program and it is not sent again.

The <<Staff Title>> issues the Welcome Package.
Procedure: 
  1. After entering budget information in Payroll System, <<Staff Title>> prepares Welcome Package to be sent to participant
  2. The Welcome Package is only issued to the participant after F/EA receives the participant’s first budget and all employment paperwork has been deemed complete.  Welcome Packets are not sent to the participant following receipt of subsequent budgets.
  3.  <<Staff Title>> is provided a list of new consumers for whom Welcome Packages should be issues.
  4. Budgets for these consumers are entered in to applicable systems (See previous chapter) and issued Welcome Packages
  5. <<Staff Title>> obtains Welcome Letter template from <<Insert File Path>>
  6. On Welcome Letter, <<Staff Title>> enters today’s date in “Date”
  7. On the blank line following “Your Consumer ID is ______”, enter participant ID
  8. Enter participant first and last name in appropriate place on Welcome Letter
  9. <<Staff Title>> obtains a complete Welcome Package from <<file path or physical storage>>
  10. Each Welcome Package includes the following documents
  • Overview of F/EA's services, operations and key roles and responsibilities
  • F/EA hours of operation and key contact information
  • Timesheets
  • -These are used for workers and consumers to report service provided by the workers
  •   Invoices
  • -These are used for non-workers goods and services requisitions
  • Termination Form
  • -The participant completes this form and submits it to F/EA when they terminate a workers
  •  Change and Request Form
  • -This form is used for the participant to request changes to their or their workers’s address, telephone number or other contact information
  • Notification of Reinstatement of Worker
  • -This form is used for a participant to notify F/EA that they are re-hiring a workers
  •  Policies
  • -<<Insert Policies that F/EA wishes to share with participant>>
  • Fraud and Abuse Policy
  • <<Staff Title>> obtains manila envelope from shipping supplies storage area
  • Obtain participant or representative mailing address
  • Mail envelope to participant or representative

 

Internal Controls: 

The internal controls used by F/EA to monitor this process establish responsibility, segregate duties, document procedures and ensure independent internal verification.

  1. All systems are password protected
    • Only staff with direct responsibility for certain budget duties have password access to systems
  2. All Welcome Package documents are maintained in a secure location within F/EA Department
  3. When a Welcome Package document is updated all copies of previous form versions are discarded from Welcome Package document storage location
    • This ensures that only the most up to date versions of documents are included in Welcome Packages
  4. Issuing Welcome Packages is the responsibility of <<Staff Title>>. Customer Service and Payroll staff are not authorized to issue Welcome Packages.
  5. Only F/EA Department staff have access to Welcome Package contents
    • Envelopes are sealed prior to delivering to F/EA front desk staff who stamp and mail Welcome Package

Operate as a Medicaid Enrolled Provider (when applicable)

Policy: 

If the F/EA is operating as such in a Medicaid program, the F/EA must be a Medicaid enrolled provider.  <<Adjust this per program rules.>>  In Medicaid programs, the F/EA must be an enrolled Medicaid provider prior to receiving participant budget funds, making payments on consumers' behalves or submitting service claims for payment.

<<Insert policy for F/EA to be a Medicaid enrolled provider for the program.>>

<<Insert policy for how F/EA maintains status as Medicaid enrolled provider.>>

Procedure: 

<<Insert procedure to apply for and receive a approval to be a Medicaid enrolled provider, as applicable.>>

Internal Controls: 

<<Insert any internal controls related to operating as a Medicaid enrolled provider.