Service Delivery Entries in ITeams
I-TEAMS (Infant-Toddler Electronic Administration and Monitoring System) is the web-based application which allows DES/AzEIP, as well as its contractors and partner agencies, including the Arizona State Schools for the Deaf and the Blind, the DES/Division of Developmental Disabilities (DDD), to enter and view child record data for children referred to and eligible for the Arizona Early Intervention Program.
As a contracted provider, a key utilization of I-TEAMS is the “Service Delivery” page. The Service Delivery page is where each billable service rendered for a child is entered into, and tracked by, the I-TEAMS database. Invoices submitted to AzEIP are based upon the billable services entered through the Service Delivery page that are classified as “billable” and help identify service that are non-billable for one reason or another. Additionally, by entering all billable services into I-TEAMS, providers are able to gather important information, such as a provider’s remaining IFSP units available under the IFSP entered and tracked by the I-TEAMS system.
To navigate to the Service Delivery page for a particular child record (after first entering into a child’s electronic record on I-TEAMS), a provider can click on the “Child Demographics” button. Once at the Child Demographics page, scroll to the bottom of the page and select the hyperlink for “Service Delivery.”
ENTERING A SERVICE INTO I-TEAMS THROUGH THE SERVICE DELIVERY PAGE
STEP 1 – ENTER SERVICE DATE: When the Service Delivery page first populates, the I-TEAMS System defaults and displays the current date which can be changed using the calendar icon to the right of the date field.
STEP 2 – SERVICE SELECTION: After setting the correct date of service, the next field is the “Service” field. By clicking on the gray box immediately under the word “Service”, a menu will appear with various service descriptions – the correct description should be selected.
STEP 3 – TEAM MEMBER SELECTION: Once a service description is selected, the “Team Member” box will activate and the user can selected the appropriate team member that corresponds with the service description previously selected. Select the team member’s name that has provided the services by using the drop down list. This field has provider name along with discipline type. This information is only available if the team member has been added to the Assign/Change Team member page. If the appropriate team member does not appear, it may be that the team member has not yet been added as a team member to the child’s file in I-TEAMS or some other pre-requite information has not been entered into the I-TEAMS system (i.e., program eligibility has not been entered yet and a provider is not able to enter an evaluation, etc.). Additionally, this box will show a provider’s “end date” (if applicable). If a service is entered for a team member with a date after such team member’s “end date”, such entered service may not save properly or may be treated as “nonbillable” by the I-TEAMS system until corrected.
STEP 4 – SELECTING SERVICE/BILLING MODIFIERS: After selecting the appropriate team member, the next progressive step is to select any billing/service modifiers that apply to the service entry being made. Not every service entered requires a modifier. For example, a joint or regular home visit does not usually have any modifier that applies (that is not automatically selected by the I-TEAMS system due to the selected team-member being the team lead). Also, service coordinators should not select any of the modifiers for the direct service of an initial visit. Below is a list of the modifiers that may apply to a service being entered into the I-TEAMS system:
The most common modifiers are:
Assessment – This modifier should be selected if the service relates to a CFA (whether part of the initial CFA or subsequent review or modification).
Meeting – This modifier is selected if the service involves the IFSP, any addendum, exit, or transition conference meeting. This modifier is not to be selected for a service coordinator’s initial visit or any other direct visit that does not involve the creation or modification to an IFSP.
Non-Direct – This modifier should be used by service coordinators for permitted/billable services that do not involve direct contact with a serviced child or family (accordingly, as noted below, the location for non-direct services are usually “other” and is the default “location” entry when the non-direct modifier is selected). This non-direct modifier is also utilized by the “team lead” for research activities, quarterly reports, and other permitted team-lead, non-direct services. Currently, team leads are permitted up to 1 unit/per quarter of non-direct units for each child for which they serve as the team lead.
Service Coordination (Dual Role) – This modifier is automatically selected if the service description selected is “service coordination” and the team member selected has a role designation other than “service coordinator”. Once the IFSP has been established, the “Service Coordination (Dual Role)” modifier should only apply to the team lead who is also acting as the service coordinator under the current IFSP.
Evaluation – This modifier should be selected if the service relates to the initial evaluation or a re-evaluation (if initial program eligibility was determined by clinical opinion) of the child. The maximum billable units available for this modifier is 2 units per provider.
Report Writing - This modifier should be selected if the service relates to the writing of the DER. This modifier is not used for any quarterly or other report. The maximum units available for all team members involved in the DER related to the initial evaluations is 1 unit and is usually apportioned between the two evaluating providers according to ACT policy. Currently under the I-TEAMS system, this modifier is not available for any report related to a re-evaluation.
Travel - This modifier should be selected if the service relates to travel time for a service coordinator that does not involve the “commute” to or from the service coordinator’s home unless the distance of such “commute” exceeds 50 miles. Accordingly, this modifier is not available for time from a provider’s home until the first point-of-service is reached, nor for the travel time back home after leaving the last point-of-service for the day. The units entered with this modifier also should not include or cover any additional time incurred due to “side” routes or “errands” that are navigated into the travel path from one point-of-service to another.
The other modifiers listed are less frequently used. Before selecting one of these other modifiers, the user should make sure that he/she fully understands the proper application of the desired modification.
STEP 5 – TPL: If the service is “TPL” reimbursable, the user has to select the “Yes” button where TPL reimbursement is questioned. If the service is not “TPL” reimbursable, then “No” should be selected or both the “Yes” and “No” buttons should be left blank.
STEP 6 – ENTER UNITS: Use the field boxes to enter the service units. Some services have a limit to the billable units that can be entered. Make sure you stay within these limits.
Providers shall adhere to the ACT’s Billing and Documentation Guidelines.
The amount of time a provider may bill for DIRECT time with family, including all meetings, therapy, and joint visits, MUST be ONLY time spent with the family. A provider may not add on extra time for prep, drive time, or discussion with other team members.
All billed time must follow the “8 Minute Rule” and must be rounded to the closest 1/4 unit. For example, if a provider’s visit with a family is 52 minutes, the provider must bill 0.75 units because the provider would be required to round to the closest quarter of a unit. If the provider’s visit with the family is 53 minutes, the provider may bill one (1) full unit because the provider is round to the closest 1/4 unit.
If the provider is rendering a service with another team member (i.e. JV, evaluation, IFSP), the amount of time each provider bills should match UNLESS one team member arrives late and the other team member starts the session. If this occurs, BOTH team members should include this in their documentation (NOTE: This does not include drive time for SCs).
Note about Non-Direct Team lead (NDTL) billing: Providers are permitted to bill 1.0 hour of NDTL each calendar quarter. A provider may bill this hour for each client for which the provider is acting as the team lead (TL) throughout the quarter. The provider must make sure of the following: (i) documentation on a contact note of all dates and times spent completing NDTL activities throughout the quarter is required; (ii) the provider cannot bill NDTL time at the end of the quarter if the child has already aged out as NDTL time must be billed before the child turns 3 years old; (iii) the provider cannot bill more than 12 units in one day.
Providers should be aware that the ITEAMS system does not permit a provider to enter more than 12 units (in total billed) for any calendar day, including therapy and meetings as well. ND time should be conducted and billied in a manner that should avoid any submitted units to be deemed nonbillable due to this 12-hour rule. Providers may bill units on weekends as well.
Note: When entering units, do not select the “Yes” button related to reversals (unless you are intending to submit a reversal of a prior entry). As a default, the “No” button will already be selected.
STEP 7 – LOCATION SELECTION: Using the location drop down list, the user should select the appropriate setting that applies to where the services were rendered:
For direct services, the location should only be home or community based. The location of “community based” may include locations such as the child's daycare and parks.
When making a location selection, if the zip code does not automatically populate, the proper zip code to be selected should be within the child’s contract region. Services will get listed as “non-billable” if the zip code of the service provided is not a zip code listed in that child’s contract region.
STEP 8 – SERVICE DELIVERY NOTES: The user may add any desired notes to the service entry.
STEP 9 – SAVE ENTRY: Once the entry has been completed, the user will click the “Save” button which will cause the entry to be saved within the I-TEAMS system. Once saved, the entry will move down to the service delivery history/grid (below the Service Delivery Notes), where the service deliveries can be seen. The user has the option to list the service deliveries by 25, 50, 100 and All.
MISCELLANEOUS MATTERS REGARDING SERVICE DELIVERY ENTRIES
Editing Entries - The user may edit the service information by selecting the “edit” link next to the particular service delivery. After selecting the “edit” link, the service will automatically populate at the top where Service delivery information was entered earlier, and the user can edit and save as desired. The user will not be allowed to delete a service.
If the service has already been invoiced (i.e., the service no longer has the blue “Edit” link but now has a “Reviewed” notation next to the service’s date in the service history grid), then the user can no longer edit the service.
Consolidating Entries - A provider can only entry one service delivery entry per day, per service modifier. For example, if a service coordinator has a phone call with a child’s parent for 0.25 units (a non-direct modifier service) and in the same day reviews and processes some of the child’s records/files for 0.50 units (also a non-direct modifier service), the service coordinator will not be permitted by the I-TEAMS system to enter two separate service delivery entries with a non-direct modifier. Instead, the provider should consolidate these non-direct services and make one service delivery entry using the non-direct modifier for a combined total of 0.75 units.
Reversals - After saving a service entry, you cannot delete it from the I-TEAMS system; to correct an entry error, use the reversal option to correct a service. When doing so, make sure that the service date, service description, team member, selected modifiers and unit total fields for the reversal entry all match the original service entry being reversed.
Another possible way to correct a service entry is to use the “edit” link for the previously entered service (unless such link is no longer available) and either correct the erroneous field(s) and hit the “Apply Edit” button when finished (or, if the whole entry was in error, then use the edit function to “zero out” the errant entry).
Using the Service History as helpful information - In the service history grid, each entry indicates whether the service “counts” against the service units reserved under the current IFSP. This indicator is an automatic application based on the current information in the I-TEAMS system at the time the service entry is saved and basically states whether or not the service is an authorized IFSP service. If it is, the entry should show the ‘Remaining Units’ authorized after deducting the saved entry. Otherwise, it will show “Not IFSP”.