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MSB VT Newsletter | October 2012



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Mail: MSB

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Somersworth, NH 03878






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Supporting Our Community
Dover Children's Home Air Show - 2
MSB supporting the Dover Children's Home at the Air Show in Newington, NH.
Director's Corner
Steve & Jordan

Steve Courter, Director of Client & Business Services


With the busyness of summer turning into fall you are probably a little overwhelmed by the start-up of school.  We want you to know that MSB is available to help any way we can, just ask us!  We are full of useful information. For example, did you know how many different varieties of Maples there are? Approximately 128 species! Oh and yes, we can answer your Medicaid questions too!


Just as you appreciate each of the different species of Maple trees for their unique qualities, we hope that as you've returned to school that you see the same uniqueness in each of the children that you work with.  These extraordinary children help remind us all of why we do what we do.

IMPORTANT REMINDERS for Case Managers and Service Providers

  1. Amendments - When a revision/amendment to the IEP is completed with a meeting, the following three documents are needed: 
    • A completed form 5c or 7a
    • A revised cover page (which includes the revision date)
    • A revised service page

    When a revision/amendment to the IEP is completed without a meeting, the following three documents are needed:

    • A completed form 5b
      • Must include how the parent was notified of the change
      • Must be signed and dated by the case manager
    • A revised cover page (which includes the revision date)
    • A revised service page
  2. No Hand Changes to IEPs - NO hand changes to the IEPs are allowed.  Pages must be updated and reprinted with the correct information.
  3. Blue Forms and Pink Forms - please submit a blue form for each annual IEP renewal (claim amount $422.00) and a pink form for every 3-year re-evaluation (claim amount $743.00).
  4. Documentation Logs - Handwritten changes, including cross-outs, must be initialed.  Do not use ditto marks, arrows, pencil or white out when filling out service logs.  The Developmental and Assistive Therapy (DAT) logs under section "IEP ACTIVITY" must be recorded exactly as it appears on the Service page of the IEP. 
  5. Personal Care Verification FormThe Personal Care Verification Form is mandatory for all students whose services are being billed as Personal Care. The purpose of the form is to verify that the student's services being billed meet the Medicaid definition of Personal Care. In order for a service to be billed as personal care, the student's IEP must require one-on-one services for the entire school day. This may be listed as one service on the IEP or a combination of one-on-one services that total the student's entire school day. This form should be attached to the corresponding IEP/Amendment section. Click to download  PCVF Instructions.
  6. Personal Care Service Documentation LogThis form is to be completed by the individual providing the majority of the services.  When a student has multiple individuals acting as a personal care aide, only one form is completed.  The provider records the number of hours  personal care was provided each day in the calendar including bus time (do not record "X" or minutes in the calendar).  The provider is allowed to document services they provide as well as those provided by substitutes who fill in on a temporary basis.  The provider needs to include a note on the log when the services provided are different than what is listed on the PCVF.
  7. Quarterly progress notes due for related services; Progress notes are required for all Related Services (Speech, PT, OT, Counseling, Nursing, etc.) billed to the School-Based Health Services Program. Progress notes can be the updated goals/objectives section of the IEP, a typed or handwritten note or a description of the student's progress.   Progress notes need to be completed quarterly or to coincide with the school marking period (minimally three times per year). If a progress note is not completed, future billing for the service cannot be submitted.
Medicaid Federal Match Rate has decreased and will reflect these changes on the January, 2013 Grant Awards






Global Commitment (GC) State Children's Health    



Insurance Program (SCHIP)



Adori Updates

State Mandated Essential Early Education Individual Education Plan (EEE IEP) is available in AdoriThe new IEP for EEE form is used for children ages 3 through 5 years who have been determined eligible to receive early childhood special education services/EEE services. Effective July 1st 2012, users of the IEP for EEE form will develop and document appropriate special education and related services necessary to address eligible student's educational needs. The new IEP for EEE form integrates IDEA Part B Early Childhood Outcomes into the IEP process.


Child Count 2012 - December 1st Child Count Report is now available in Caseload Reports/District Reports.



Reminder:   Be sure to review notifications when you see the Navigation Button illuminate in red.  This indicates that there is a new notification to review. Two notification were sent recently that will be beneficial to case managers.


Once the notification has been reviewed, click on the "Acknowledge" button.   

Annual Award
Every year MSB recognizes one of our employees for their achievements throughout the year. This year we are pleased to announce that Heather Plourde, NH Claims Analyst is the recipient of this award. Her commitment and dedication to her clients, as well as to her team, is invaluable. We are so fortunate to have Heather as part of the MSB family!
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