5. Supervise/directly observe on site for at least one (1) hour monthly as determined by the needs of the child, family, and/or direct treatment staff; and 6. Attend and participate in monthly team meetings 28.08-3 Program Integrity The Program Integrity Unit monitors MaineCare reimbursed treatment services provided and determines the appropriateness and necessity of the services, including duplication of services. All Program Integrity requirements apply as defined in the Chapter I, MaineCare Benefits Manual, “General Administrative Policies and for more detail. Procedures” 28.09 BILLING The documentation must demonstrate only one staff person's time is billed for any specific activity provided to the member. Billing must be accomplished in accordance with the for Services for Children with Cognitive Impairments and Department's “Billing Instructions Functional provided by the MaineCare Services, Division of Customer Service: Limitations” ( ) 28.10 REIMBURSEMENT 28.10-1 Rates. Reimbursement is specified in the MaineCare Benefits Manual, Chapter°III, Section 28. 28.10-2 Reimbursement Allowances. In accordance with Chapter I of the MaineCare it is the responsibility of the provider to seek payment from Benefits Manual, every other source that is available for payment of a rendered service before billing MaineCare. MaineCare will pay the lowest of the following: The fee established by MaineCare; The lowest payment allowed by Medicare; or The usual and customary charge. provider’s
5. Supervise/directly observe on site for at least one (1) hour monthly as determined by the needs of the child, family, and/or direct treatment staff; and 6. Attend and participate in monthly team meetings 28.08-3 Program Integrity The Program Integrity Unit monitors MaineCare reimbursed treatment services provided and determines the appropriateness and necessity of the services, including duplication of services. All Program Integrity requirements apply as defined in the MaineCare Benefits Manual, Chapter I, “General Administrative Policies and Procedures” for more detail. 28.09 BILLING The documentation must demonstrate only one staff person's time is billed for any specific activity provided to the member. Billing must be accomplished in accordance with the Department's “Billing Instructions for Services for Children with Cognitive Impairments and Functional Limitations” provided by the MaineCare Services, Division of Customer Service: ( ) 28.10 REIMBURSEMENT 28.10-1 Rates. Reimbursement is specified in the MaineCare Benefits Manual, Chapter°III, Section 28. 28.10-2 Reimbursement Allowances. In accordance with Chapter I of the MaineCare Benefits Manual, it is the responsibility of the provider to seek payment from every other source that is available for payment of a rendered service before billing MaineCare. MaineCare will pay the lowest of the following: The fee established by MaineCare; The lowest payment allowed by Medicare; or The provider’s usual and customary charge.