Guidelines for Reimbursement

Reimbursements can only be processed once the service has been rendered.

Items/services must have available funding in the corresponding Self-Direction Budget line for the Reimbursement to be processed.

• The Life Plan must correctly reflect the budgeted section(s) that the items/services are to be reimbursed from.

Items/Services that require prior approval should not be submitted for reimbursement until approval is given by the FI.

Overnight out-of-state services require prior approval.

• A Yedei Chesed Out of State form should be submitted to the FI for review and approval.

Reimbursements need to be submitted through eVero unless prior written approval is given by the FI.

Reimbursements need to be submitted correctly no later than 60 days from the month of service.

• For example, an invoice submitted on October 30th with a date of service of August 1st has the month of service of August. Since October is still within 60 days of the month of service, this invoice can be submitted. 

Self-Hired Staff reimbursements submitted by the staff or on behalf of the staff must be submitted correctly no later than 30 days from the date of service.

• This applies to IDGS Transportation and OTPS Staff Activity Fees

• The Individual/Designee must review the Self-Hired staff reimbursements no later than 60 days from the date of service

Only reimbursements that are CORRECT will be processed. Payment may be delayed if corrections are needed. No payments will be issued until submissions are in absolute compliance with all regulations and policies.

• If corrections are required, the invoice would need to be corrected and resubmitted within the allowable timeframe.

Invoices that are submitted for Direct Payment, such as Community Classes, will be added to and processed in eVero by a Direct Pay Coordinator instead of your FI Coordinator.

Expense reports are distributed monthly through the eVero platform. Expense reports should be reviewed with your Broker to ensure correct expenditure and budget utilization.

If an error is identified with paid invoices, the agency will conduct a review. Upon confirmation of an error, corrective action may include reversing billed amounts from Medicaid and OPWDD and recovering funds from the individual or their designee. Recovery will generally include any erroneous reimbursements made within 60 days prior to the month the error is flagged, and the individual/designee is notified. This will be reviewed on a case-by-case basis by the FI Billing Supervisor.