CCS Claims must be submitted by the 7th of the month following the month of service. For example, all claims for January dates of service must be submitted by February 7th. All claims for February dates of service must be submitted by to March 7th. And so on...
We have an automated process that gathers up Submitted claims from the previous month on the 8th, the process creates packages to send to Forward Health. Forward Health pays Dane County CCS, and we distribute the payments out to the agencies that provided the service. We need to set the billing deadline like this becuase of how 'rigid' Forward Health is when accepting claims. Forward Health will accept 1 claim per client per day. (Other criteria come into play, like Place of Service and Degree Level of provider, but to simpify the explanation, assume 1 claim per client per day) But in CCS, a client can potentially receive multiple services on any given day, from different agencies. When multiple services are provided to the same client on the same day, we need to 'roll' the individual claims together into a package. We then submit the package to Forward Health who pays us for the packaged of services, and we distribute the payments to the individual agencies. If an agency is late in submitting their claims, they run the risk of losing out on their payment, if that late claim needed to be 'rolled' with another like claim.
