Certified Nurse Assistant Reimbursement

Important Points - Billing Instructions - Additional Assistance

Certified Nurse Assistant reimbursement establishes a method for payment of nurse assistant training as required by Omnibus Budget Reconciliation Act (OBRA) '87.

Provisions of this reimbursement plan apply only to nursing facilities with valid provider agreements certified for participation in the Missouri Medical Assistance (Medicaid) Program. The Missouri Medicaid Nurse Assistant Training and Competency Evaluation Billing form is currently available online. You may go to the following link for further information. For further information: http://www.dss.mo.gov/mhd/providers/index.htm.

If you are interested in utilizing the Internet for eligibility verification, electronic claim submissions, and Remittance Advice retrieval, you need to apply online via the Application for Missouri Medicaid Internet Access Account link. Each user is required to complete this online application to obtain a user ID and password. The application process only takes a few minutes and provides you with a real-time confirmation response, your user ID, and password. Once you have received your user ID and password, you can begin using the www.emomed.com web site.

Important Points of the Division of Medical Services Regulations

  1. Prohibition of Charges - No nurse assistant who is employed by, or who has an offer of employment from, a nursing facility on the date on which the assistant begins training and testing program may be charged for any portion of the program.
  2. The facility must bill for reimbursement within 1 year of the final exam.
  3. You must wait 60 days after the final exam before submitting your billing statement. This will allow sufficient time for the register to reflect the results of each exam. Any billings received before this time will be denied.
  4. A facility is obligated by federal regulation (483.152(7)c(2)) to reimburse on a prorated basis, a nurse aid for any training that he/she took prior to being hired, if the training took place within 12 months of hire. The facility should then complete the online billing form for reimbursement at www.emomed.com. The facility for audit purposes will need to maintain a file (cancelled check) verifying reimbursement to the student and the students' proof showing payment of the CNA class (invoice, receipt or bill). The billing form should be filled out according to the directions given above.
  5. At this time the regulations do not allow reimbursement for an individual who needs to retake the course or challenge the exam because of expired or inactive status if their original training was reimbursed.

If you have any questions contact us. If you are denied, we will try to help you understand why you were denied and to resubmit correctly.

Medicaid Nurse Aide Training Billing Instructions

Line No. And Description of Required Information:

1.-2. Name and Social Security Number of Nurse Aide completing the Nurse Assistant Training Program.

3. Date the Nurse Aide was hired by your facility. The format of the date is as follows: 01/01/2005.

6. Nurse Aide Training Agency (N.A.T.A) number that provided the final examination.

7. Name of N.A.T.A.

8. Indicate whether the Nurse Aide received on-the-job training.

9A. Indicate whether the Nurse Aide completed the entire 75 hours of classroom training (all 46 Lesson Plans).

9B. Indicate whether the Nurse Aide received only the Orientation Module.

9C. If the answer to 9A and 9B is "No", please indicate the lesson plans or modules the Nurse Aide completed. Please note, if the Nurse Aide challenged the Final Exam without any required classroom training, no boxes should be checked.

Additional Assistance on Questions 8-9
If the student took the training indicated in the 1st column, answer questions 8, 9A, 9B and 9C as indicated:

Training

8

ANSWER

9A

ANSWER

9B

ANSWER

9C

ANSWER

Entire Course:

  • 75 hours of classroom training
  • All 46 Lesson Plans
  • 100 hours of on-the-job training
  • Final Exam

Yes

Yes

Stop you are finished.

   
         

Challenge After:

  • Orientation Module only
  • 100 hours of on-the-job training
  • Final Exam

Yes

No

Yes

Stop you are finished.

 
         

Challenge After:

  • Only Specific Lesson Plans required
  • Orientation Module
  • 100 hours of on-the-job training
  • Final Exam

Yes

No

No

Check lesson plans required.

Stop you are finished.

         

Challenge After:

  • Final Exam only

No

No

Stop you are finished.

   

If you are denied and don't understand why, you may contact the Department of Health and Senior Services. You will need to have a copy of Appendix A-B, the billing application form and the Missouri State Medicaid Remittance Advise Sheet. We will be happy to help you.