Participation in Respite Provider Network

 

• The Respite Provider agrees to participate in the Anthony's Villa Respite Provider Network.

 

 

Independent Contractor Status

 

• The Respite Provider acknowledges and agrees that this is a 1099 independent contractor position. This agreement does not create an employer-employee relationship between the Respite Provider and Anthony's Villa.

 

 

Payment Terms

• Payments will be made to Respite Providers on a monthly basis after Anthony's Villa receives the billing information from the Respite Provider and payment from the payer source, such as Aetna Ohio Rise.

• In the event that a service is denied, no payment will be issued. Anthony's Villa acts as an intermediary between Aetna Ohio Rise and the Respite Provider, managing claims, denials, and working to secure payment for services rendered.

• Respite payments will be made as follows:

• $7.50 per 15 minutes for services up to 3 hours

• $125 for services lasting 3 hours and 1 minute or more.

 

 

Service Eligibility and Documentation

• Respite services will only be rendered to eligible members of Aetna Ohio Rise or other payer sources as they become available.

• Respite Providers must submit billing for reimbursement within 30 days of providing services.

• Each day of service should be documented separately. For example, if a child receives respite care from Friday to Sunday, three separate Respite Service forms must be submitted—one for each day.

• Documentation must be completed separately for each child if providing group respite services. For instance, if three children receive services across three days, nine total service forms must be submitted.

 

 

Provider Responsibilities

• Respite Providers agree to perform services at a mutually agreed-upon location with the child’s parent or guardian.

• Respite Providers are responsible for verifying that the child is eligible for services on the day(s) of respite. Contact the Respite Program Manager at Anthony's Villa to confirm insurance verification prior to providing services.

• Respite Providers are responsible for submitting accurate claims. Fraudulent claims may result in removal from the network and payment recoupment.

• Respite Providers are required to carry their own liability insurance and must have a current, unrestricted driver’s license and automobile insurance.

 

 

Service Limitations

• Respite services cannot be rendered on the same day as another service provided by Anthony's Villa. If other services are rendered on the same day, the respite service will not be reimbursed.

• Respite Providers will not be reimbursed for background checks, mileage, or any additional expenses incurred during the provision of services. The agreed-upon rates are all-inclusive.

 

 

Legal and Compliance Requirements

• Respite Providers must pass all required background checks to participate in the network.

• Respite Providers must be eligible to provide services under the Department of Medicare and Medicaid and must not be disbarred at any time.

• Respite Providers agree to be bound by the laws of the State of Ohio, with all legal issues subject to mediation.

 

Required Education and Certification

• Respite Providers must have the minimum:

• BLS Approved First Aid and CPR Certificate from American Red Cross or American Heart Association

• High School Diploma or GED

• Current Unrestricted Driver's License

• Current Automotice Insurance

• Current Liability Insurance

 

Miscellaneous Provisions

• Respite services may be provided by any individual who is not the primary caregiver of the child.

• Respite services cannot be rendered payable by Anthony's Villa until the respite provider has received notification that they are participating fully and credentialed for respite services. Previously rendered services are not payable by Anthony's Villa.

• The Respite Provider acknowledges that Anthony's Villa will not reimburse for background checks, mileage, or any other incidental expenses.

• This agreement represents the entire understanding between Anthony's Villa and the Respite Provider and supersedes any prior agreements or understandings.

• A separate Contracting Document will be sent upon acceptance into the respite provider network.

• Provider agrees to receive 1099 and Direct Deposit for rendered, payable services.