By Holly Christopher

Stellar Therapy services was founded in 2003 by Melissa Christopher, Occupational Therapist and has been supporting Tennessee schools in Medicaid Reimbursement since 2010. We provide pediatric outpatient occupational therapy, physical therapy, and speech therapy and have 100+ therapists providing services in all types of clinical settings, including hospitals, nursing homes, home health, and schools. We’re currently providing contract therapy services for facilities and schools and Medicaid Reimbursement Services to more than 50 Tennessee School Districts!

OUR MISSION:  

To provide quality services with integrity while maintaining a “life-friendly” corporate environment.

Background of MRP

Medicaid is a federal program that provides health insurance for those who cannot afford coverage or are otherwise uninsurable. TENNCARE is Tennessee’s State Medicaid program, and each state has their own state Medicaid program.

A Managed Care Organization (MCO) is a private insurance company that contracts with TennCare to administer the state Medicaid program (i.e. United Healthcare, Amerigroup, and Blue Cross & Blue Shield through BlueCare and TennCare Select)

“Although Medicaid is traditionally the payer of last resort for health care services, it is required to reimburse for IDEA-related medically necessary services for eligible children before IDEA funds are used.”

-The Medicare Catastrophic Coverage Act of 1988 enacted this requirement which is currently codified at 42 U.S.C. 1396b(c).

“When a ‘related service’ is a service that is otherwise coverable by
TennCare (i.e., it is a covered service that is medically necessary), then
the MCOs have an obligation to cover these services upon request,
subject to the usual requirements.”

–BUREAU OF TENNCARE POLICY MANUAL, Policy Number CON 07-003(rev.1) 7/21/2009

Stellar Therapy Services has been supporting schools in Medicaid Reimbursement since 2010.

Since 2010, Stellar has been involved with a national organization, National Alliance for Medicaid in Education (NAME), that promotes and supports Medicaid Reimbursement Programs in schools

In 2017, Stellar Therapy along with LEA representatives presented to the TN State Senate Education Committee / Health and Welfare Committee to discuss the administrative barriers that TennCare/MCOs were placing on school districts participating in an MRP.

Currently, Stellar has continued to participate in a joint Task force that includes members from TennCare, Tennessee Department of Education, LEAs, and other Vendors.

Over the last few years, the following barriers have been removed and
enhancements have been made:

• Signed consent to bill one time per lifetime of the student in a district
• MCOs cannot deny credentialing school-based providers due to networks being closed
• MCOs are required to credential school districts as groups
• School districts now have 365 days from the date of service to submit a claim
• School districts have access to a manual from TennCare and TDOE that provides
  guidance on how to set up an MRP
• Effective 07/01/2022, doctor orders will no longer be required from the student’s PCP to bill OT, PT, or SP; evaluating therapy providers will be able to order therapy services for billing purposes
• Effective 07/01/2022, updated consent form will also include nursing services within an IEP or IHP

Reimbursable Services

Parts of the MRP

Benefits of a MRP

Why should your school district participate?

• Brings in additional federal funds
• Lessens the use of other state and local funds
• Consistent documentation across all disciplines
• Reimbursements can be used for what the school district deems appropriate – materials, supplies, CEUs, staffing, etc.

Benefits of Using StellarDoc

Uniform USER-FRIENDLY documentation system for related service providers and administrators

• Collects all the required information for TennCare reimbursement
• Consistent and standardized documentation
• Time Saver
• Discipline specific
• Goals can be entered in StellarDoc for easy progress monitoring
• No More Paper!

Benefits of Related Service Providers Using StellarDoc

• Shows evidence that progress was made or not made on IEP goals
• Easily exports reports into Excel
• Formats the data to be used for a variety of reasons
• Providers that are covering for a leave of absence or taking over
  caseloads have direct access to student’s documentation therefore
  are more informed of the student’s individual needs providing an
  efficient transfer of care for your students.

Benefits of a Supervisor Using StellarDoc

• Real time access to all service documentation
• Supports school district as proof that something did or didn’t happen
• Provides evidence that students received services as written into their
  IEPs
• Prepares school staff for difficult IEP meetings or legal situations
• Presents all the information you need to speak to a concerned parent

Benefits of a Supervisor Using StellarDoc Dynamic Calendar

The Calendar is Always Current!

• Ensures all related service staff have balanced caseload/workload
• Supports you in quickly covering a midyear leave of absence
• Assists you in scheduling required observations of related service staff
  throughout the year
• Reportsthat related service staff satisfactorily completed required professional
  duties (entered implemented therapy sessions) as part of their annual evaluation
  process

Note: A therapist may present an export of StellarDoc as an artifact to support themselves as part of their evaluation

Stellar Therapy Services MRP Statistics

• Currently manages 43 TN school districts
• Implemented a MRP to TN school districts for the past 13 years
• Assisted TN schools in bringing in over $22 million dollars in health-
  related Medicaid reimbursements

➢Speech Therapy Services $12.4 million

➢Occupational Therapy Services $2.8 million

➢Physical Therapy Services $1.5 million

➢Nursing Services $1.7 million

*Totals above begin with the 2014-2015 school year through the current school year 2021-2022

District MRP Statistics

Includes PT, OT, and Speech Reimbursements

Managing a MRP

Why should you partner with Stellar for your MRP?

Stellar Therapy Services take care of everything for the MRP!

• No cost to set up
• Assist district with setting up Medicaid ID
• Credential Therapists- school employees and contractors may be credentialed
  under the school district
• Provide an EASY web-based documentation system for therapists
• Provide all forms, parent notifications and obtain physician orders
• Maintain medical charts including tracking parental consents and physician
  orders for billing
• Provide training for therapists on documentation system,
  forms, and compliance training from the MCOs.
• Help with therapist buy-in

Why Work With Stellar?

Stellar Therapy Services was the first company in Tennessee to
successfully obtain reimbursements FOR school districts.

Our administrative staff and management teams have been directly
involved in meetings and negotiations with the Managed Care
Organizations (MCOs).

We constantly monitor changes taking place in TN and across the
nation in order to stay abreast of current rules and regulations.

Our program sets the standard for best practice processes for school-
based Medicaid Reimbursement Programs in TN.

School District Testimonials

➢ Besides the revenue, I think it holds the professionals taking the data responsible for doing the data input and making sure their sessions are all accounted for on a regular basis.
➢ Receiving percentage of money that we would not be getting if we didn’t participate.
➢ I would just be leaving funds on the table if we didn’t have a program. There is no way we could handle the reimbursement ourselves and are very thankful for Stellar’s prompt, professional, and very helpful supports.
➢ It provides money to purchase equipment and support salaries for staff
➢ It helps provide funding for an extra SLP and help in purchasing testing equipment like iPads and apps they can use for therapy and testing.
➢ Since we began our partnership with Stellar Therapy, our district has been able to provide our therapists with supplemental devices and materials that we would not have been able to provide otherwise – it’s a WIN WIN!!!
➢ Coming in as a new supervisor and being unfamiliar with the program, transition was handled appropriately and effectively. Processes and procedures were detailed, and benefits of the program are exceptional.