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December 2016 Texas Medicaid Provider Procedures Manual

Children’s Services Handbook : 3 School Health and Related Services (SHARS) : 3.5 Claims Filing and Reimbursement : 3.5.3 Reimbursement : Quarterly Certification of Funds
SHARS providers are required to certify on a quarterly basis the amount reimbursed during the previous federal fiscal quarter. TMHP Provider Enrollment mails the quarterly Certification of Funds statement to SHARS providers after the end of each quarter of the federal fiscal year (October 1 through September 30). The purpose of the statement is to verify that the school district incurred costs on the dates of service that were funded from state or local funds in an amount equal to, or greater than, the combined total of its interim rates times the paid units of service. While the payments were received the previous federal fiscal quarter, the actual dates of service could have been many months prior. Therefore, the certification of public expenditures is for the date of service and not the date of payment.
In order to balance amounts in the Certification of Funds, providers will receive, or have access to, the Certification of Funds Claims Information Report. For help balancing the amounts in the statement, providers can contact the TMHP Contact Center at 1‑800‑925‑9126.
Refer to:
Preliminary Information” in (Vol 1, General Information) for more information about provider relations representatives.
The Certification of Funds statement must be:
Failure to do so may result in recoupment of funds or the placement of a vendor hold on the provider’s payments until the signed Certification of Funds statement is received by TMHP. Providers must contact the TMHP Contact Center at 1‑800‑925‑9126 if they do not receive their Certification of Funds statement.
On an annual basis, SHARS providers are required to certify through their cost reports their total, actual, incurred costs, including the federal share and the nonfederal share. Refer to the section below for additional information about cost reporting.

Texas Medicaid & Healthcare Partnership
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