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CareConnect Enterprise - External Provider Payment Processing Introduction Overview Follow

When dealing with completed timesheets from external providers, a structured approach is essential for accurate payment processing. This guide outlines the steps to efficiently utilize CareConnect Enterprise for payment processing, serving as both a checklist and a reference for this critical process.
Article Sections:
  1. Payment Status
  2. Workflow Breakdown

Payment Status Workflow

Understanding the payment status workflow is crucial for maintaining a streamlined payment processing system. There are six distinct payment status values that signify the progress of each payment:
  1. New: The provider has access to the payment through CareConnect and can digitally submit it.
  2. Received: The provider has digitally submitted the timesheet.
  3. Hold: Payment authorization is pending until specific criteria are met.
  4. Not Payable: Payment is no longer eligible for processing.
  5. Authorized: The agency has approved the payment for processing and export.
  6. Paid: The payment has been successfully exported.
If a provider submits a physical timesheet, manually change the status to "Received."

Workflow Breakdown

The payment processing workflow follows these steps:

A. Receiving Payments

Providers will utilize their own CareConnect account to track attendance and digitally submit their timesheets. This streamlined process ensures accurate and timely submissions, facilitating efficient payment processing. If you're interested in learning more about the provider's submission process, you can click here. To initiate the processing of a payment, follow these steps:

  1. Locate a payment for processing within the Provider Payments section, under the Submitted tab.
  2. Click on the Payment ID to initiate the processing.

B. Authorizing Payment

The process for authorizing a payment may vary based on agency policies. It's important to establish an internal protocol for this step. The involvement of accounting staff and state billing staff is crucial. The process involves:

For State Billing Staff:

  • Review all attendance records for the month, accessible under the Attendance and Provider Invoice tab.
  • Assess all absences to determine their type. Refer to specific absence types.
  • Classify absences appropriately for accurate reporting.

See CareConnect (Website) - SUBSIDY ATTENDANCE AND SUBMISSION

For Provider Payment Staff:

  • Review the payment calculation and make necessary adjustments for the payment. Access this information under the Payment tab.
  • Modify payment details to align with the specific provider's requirements.
  • Details will be visible to the provider via the Explanation of Payment (EOP).

See CareConnect Enterprise - Generate FCCHEN Payments

Given the significance of this step in deciding accurate compensation for providers and appropriate state reimbursements, it is essential to involve multiple parties or staff members for a thorough review before changing the payment status to Authorized.


In cases where a payment or attendance error/mistake is identified after exporting, you will need to go through the adjustment process to make any modifications to an already exported payment. This adjustment process ensures that any discrepancies or errors are rectified accurately to maintain precise financial records and provider payments.
C. Exporting Payments
After successfully processing and authorizing one or more payments, the final step is exporting payments to your accounting software. This step involves:
  1. Exporting payments to your accounting software to ensure proper financial recording.
  2. After the export, access essential files like the EOP, Payment Export, and Payment Summary for comprehensive record-keeping.
  3. Note that the EOP and payments specific to the provider will be accessible to the provider.

D. Payment and CDNFS/EENFS Adjustments

1. Payment Adjustments

Once the payment ID has been exported and is in PAID status, any changes must be done via an adjustment. In the Payment ID screen, select the Payments > Adjustments tab to enter any adjustments. Select +Add Items.

In the next screen, enter the adjustment details. 

Choose Payment Adjustment for payment amount or reporting data updates. Select Other Amount Adjustment if adding or adjusting Cost of Care payments.

  • Select +Add Items. Populate the fields and select Done.
  • Scroll down to Adjust Detail and select to Edit and Recalculate to update the child's data

 

2. CDNFS/EENFS Adjustments

Once the payment ID is in Authorized or Paid status, data will return in state reports. To update reporting or payment data in Paid status once calendar, schedule, attendance or family record data has been changed, see below. 

To correct the student's reporting enrolled or attended days, report type or reporting category for CDNFS/EENFS reports:

  • Enter the Payment Adjustment as a Payment Adjustment for $0.00 and select Done.
  • Scroll down to Adjustment Detail and select to Edit and ReCalculate to update the child's data
  • Calculate > Batch CDNFS/EENFS the Attendance > CDNFS/EENFS data to see updated values.

 

E. Subsidized Provider Report (SPR)

Once the provider payment has been exported and marked as Paid, generate the monthly SPR report under Billing > Reports > Subsidized Provider Report as required for state submittal:

 

 

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