Third Party ReimbursementLearning Support : Minnesota Department of Education

Third Party Reimbursement

Third Party Reimbursement

Third Party Billing
The federal Individuals with Disabilities Education Act (IDEA) and Minnesota statutes require all school districts to seek payments from third parties when the cost of assessments and related services are covered by a student’s public or private health plan.  To accomplish this mandate, districts must integrate complex health plan requirements with the intricate details of IDEA.

Parents, educators, and administrators can access information, forms, tools, and data about third party billing for covered health related Individualized Education Program (IEP) services below or through the related links located on the left side of this page.   

Contact Information:
MDE Policy: Cathy Griffin, 651-582-8263 email: Cathy Griffin
MDE EDRS: Mona Regan, 651-582-8638 email: Mona Regan
* DHS Policy: Genie Potosky, 651-431-2622 email: Genie Potosky
* DHS Rates: Jesusa Williams, 651-431-2538 email: Jesusa Williams

* Links to third-party sites are provided as a service to Minnesota Department of Education (MDE) Website visitors. See our disclaimer regarding these sites in our copyright information linked at the bottom of this page. Links will open in a new browser window.

* By clicking on links on this page, you will leave the MDE Web site. See our copyright notice for our disclaimer regarding these links.

Combined Consent to Share Data and Seek Payment for Individualized Education Plan (IEP) Health Related Services - A  113Kb (11/27/07)  77Kb (11/27/07)
     Combined consent and data sharing form for public or private health plans. Includes denied consent and revocation of consent. Updated 11/07.
Combined Consent to Share Data and Seek Payment for Individualized Education Plan (IEP) Related Services - B  115Kb (11/27/07)  75Kb (11/27/07)
     Combined consent and data sharing form for public or private health plans. Includes denied consent, revocation of consent,and annual service specific consent as described in IDEA 2004 Updated 11/07.
Consent to Seek Payment for IEP Health Related Services  47Kb (7/29/05)  50Kb (7/29/05)
     Third Party Billing Form in Spanish.
District Third Party Billing Contacts  298Kb (11/21/08)
     List of districts in alpha order that contain the self-reported names and contact information for Third Party Billing Coordinators and Billing Agents.
Interagency Agreement Between Minnesota Department of Education and Minnesota Department of Human Services Regarding Medicaid Reimbursement for Individual Education Plan Related Services  369Kb (11/21/08)
    
Minnesota Health Care Programs Data Sharing Letter - A  95Kb (1/18/08)  45Kb (1/18/08)
     Data sharing format for students covered only by Medical Assistance or Minnesota Care. Updated 8/15/07.
Minnesota Health Care Programs Data Sharing Letter - B  96Kb (11/19/07)  44Kb (11/19/07)
     Data sharing format for students covered only by Medical Assistance or Minnesota Care. Includes ability to obtain annual service specific consent. Updated 8/15/07.
Summary Reference Tool to Obtain Release/Consent for Third Party Billing  79Kb (11/21/07)  36Kb (11/21/07)
     Reference document to help understand how and when districts need to obtain informed consent and/or consent to release information to bill health-related services to a third party. Updated 7/25/07.
Third Party Billing Information  27Kb (7/20/05)  38Kb (7/20/05)
     Information for parents.
Third Party Billing Information - Spanish  78Kb (7/29/05)  59Kb (7/29/05)
     Information for parents.
Third Party Billing Questions and Answers  190Kb (7/20/05)  66Kb (7/20/05)
     Frequently asked questions about third party billing.
Third Party Payment Program Information  97Kb (7/20/05)
     Information for parents and guardians.

HIPPA


Below users can access information about the Health Insurance Portability and Accountability Act (HIPAA) as it relates to schools.


HIPPA Homework for Schools PDF Version 87Kb (7/20/05)
     Complying of the three main components of HIPAA; Electronic Data Interchange (EDI), Privacy and Security
Minnesota Education Privacy Matrix PDF Version 121Kb (7/20/05)
     Shows the relationship between state and federal laws which govern health records, private or confidential health data, protected health information and education records
The HIPAA-FERPA Conundrum PDF Version 6Mb (7/20/05)
     A PowerPoint presentation on HIPAA