Nexus-PATH Foster Care Rates 623-05-20-35

(Revised 4/1/2024 ML #3807)

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Nexus-PATH provides services and supports to children and families as a licensed child placing agency. Nexus-PATH is accredited by the Council on Accreditation for Services to Children and Families (COA).

 

Billing Address:

Nexus-PATH, Inc. ND
1202 Westrac Dr S, Suite 400
Fargo, ND 58103

 

Maintenance rates effective April 1, 2024:

NEXUS-PATH RATES BY LEVEL OF CARE	Avg. Monthly Rate (30 day)	Fee for Service (daily)
Enhanced Treatment Foster Care (ETFC)	$7,650	$255/day
Treatment Foster Care (TFC)	$4,560	$152/day
Regular Foster Care(RFC)	$2,280	$76/day

 

NOTE: The “monthly” rate is provided for reference. The child’s foster care reimbursement is paid as a daily fee for service, specific to the actual number of days the child is in the Nexus PATH provider placement during the service month. Foster care reimbursement is made to a licensed child placing agency (LCPA), the fee for service is inclusive of the administrative, training, case management and costs of care for the child. Foster care providers are reimbursed an established daily rate directly from the agency.

 

The custodian, Nexus-PATH and child and family team participants will evaluate the child’s level of care quarterly. If a child begins as a treatment foster care (TFC) placement, it may be determined that a lower level of care is necessary and appropriate. When the level of care changes, the custodial case manager is responsible to notify the FCSA Eligibility Unit by completing a new SFN 45 immediately.

 

Nexus-PATH MONTHLY BILLING

Payments to Nexus-PATH will not be authorized until a billing statement has been received for the service month. The amount billed is based on the level of care (ETFC, TFC, Regular) and number of days in placement, not to exceed the number of days in the month.

 

Reimbursement of overlapping days of placement from one Nexus-PATH provider to another is not allowed, with the exception of transition to a Supervised Independent Living setting or secondary placements identified as a "pre-placement visit".

 

The Nexus-PATH billing office will send an individual child specific bill to FCSA Eligibility Unit monthly. Nexus-PATH payments are not automatically calculated by the payment system and require manual data entry by the assigned eligibility worker. The bill must be kept in the foster care eligibility file for auditing purposes.

 

Itemized Bill:

1. Child specific - one bill per child
   
   
2. Provider specific - for bills containing multiple providers, each provider must have an approved placement in FRAME. Payment authorization will be made to each provider based on the billed dates and amount specific to that provider.
   
   
3. Secondary placements for children accepted into a level of care provided by a treatment agency are not reimbursable (TFC to TFC or TFC to Regular). However, if the child is transitioning to a Nexus-PATH home from a non-Nexus-PATH provider (State home, residential, etc.) the “pre-placement” can be reimbursed as a secondary placement.
   
   
4. Irregular payments must be approved by the custodial case manager.
   
   
5. The FCSA Eligibility Unit will authorize reimbursement to Nexus-PATH as the designated payee on behalf of the licensed provider.
   
   
6. Nexus-PATH will directly reimburse the foster care provider.
   
   

Nexus-PATH Overpayments

If there is an overpayment made to a Nexus-PATH provider, the FCSA Eligibility Unit can auto-recoup the overpayment during either the supplemental or standard check write so long as the provider has a foster care placement. An SFN 839 Foster Care Overpayment Notification will be sent to the Nexus-PATH billing office to notify them of the overpayment and provide instructions for repayment.

 

Nexus-PATH Irregular Payments

Allowable irregular payment reimbursements per policy 623-05-25-05 are approved through the custodial case manager as follows:

1. All irregular payments must be eligible and approved as set forth in policy. The custodial case manager is responsible to monitor the child’s irregular payment annual maximums allowed per category to ensure adequate funds are available prior to approval.
   
   
2. Receipts must be sent to the Nexus-PATH case manager for submission to the Nexus-PATH billing office. All irregular payments require a receipt and a SFN 903 Foster Care Provider Reimbursement Request for reimbursement. Nexus-PATH will attach the receipts and a SFN 903 to the monthly invoice. Receipts received directly from a foster care provider or custodial case manager at the FCSA Eligibility Unit for a Nexus-PATH provider will be returned to the custodial case manager for proper routing to the Nexus-PATH case worker.
   
   
3. Nexus-PATH will create an itemized bill with the standard maintenance rate for the specific level of care placement dates and any approved irregular expenses.
   
   

If Nexus-PATH’s billing office has questions regarding the amount received over and above the standard foster care rate, the custodial case manager will be contacted for placement date clarification.