Q&A for Providers

Reconciliation Questions and Answers

  1. Is there a deadline for providers to verify all of their child rosters and attendance in EFS-Mod dating back to July 2018?

A: There is NO hard deadline at this time.  However, OEL is encouraging the Coalitions to work with providers to complete as much of the verification process as possible by December 31, 2019 in order to assist with estimating total actual costs for last year.  

  1.  If I was underpaid for the services I provided last year, when will I receive my reimbursement?

A:  If you believe that you were underpaid for the services you provided last year, ELC will reimburse you as soon as we are able to reasonably estimate the amount you are owed.  Please contact your provider reimbursement specialist for more information as soon as possible.

  1. If I was overpaid, how long will I have to repay the amount to ELC?

A: OEL granted the coalitions local discretion to determine the length of all repayment plans.  We understand that providers received overpayments because of system problems through no fault of their own and we will create repayment plans that will not cause hardship or harm to your business.  OEL recommends six month installment plans but we will create longer plans as needed upon request. 

  1.  What will happen if I collected a lower parent copay than was required because the verbal authorization or certification I received from ELC when EFS Mod was not working was incorrect?

A: OEL will NOT hold the provider responsible for under-collected copays that are caused by EFS Mod or ELC and ELC will NOT collect the difference from the provider retroactively.  Instead, ELC will issue a corrected certificate that the provider for all future payments only.  Please contact your Reimbursement Specialist if you think this issue applies to you.