Public Partnerships, LLC (PPL) Support Broker’s Agency ... · All forms must be signed and...

Forms & Instructions Check Run Schedule Timesheets Timesheet Instructions Invoice – Used for the purchase or goods and Items Visit and Daily Services Invoice Invoice Check list Invoice Instructions

Employer of Record Employer of Record Instructions How to calculate rate?

Provider Paperwork Employee vs Independent Contractor Provider Paperwork Matrix

All forms must be signed and returned to PPL prior to issuing paychecks.

If you have any questions, please call PPL at (866) 315-3740.

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Public Partnerships, LLC (PPL) Agency Payroll Department One Cabot rd. STE. 102Medford, MA 02155

Phone (866) 315-3740 Fax (866) 578-0533

One Cabot rd. STE 102 Medford, MA 02155 Phone (866) 315-3740 Fax (866) 578-0533

Need help? Call Customer Service Toll Free at 1-866-315-3740

Electronic Timesheet and Invoice Submission Need Help? Visit https://fms.publicpartnerships.com/PPLPortal/login.aspx?maasd for a complete user guide

DDS has contracted with PPL to provide Financial Management Services to improve services to you. Please do your part to correctly complete timesheets so that payment is not delayed.

The Autism Waiver Program offers all providers the option to submit timesheets and invoices online, directly into PPL’s Web Portal. The electronic timesheet and invoice option has many great features for users, including:

• Real‐time Budget validation• Ability to access and submit timesheets and invoices 24/7• Security for Users• More environmentally friendly – less paper used!

Electronic timesheets are paid on a bi‐weekly check run, and follow the same guidelines of submission as paper timesheets and invoices. See the attached check run schedule. Timesheets are due by Monday at noon after the close of the pay period.

The Autism Waiver Program offers two different methods for online timesheet and invoice submission:

Option 1) The provider and participant can submit and approve timesheets directly inPPL’s Web Portal.

The online tool will provide real time feedback if the timesheet can be processed or if PPL requires anyadditional information or authorizations from DDS

Option 2) The Provider can submit online and receive the same real time feedback, thenprint out the completed timesheets and have the participant review and sign the papercopy.

The system will already have the timesheet data stored and only need the signature of the participant toprocess a check.


Timesheet Instructions for Independent Contractors & Agencies

Need Help? Call Customer Service Toll Free at 1-866-315-3740

DDS has contracted with PPL to provide Fiscal Agent services to improve services to you. Please do your part to correctly complete timesheets so that payment is not delayed. Call PPL for help if you need it.

Keep these important instructions. Timesheets are paid on a bi-weekly check run. See the attached check run schedule. Timesheets are due by Monday at noon after the close of the pay period. Any timesheets received after the deadline will be processed in an off cycle check run the following Friday.

Completed timesheets should be faxed toll free to 1-866-578-0536. Timesheets can also be mailed to the following address: Public Partnerships, LLC, One Cabot rd. STE. 102, Medford, MA 02155. Faxing timesheets may speed the payment process for you. If possible, please fax your timesheets to PPL. For additional copies go to http://www.publicpartnerships.com.

Important Do’s and Don’ts

MUST DO MUST NOT DO Use black ink Don’t use pencil or colored ink Stay inside the lines Don’t use military time Write numbers and letters clearly. A machine will read your timesheet. Take the time to write clearly, or ask someone else to write for you.

Do not round time. PPL will do this.

Complete one timesheet per consumer. Use a new timesheet for each consumer you serve.

Don’t use any other timesheet. PPL cannot pay attendants if a different timesheet is submitted.

Use a separate timesheet for each service type. Don’t use one timesheet for two consumers or more than one service type.

Consumers (or designated signatory) and Attendants must sign and date the timesheet

Try not to touch the edges of the box when writing numbers and letters.

Fill in ALL required boxes, including Consumer and Provider Name, ID and Service Type.

Don’t cross out information if you make a mistake. Start a new timesheet.

Use 2 lines when a provider starts and stops work 2 times in the same day

Don’t write notes on the timesheet. This will cause our scanners to reject the timesheet and may delay payment.

Use A.M. and P.M. correctly. We show you how on the following page.

Don’t forget to fill in all information such as Attendant and Consumer Name, ID, Service Type. Timesheets must be signed and dated by both the consumer and the attendant.

http://www.publicpartnerships.com/�

PPL Provider ID:

-W

#CNSMRServed

#CNSMRServed

PUBLIC PARTNERSHIPS, LLC Provider TIMESHEET (Financial Management Services for MA DDS Autism Waiver Program)

MAIL: PUBLIC PARTNERSHIPS LLC, One Cabot rd. STE. 102, Medford, MA 02155

USE B L A C K INK, PRINT O N E CHARACTER PER BOX, F I L L C I R C L E S COMPLETELY, DO NOT WRITE ON THE LINES !!!

Provider Signature:

Date:

/ /By signing below, I certify thatI have provided the services tothe consumer during the timesdescribed on this time sheet.

Begin: Sunday (mm/dd/yyyy) / / T i m e IN

:

T i m e OUT

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:

Week 1

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End: Saturday (mm/dd/yyyy) / / T i m e IN

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:

Week 2

Fri

Sun

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: : :: : :: : :: : :: : :: : :: : :: : :: : :: : :: : :: : :

Consumer or Responsible Party Signature:

Date:

/ /I certify that the consumerhas received hours of serviceas reported above.

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FAX: PPL @ 1-866-578-0536

AM PM AM PM AM PM AM PM

Provider's Name:

Consumer's Name:

Consumer's ID Number:

Service Type(fill one)

HomemakerHabilitation - Community IntegrationExp Hab - Education - Senior TherapistExp Hab - Education - TherapistExp Hab - Education - Direct Support WorkerRespiteFamily TrainingBehavioral Consultation - Senior TherapistBehavioral Consultation - Therapist

1402

3

1402

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Recording Header Information: 1. Complete all header information for the Provider and the Consumer.

Include name and ID of Provider and Consumer. The Provider ID is the ID provided to your employee by PPL. The Consumer ID is will be provided by your support broker. Contact PPL Customer Service if you have any questions regarding these identification numbers.

2. Use the correct pay period for your region (attached). Write the date in

MM/DD/YYYY format. Make sure you write the start and end date for your pay period.

3. Record the time of day correctly using A.M. and P.M.

A.M. means morning. Morning starts at midnight, and ends at 11:59:59, or 11 o’clock, fifty-nine minutes and 59 seconds, or one second before noon.

P.M. Afternoon and evening (or night time) is captured by the initials P.M. Afternoon starts at noon, or 12:00, and ends at 11:59:59, or 11 o’clock, 59 minutes and 59 seconds, or one second before midnight. The date changes at midnight.

4. Indicate the correct service type

Confirm only ONE service type has been bubbled in completely. Each service type has a specific tax implication which is why it is important to fill each timesheet out based on service type provided.

5. Be sure to sign and date the timesheet.

MA DDS Autism Waiver Program Invoice

Vendor: Vendor ID#: W

Vendor Address:

City, State, Zip: Consumer First Name:

Consumer Last Name:

Ship to Address: Consumer ID#:

Tax Identification Number:

Check here to send check to consumer's parent or legal guardian. Enter name/address here:

/ / .

/ / .

Date of Acquisition/Service (mm/dd/yy)3

Service Code 4 Item Code 5 Amount to be Paid 6

Quantity of items purchased 7

Invoice Guidelines 1. All attached invoices must be from the vendor identified at the top of this form and have a quote or price check receipt from the vendor as backup documentation accompanying this form. 2. Enter one line per service code. If you purchased 2 of the same item, enter all on one line.3. Enter the mm/dd/yy that the quote or price check receipt was produced.4. Enter the service code that matches the service authorized in the consumer's budget.

5540 Other Services-Assistive Technology/Adaptive Aids 5550 Vehicle Adaptations

5545 Home Adaptations 5555 Individually Directed Goods and Services

5. Enter the item code which identifies the type of item being purchased.

Item Code Description Item Code Description Item Code Description Item Code Description

01 Adaptive Equipment 04 Computer Software 07 Home Saftey 10 Supplies & Materials

02 Communication Devices 05 GPS Unit 08 Membership & Fees 11 Vehicle Safety

03 Computer Hardware 06 Home Fence 09 Ramp 12 Other

6. Enter the total amount (including taxes) that the check will be made out for. If you have more than one service code on the quote or price checkreceipt, distribute the taxes evenly among the service codes. 7. Enter the number of items that will be purchased.

Consumer's Representative must write the consumer ID number on the invoice. Sign the invoice and print the name of either the consumer or representative who signed. Write the date signed next to the signature.

PLEASE KNOW THAT FAILURE TO FILL OUT THIS FORM COMPLETELY AND ACCURATELY CAN RESULT IN DELAY OF PAYMENT.

____________________________________________________________ ____________ Employer Signature Date

____________________________________________________________ ____________ Support Broker Signature Date

Ver. 10/22/09 FAX OR MAIL INVOICE REQUEST WITH COPY OF QUOTE/PRICE CHECK RECEIPT TO: FAX To: 866-578-0533

MAIL To: PPL, MA DDS Autism, One Cabot rd. STE. 102Medford, MA 02155 Ver. 12.30.10

Ship to Address:

(*Complete this field ONLY if above box is checked / completed)

MA DDS Autism Waiver Program Visit and Daily Services Invoice

FAX OR MAIL INVOICE REQUEST WITH COPY OF QUOTE/PRICE CHECK RECEIPT TO: FAX To: 866-578-0533 MAIL To: PPL, MA DDS Autism, One Cabot rd. STE. 102, Medford, MA 02155 Ver. 12.30.10

Therapy Form Guidelines: 1. Enter one line per service code.2. Enter the begin and end date of the pay period.3. Enter the mm/dd/yy that the service occurred on.4. Enter the service code that matches the service authorized in the consumer’s budget.

Consumer’s Representative must write the consumer ID number on the top of this form. Sign the form and print the name of either the consumer or representative who signed. Write the date signed next to the signature. PLEASE NOTE THAT FAILURE TO FILL OUT THIS FORMCOMPLETELY AND ACCURATELY CAN RESULT IN DELAY OF PAYMENT.

____________________________________________________________ ____________ Therapist Signature Date

____________________________________________________________ ____________ Employer of Record Signature Date


Instructions for the purchase of items, goods or adaptations Need Help? Call Customer Service Toll Free at 1-866-315-3740

DDS has contracted with PPL to provide Fiscal Agent services to improve services to you. Please do your part to correctly complete invoice so that payment is not delayed. Call PPL for help if you need it. Keep these important instructions. Vendor Payments are paid on a bi-weekly check run. See the attached check run schedule. Vendor Payment Requests are due by Monday at noon after the close of the pay period. Any Request received after the deadline will be processed in an off cycle check run the following Friday. Vendor Payment Requests can only be used if your budget allocates funds for: You must obtain a written estimate or quote (for example from Home Depot or a contractor) or a price check receipt (from most other stores including Best Buy and Wal-Mart) from the store you will purchase the item from. This estimate or receipt needs to include the:

Full company name Address Phone number Tax Identification Number The type of item being purchased and quantity The total amount of the check for the work or cost of the items (including any sales taxes or shipping costs) that you are purchasing

Completed Request for Vendor Payment Forms should be provided to your Support Broker. Your Support Broker will fill out the service code and item code. http://www.publicpartnerships.com.

5540 Assistive Technology/Adaptive Aids 5545 Home Adaptations 5550 Vehicle Adaptations 5555 Individually Directed Goods and Services

http://www.publicpartnerships.com/�


1. Complete all header information for the Vendor and the Consumer. Fill out all vendor and consumer information. Include if you want the check to be sent to the consumer’s address, so you can bring the check to the vendor.

2. Fill out the date on the purchase order in the Date of Acquisition/Service

and total amount to be paid Your Support Broker will complete the service code and item code based on the purchase order that you provide.

3. Sign above the Employer Signature line and Date

4. Provide the Estimate, Quote or Price Check Receipt and the Request for

Vendor Payment Form to your Support Broker Your Support Broker will review, complete and sign the form and submit to PPL for payment.

IINNVVOOIICCEESS 1) Confirm the family has provided you with the following:

The quote or price check receipt from the vendor A completed Form W-9 from the vendor Commonly known national providers do not need to

complete this form A filled out invoice cover sheet

2) As the Support Broker, you have filled out/confirmed thefollowing:

The Service Code as it relates to the budget that has beenapproved by the DDS Clinical Manager

The item code based on the quote (above) Signed the bottom of the invoice cover sheet confirming

service code / item codes are correct

3) Fax the invoice and purchase order togetherAny invoice or purchase order faxed separately will be rejected.

to 1-866-578-0533.

All forms must be signed and returned to PPL prior to issuing paychecks to vendors.


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Phone (866) 315-3740 Fax (866) 578-0533

Who Can Be the Employer of Record?

Person Selected Needs to:

Provide Social Security Number on Forms Assume all employer responsibilities Complete tax paperwork and submit to PPL If guardian, provide PPL copy of guardian paperwork Receive mailings from tax and labor agencies Sign Employee Timesheets Does not already have an IRS Employer Identification Number (EIN) in

their name

Managing Payroll Responsibilities

Family Member Does… Serve as “The Employer” Define Job, Schedule and Pay

Rate Recruit, Interview, Terminate Supervise and Prioritize Work Provide Necessary Training Complete Initial Paperwork Review, Sign & Submit

Timesheets Respond to Employee Inquiries

Public Partnerships Does… Serve as “Payroll Department” Distribute Federal, State and

Local Tax Forms to Employersand Employees

Issue Paychecks Per Timesheets Withhold All Necessary Taxes File Monthly, Quarterly and

Annual Tax and Labor Reports Issue Annual W-2 Wage

Statements Respond to All Question


Guardian

Parent Employer of Record

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Phone (866) 315-3740 Fax (866) 578-0533

How to calculate Hourly Employees Rate?

EMPLOYEE'S HOURLY RATE ON BUDGET $11.13 $13.92 $16.70 $19.48 $22.27

Hourly Employee Negotiated Rate $10.00 $12.50 $15.00 $17.50 $20.00

Employer Taxes Tax RateFICA (Social Security & Medicaid) 7.65% $0.77 $0.96 $1.15 $1.34 $1.53State Unemployment Tax (est) 2.89% $0.29 $0.36 $0.43 $0.51 $0.58Federal Unemployment Tax 0.80% $0.08 $0.10 $0.12 $0.14 $0.16

Minimum Billing Rate $11.13 $13.92 $16.70 $19.48 $22.27Medicaid Billing Rate $11.13 $13.92 $16.70 $19.48 $22.27Check divisible by 4 - Medicaid billing rate $2.78 $3.48 $4.18 $4.87 $5.57

Workers Comp annual $563.00 $563.00 $563.00 $563.00 $563.00

Hourly Employee's Taxes and Take Home Pay

Employee Pay-Stub Taxes Tax RateFederal Income Tax (est) 15% $1.50 $1.88 $2.25 $2.63 $3.00State Income Tax (est) 5.85% $0.59 $0.73 $0.88 $1.02 $1.17FICA (Social Security & Medicaid) 7.65% $0.77 $0.96 $1.15 $1.34 $1.53

Net Pay (est) $7.15 $8.94 $10.73 $12.51 $14.30

Each employer has the opportunity to negotiate their employee’s hourly wage based on the service being delivered and qualifications of the provider.

The employee and the employer are both responsible for paying taxes. PPL will withhold the required state and federal taxes from employees’ paychecks and deposit based on state and federal requirements.

The gross wages above are not the only wages that can be negotiated but provides a matrix of the take home pay of the employee and the Medicaid Billing Rate that will need to be entered into the consumer’s budget.

If you have any questions, please call PPL at (866) 315-3740

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Phone (866) 315-3740 Fax (866) 578-0533

Each status requires a different tax form. Simply put, a W-4 Form is used if the worker is an employee and Employment paperwork must be completed, and a W-9 Form is used if the worker is an independent contractor and a Vendor Packet must be completed.

Please call us at 866-315-3740 if you have any questions.

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When a worker performs services and receives some form of payment, an important question is whether the payment is subject to employment taxes. The answer depends on whether the person is an employee or independent contractor. Employees have taxes withheld every paycheck; independent contractors do not have taxes withheld by PPL but are responsible for declaring their earnings at the end of the year.

Below are the services available to individual providers in the MA DDS Autism Waiver Program. Based on the service description the provider will be an employee or an independent contractor.

Service Employee Independent Contractor

Homemaker - Individual X Habilitation - Community Integration - Individual X Expanded Habilitation Services - Education-Senior Therapist-Individual X Expanded Habilitation Services - Education-Therapist-Individual X Expanded Habilitation Services - Education-Direct Support Worker-Individual X Respite - Individual X Respite – Caregiver’s Home X Family Training - Individual X Occupational Therapy – Individual XPhysical Therapy - Individual XSpeech Therapy - Individual XBehavioral Consultation – Senior Therapist - Individual XBehavioral Consultation –Therapist - Individual X Paperwork to complete Employment Vendor

In order to determine whether an individual is an employee or an independent contractor, the IRS stresses that evidence of the degree of control and independence must be considered. An Independent Contractor must exercise independent judgment, define assignments, setting priorities and schedules. The IRS states, “A general rule is that you, the payer, have the right to control or direct only the result of the work done by an independent contractor, and not the means and methods of accomplishing the result.”

The items below are helpful in determining if the worker is an employee or an independent contractor. If you select even 1 box from the employee list than your provider is an employee.

EMPLOYEE Is assigned tasks by employer Does not set priority of tasks Receives work schedule & breaks Does not determine workplace Does not provide own equipment

INDEPENDENT CONTRACTOR Professionally licensed or certified by

occupation Exercises independent judgment to

determine work tasks, work schedule, priorities & equipment need

Public Partnerships, LLC Fiscal/E mployer Agent One Cabot rd. STE. 102Medford, MA 02155

Toll Free Numbers Phone: 1-866-315-3740 Administrative Fax: 1-866-578-0533

Identifying the correct provider ID on your timesheets is crucial to PPL’s payroll system withholding taxes correctly.

Please check all that apply and PPL will produce the necessary provider IDs for you. As an individual provider you will have at least one provider ID and might

have two.

Individual Provider

If you are an individual that will provide independent contractor services and will not have taxes withheld by PPL, check:

Individual, Independent Contract ID

If you are an individual that will provide employee services and will have taxes withheld by PPL, check:

Individual, Employee ID

PPL will provide you with your provider ID(s) once PPL has processed all the necessary paperwork.

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Public Partnerships, LLC

MA DDS Autism Waiver Program Payment Schedule

Fiscal Year 2014 (July 1, 2013 - June 30, 2014)

One Cabot rd. STE. 102

Medford, MA 02155

Phone: (866) 315-3740

TS Fax: (866) 578-0536

Email: [email protected]

Fax: (866) 578-0533

Will be mailed on:

Start (Sunday) Finish (Saturday)Timesheets

Due by NoonCheck Run Date

June 30, 2013 July 13, 2013 July 15, 2013 July 19, 2013

July 14, 2013 July 27, 2013 July 29, 2013 August 2, 2013

July 28, 2013 August 10, 2013 August 12, 2013 August 16, 2013

August 11, 2013 August 24, 2013 August 26, 2013 August 30, 2013

August 25, 2013 September 7, 2013 September 9, 2013 September 13, 2013

September 8, 2013 September 21, 2013 September 23, 2013 September 27, 2013

September 22, 2013 October 5, 2013 October 7, 2013 October 11, 2013

October 6, 2013 October 19, 2013 October 21, 2013 October 25, 2013

October 20, 2013 November 2, 2013 November 4, 2013 November 8, 2013

November 3, 2013 November 16, 2013 November 18, 2013 November 22, 2013

November 17, 2013 November 30, 2013 December 2, 2013 December 6, 2013

December 1, 2013 December 14, 2013 December 16, 2013 December 20, 2013

December 15, 2013 December 28, 2013 December 30, 2013 January 3, 2014

December 29, 2013 January 11, 2014 January 13, 2014 January 17, 2014

January 12, 2014 January 25, 2014 January 27, 2014 January 31, 2014

January 26, 2014 February 8, 2014 February 10, 2014 February 14, 2014

February 9, 2014 February 22, 2014 February 24, 2014 February 28, 2014

February 23, 2014 March 8, 2014 March 10, 2014 March 14, 2014

March 9, 2014 March 22, 2014 March 24, 2014 March 28, 2014

March 23, 2014 April 5, 2014 April 7, 2014 April 11, 2014

April 6, 2014 April 19, 2014 April 21, 2014 April 25, 2014

April 20, 2014 May 3, 2014 May 5, 2014 May 9, 2014

May 4, 2014 May 17, 2014 May 19, 2014 May 23, 2014

May 18, 2014 May 31, 2014 June 2, 2014 June 6, 2014

June 1, 2014 June 14, 2014 June 16, 2014 June 20, 2014

June 15, 2014 June 28, 2014 June 30, 2014 July 3, 2014

June 29, 2014 July 12, 2014 July 14, 2014 July 17, 2014

Invoices Received by PPL…

NOTE: The schedule below reflects a bi-weekly check run. Checks are mailed and EFTs are sent to the

bank on the Friday after the Finish date of the bi-weekly check run.

mailto:[email protected]�

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When you are building a budget, it is very important that the correct provider ID is selected.

You will use the employment or vendor agreement to ensure that you enter the rate that the provider and family have agreed to pay, for each service that will be delivered. The family should provide you with a copy of the agreement.

The letter –E, -C, or –A at the end of each provider ID will indicate each provider for the correct type of service. • All Agency services must have a provider with a –A selected.• Individuals providing Respite or Homemaker services must have a provider ID with an –E• All other Individuals must have a –C provider ID selected.

Please follow the matrix below when authorizing Providers in individual’s budgets

Service Individual Agency Homemaker C A Habilitation - Community Integration C A Expanded Habilitation Services - Education-Senior Therapist C A Expanded Habilitation Services - Education-Therapist C A Expanded Habilitation Services - Education-Direct Support Worker C A Respite E A Respite – Caregiver’s Home C - Family Training C A Occupational Therapy C A Physical Therapy C A Speech Therapy C A Behavioral Consultation – Senior Therapist C A Behavioral Consultation – Therapist C A

PPL’s financial management system will validate if taxes are withheld from a paycheck based on the provider ID and the type of service.

For example, Sally Sample is providing Community Integration and Respite services. When you build the budget, you will select provider ID ‘wSAMP001-C’ for the Community Integration authorization and provider ID ‘wSAMP001-E’ for the Respite authorization.

Please call us at 866-315-3740 if you have any questions.

Public Partnerships, LLC Fiscal/E mployer Agent One Cabot rd. STE. 102Medford, MA 02155


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ADDRESS/NAME CHANGE

(Please Print)

Former Name: New Name:

Former Address

Street:

New Address

Street:

City: State: Zip: City: State: Zip:

Employee SSN:

Name of Consumer for whom you work:

Consumer’s ID #:

If you are completing this form because of a name change, please give this form and a copy of

your new Social Security card to your employer. We will need a copy of this card, along with

this form, signed and completed, before the change will take effect.

Employee Signature Date

PPL encourages you to call us toll free at 866-315-3740 if you have any

questions.

NOTE: Information provided on this form is confidential and is treated as such. Completion of

this data is voluntary and will not affect your employment status. Identification can be declared

at any time prior to, or if applicable, after hire.

Public Partnerships, LLC Fiscal/Employer Agent One Cabot rd. STE. 102Medford, MA 02155


Public Partnerships, LLC (PPL) Support Broker’s Agency ... · All forms must be signed and...

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Transcript of Public Partnerships, LLC (PPL) Support Broker’s Agency ... · All forms must be signed and...