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SPM - DS 5862
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Home > DS 5862
SPM automates the printing a form DS 5862
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This bill would require, on and after July 1, 2012, with specified exceptions, all providers of early intervention services purchased through a regional center and all vendors and contracted providers of services or supports for a consumer purchased through a regional center to submit all billings through the regional center e-billing system Internet Web application provided by the department. The bill would also require, effective July 1, 2011, regional centers to begin transitioning vendors and contracted providers into the regional center e-billing system.
This bill, beginning July 1, 2011, would require any vendor who provides specified services to submit prescribed verification to the regional center for services provided to consumers who are under 18 years of age and residing in the family home, and would make related changes.
Q. Why do I have to use the new form?
A. Assembly Bill 104 signed into law on June 30, 2011 amended the Lanterman Act (Welfare and Institutions code 4686.31) requiring any service provider who provides Behavioral Services as specified in Title 17 of the California Code of Regulations to submit this verification form.
Q. Where can the required form and information about the change in law be found?
A. You can download required form here
Q. Who is required to use this form?
A. Service providers vendored under the following service codes: 612,613,615,616,620,625,680,025,048, and 077 and providing services to those under the age of 18 years residing in the family home.
Q. When do i have to start using this form?
A. The intent of the law is for behavioral service providers to start using the State of California DS5862 form effective July 1, 2011.
Q. Why didn't i receive this form until the middle of July?
A. The State of California Department of Developmental Services did not have the form available until July 11, 2011.
Q. Can you accept invoices without the required form for services provided during the month of July 2011?
A. The Regional Centers do not have the authority to make any exceptions for providers on completing and submitting the DS5862 form even though providers will need to go back to parents for their signatures for services provided since July 1, 2011.
Q. What if a parent refuses to sign the form?
A. Parents can contact their case manager if they have questions about the form as well as if they have disagreements with what they are being asked to verify.
Q. Who should i contact if a parent won't sign the form?
Vendors can contact the case managers regarding these issues.
Q. Can i create my own form? This one does not have enough space?
No. The law requires that providers use the form developed by the Department of Developmental Services (DS5862). DDS has posted this form to their website www.DDS.ca.gov and any future changes to the form will be posted on their website.
Q. Is the form available in languages other than English?
The form is available in English, Spanish, Chinese, Tagalog, Vietnamese, and Russian.
Q. Can Services be discontinued if parents do not verify services?
Failure of the parents or legally appointed guardians of a minor consumer to submit a verification of services to the service provider shall not be a basis for terminating or changing behavioral services to the minor consumer.
Q. Will you pay me for the services if i don't have signed verification from a specific family?
A. Regional Center cannot pay for any services provided to a consumer if the required forms have not been completed and submitted. However, because this form was not made available to service providers until July 11, 2011, Regional Center will pay for July 2011 services even if all attendance forms have not yet been submitted. Regional Center is providing behavioral service providers with some additional time to get these forms completed and signed. We will later reconcile your July 2011 billing to the July 2011 attendance forms. Please be certain to submit your July 2011 attendance forms at a later date so that it does not affect your future Regional Center payments. Please note that Regional Center will only pay for August 2011 services if completed and signed forms are submitted with the invoice.
Q. Can i submit these forms by fax or electronically?
A. It is uncertain whether or not the State will require Regional Centers to maintain signed original attendance forms, or whether electronically submitted forms will be acceptable. While we wait for guidance from DDS, we will accept fax or scanned forms to Regional Center as long as providers retain signed original attendance documents in their file for audit purposes.
California Assembly Bill 104 Requirements for Behavioral Services Providers
SPM automates the printing a form DS 5862
Download Form
This bill would require, on and after July 1, 2012, with specified exceptions, all providers of early intervention services purchased through a regional center and all vendors and contracted providers of services or supports for a consumer purchased through a regional center to submit all billings through the regional center e-billing system Internet Web application provided by the department. The bill would also require, effective July 1, 2011, regional centers to begin transitioning vendors and contracted providers into the regional center e-billing system.
This bill, beginning July 1, 2011, would require any vendor who provides specified services to submit prescribed verification to the regional center for services provided to consumers who are under 18 years of age and residing in the family home, and would make related changes.
Q. Why do I have to use the new form?
A. Assembly Bill 104 signed into law on June 30, 2011 amended the Lanterman Act (Welfare and Institutions code 4686.31) requiring any service provider who provides Behavioral Services as specified in Title 17 of the California Code of Regulations to submit this verification form.
Q. Where can the required form and information about the change in law be found?
A. You can download required form here
Q. Who is required to use this form?
A. Service providers vendored under the following service codes: 612,613,615,616,620,625,680,025,048, and 077 and providing services to those under the age of 18 years residing in the family home.
Q. When do i have to start using this form?
A. The intent of the law is for behavioral service providers to start using the State of California DS5862 form effective July 1, 2011.
Q. Why didn't i receive this form until the middle of July?
A. The State of California Department of Developmental Services did not have the form available until July 11, 2011.
Q. Can you accept invoices without the required form for services provided during the month of July 2011?
A. The Regional Centers do not have the authority to make any exceptions for providers on completing and submitting the DS5862 form even though providers will need to go back to parents for their signatures for services provided since July 1, 2011.
Q. What if a parent refuses to sign the form?
A. Parents can contact their case manager if they have questions about the form as well as if they have disagreements with what they are being asked to verify.
Q. Who should i contact if a parent won't sign the form?
Vendors can contact the case managers regarding these issues.
Q. Can i create my own form? This one does not have enough space?
No. The law requires that providers use the form developed by the Department of Developmental Services (DS5862). DDS has posted this form to their website www.DDS.ca.gov and any future changes to the form will be posted on their website.
Q. Is the form available in languages other than English?
The form is available in English, Spanish, Chinese, Tagalog, Vietnamese, and Russian.
Q. Can Services be discontinued if parents do not verify services?
Failure of the parents or legally appointed guardians of a minor consumer to submit a verification of services to the service provider shall not be a basis for terminating or changing behavioral services to the minor consumer.
Q. Will you pay me for the services if i don't have signed verification from a specific family?
A. Regional Center cannot pay for any services provided to a consumer if the required forms have not been completed and submitted. However, because this form was not made available to service providers until July 11, 2011, Regional Center will pay for July 2011 services even if all attendance forms have not yet been submitted. Regional Center is providing behavioral service providers with some additional time to get these forms completed and signed. We will later reconcile your July 2011 billing to the July 2011 attendance forms. Please be certain to submit your July 2011 attendance forms at a later date so that it does not affect your future Regional Center payments. Please note that Regional Center will only pay for August 2011 services if completed and signed forms are submitted with the invoice.
Q. Can i submit these forms by fax or electronically?
A. It is uncertain whether or not the State will require Regional Centers to maintain signed original attendance forms, or whether electronically submitted forms will be acceptable. While we wait for guidance from DDS, we will accept fax or scanned forms to Regional Center as long as providers retain signed original attendance documents in their file for audit purposes.