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Service Provider Requirements

Updated

Service Providers participating in the Ohio ACE program are required to comply with the following guidelines with respect to claim eligibility and reimbursements.

 

Out-of-network Provider Requirements:

  • Claims for out-of-network providers must be for services that align with their primary business.
  • Out-of-network providers must be able to provide credentials related to the services provided and/or business licenses.
  • Email addresses and phone numbers for out-of-network providers are required for claim processing.
  • If a provider does not respond to verification requests, the claim is subject to rejection.
  • If a provider does not respond to claim processing requests, the claim is subject to rejection.

The Primary Business or Service Must Align with an Allowable Service Category:

  • Language classes
  • 1:1 Instrument lessons
  • 1:1 Academic Tutoring
  • For homeschool students only, curriculum and materials

Schedule of Fees:

  • A schedule of fees must appear on the provider’s website or be on file with Merit.
  • Fees included on invoices must align with the fee schedules online or submitted.
  • Fees posted in the Marketplace must align with the online or submitted fee schedule.
  • Fees should be the same for students with ACE accounts and non-ACE participants.
  • Packages exclusive to ACE participants are not allowable.

Claims:

  • Thirty-Day Guidance
  • Claims with a paid invoice/receipt cannot be for services more than 30 days in advance. This applies to all service categories, with curriculum and materials being the single exception.

Invoice/Receipt Requirements:

  • A receipt is necessary when a service or good has been paid for, and the parent/guardian would like to be reimbursed.
  • An invoice is necessary when a service or good has not been paid for, and the parent/guardian would like the service provider to be reimbursed. Please note: Only participating providers may offer this service.

Special Education (Peterson/Autism Providers):

  • ACE funds are not available to pay for tuition for chartered nonpublic schools or related services designed to achieve student IEP goals.

ACE Provider/Program Requirements:

  • ACE providers must attest that all personnel associated with their organization have completed current criminal background checks.
  • All education programs must reflect the provider/organization's primary business to be approved to provide services allowable under ACE.
  • The address where the service provider provides goods or services must be a commercial address to be listed on the ACE Marketplace, with no exceptions.
  • Services offered at the location must align with the selected service category.
  • Individuals providing services should have a background (education and/or experience) consistent with the educational program provided.
  • ACE providers must primarily serve individuals ages 6-18 and demonstrate experience providing educational programs for the age group.
  • Images of all provider-submitted photo IDs (driver’s licenses) must be fully readable.
  • All educational programs should be able to describe how their program aligns with and meets the academic content standards adopted by the State Board of Education and provide examples of lesson plans that demonstrate alignment.
  • ACE participants will abide by the Code of Conduct.

Prohibited Provider Activities:

  • Providers and programs cannot advertise themselves as “ACE-Approved.” Approved providers who participate in the ACE program may indicate that the organization is a “Participating ACE Provider.
  • Only approved and participating organizations may use the ACE logo on their website or program materials.
  • Providers that request information from families regarding participation in government support programs shall be removed from the program.

  • All claims pending review by the service provider shall be approved or rejected within 10 business days of receipt so reimbursement can take place in a timely manner.

  • Services provided for family members are not reimbursable with the ACE Ohio Program.

  • Service providers cannot apply for an ACE grant for other families on their behalf.

  • Service providers cannot submit claims on behalf of others.

  • Service providers cannot provide kickbacks to other families or organizations for enrolling in the program and/or participating in services.

  • Service providers should never give/request access to anyone else's ACE Ohio account.

  • Service providers that request information from families regarding participation in government support programs shall be removed from the program.

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