State 28808 Form in PDF

What is the purpose of the State 28808 form?

The State 28808 form is used for submitting a claim for child support payments payable from Family and Children Funds in Indiana. The form ensures that children’s support and allowances are duly processed and paid by documenting the services provided and the associated costs.

Who is required to complete this form?

Any vendor authorized to provide services to children under the supervision of the Indiana Department of Child Services must complete this form. This includes residential care providers, foster parents, adoption services, and other child welfare-related service providers.

What information do I need to complete State Form 28808?

Completing the form requires information including the vendor's name, Tax ID, State Vendor ID, invoice number, date of invoice, and address. Details on the invoice type, service type, period of claim, children's information, services provided, and the cost of these services are also necessary. Additionally, the form requires the vendor's signature, telephone number, and email address.

How do I submit State Form 28808?

After accurately filling out the form, ensure every page is signed (preferably in blue ink) and submit it to the designated office within the Indiana Department of Child Services. It must be submitted within 10 business days of the invoice date.

Can I adjust the Total of Claim after submission?

No, once the Total of Claim has been submitted, it cannot be adjusted upward. Ensure all calculations are correct before submission to avoid discrepancies and potential delays.

What happens if there is a discrepancy in the submitted invoice?

Invoices are subject to independent audits. Should any discrepancy arise, the case may be referred to a local prosecutor for criminal prosecution. It is crucial to ensure that all information provided on the form is accurate and truthful.

Why is it recommended to sign the form in blue ink?

Signing in blue ink helps distinguish the original document from photocopies or digital copies, ensuring the authenticity and integrity of the form when it is reviewed by the Indiana Department of Child Services.

Filling out the State Form 28808, particularly for claims from the Family and Children Funds, demands attention to detail. Frequently, errors occur that can delay processing or result in denied claims. Understanding these common pitfalls can streamline the submission process.

Several mistakes are commonly made:

1. Using an incorrect or outdated Vendor Name, which must match the name submitted via the Vendor Information Form.
2. Incorrectly entering the Last Four Digits of the Tax ID/SSN. This number is crucial for identifying the vendor and must be accurately provided.
3. Misunderstanding the ST Number's importance, a unique identifier that facilitates tracking and payment processes.
4. Assigning an improper Invoice Number or using a format that exceeds the 8-character limit, which can include letters and/or numbers.
5. Errors in the Date of Invoice, which must be specified according to the format and timelines stipulated in the instructions.
6. Listing an incorrect or incomplete Address, which should align with the most recent Vendor Information form on file.
7. Selecting an inaccurate Invoice Type, which affects how the invoice is processed and categorized.
8. Failure to detail the Invoice Service Type correctly, leading to confusion over the services billed.
9. Confusion between the Claim Period and Dates of Service, which are distinct and must be accurately recorded to reflect when services were provided versus the billing period.

Common areas overlooked also include:

• Signature of Vendor: All pages of the submission must be signed, preferably in blue ink, to certify the accuracy and agreement to terms.
• Telephone Number and E-mail Address of Vendor: These must be current and belong to a representative capable of resolving any billing issues or clarifications.
• Date of completing the claim form: This cannot precede the last service date and should be verified for accuracy.

Ensuring accuracy in these fields is paramount. Missteps not only cause processing delays but can also lead to denied claims or the necessity for re-submission, each of which carries its own set of frustrations and delays. Diligence and careful review of the claim form prior to submission will significantly mitigate these risks and contribute to a smoother claims process.

When dealing with State Form 28808 in the context of child support claims in Indiana, various other forms and documents tend to be necessary for a comprehensive approach to child support and welfare cases. These additional documents ensure accurate and timely processing of claims, along with adherence to legal and procedural requirements. They span a range of purposes, from establishing paternity to appealing decisions regarding child support.

• CS-1 Form: Child Support Obligation Worksheet. This document helps calculate the financial responsibility of each parent based on their income, the needs of the child, and any special circumstances that may affect support obligations.
• IV-D Application: Application for Child Support Services. For parents or guardians needing assistance in obtaining child support, this application enrolls them in the Title IV-D program, which provides services such as locating absent parents, establishing paternity, and enforcing support orders.
• Paternity Affidavit: A legal document typically signed at the hospital or birth center shortly after a child's birth. It establishes the legal father of the child when the parents are not married, which is crucial for child support and legal purposes.
• Income Withholding Order (IWO): An order to withhold child support from a parent's wages. It directs the employer to deduct the ordered amounts from the parent's earnings to ensure regular and consistent child support payments.
• Voluntary Acknowledgment of Paternity: Similar to the Paternity Affidavit, this form is signed voluntarily by both parents to establish the child's legal paternity. It is used when the Paternity Affidavit is not signed at the hospital.
• Health Insurance Information Form: This document is used to provide or update information about the child's health insurance coverage. It's important for ensuring that the child's healthcare needs are met and that any available insurance is used to cover costs.
• Modification Review Form: When there is a significant change in circumstances, this form is used to request a review of the current child support order. Changes can include alterations in income, employment status, or the needs of the child.
• Appeal Form: For disputing decisions made regarding child support, such as the amount of support ordered or enforcement actions. This form initiates the legal process to have the case reviewed by a higher authority.
• Termination of Support Form: Used to request the cessation of child support payments, typically when the child reaches the age of majority, becomes emancipated, or under other specific circumstances outlined by law.

Together, these forms and documents support the primary function of State Form 28808 by providing a full circle of documentation needed for the establishment, enforcement, modification, and, eventually, the termination of child support. They serve to protect the interests of the child while ensuring fairness to the parents or guardians involved. Accurate completion and timely submission of these forms are crucial for the effective functioning of child support services.

The State 28808 form is similar to several other legal documents used within the context of child welfare and support services. Each of these documents serves a specific purpose, yet they share common characteristics with the State 28808 form, such as providing detailed information on services rendered, cost calculations, and identification of service providers and recipients.

The Financial Statement for Child Support is a document often used in family law to detail the financial obligations of a parent toward their child. Like the State 28808 form, it requires detailed financial information, including income sources, expenditures related to the child's care, and other relevant financial data. Both forms are integral in calculating the financial responsibilities of parents and ensuring the well-being of children through financial support.

The Child Welfare Agency Service Invoice shares similarities with the State 28808 form in its function of billing for child-related services. It typically includes details such as the service provider's information, services rendered, period of service, and costs. Both documents are used by agencies to claim expenses incurred while providing care or services to children, whether through foster care, adoption, or family preservation efforts.

The Foster Care Placement Agreement is a contract between a foster care agency and a foster parent, detailing the responsibilities of both parties in the care of a foster child. While this document focuses more on the terms of care rather than financial aspects, it often includes sections on reimbursement or support similar to the information found in the State 28808 form, such as rates and billing codes for foster care services.

When completing the State 28808 form for claiming support of children, it is essential to follow specific dos and don'ts to ensure the process goes smoothly and errors are minimized. Here is a comprehensive list to guide you through filling out this form accurately.

• Do ensure that the name of the vendor matches the one submitted via the Vendor Information Form.
• Do provide the last four digits of your Tax ID/SSN accurately to identify your account.
• Do include the correct State Vendor ID # (ST Number) that has been assigned to you by the DCS payment system (KidTraks).
• Do assign a unique invoice number for each submission, which can include letters and/or numbers.
• Do enter the complete address of the vendor, ensuring it matches the most recent Vendor Information form on file.
• Do accurately record the start and end date of the month being billed in the "For the period" section.
• Do sign all pages of the submitted Claim in blue ink, as it is strongly recommended.
• Don't leave any required fields (*) incomplete, as this can lead to the rejection of your Claim.
• Don't adjust the total of the claim upwards after it has been submitted; ensure all calculations are correct before submission.
• Don't forget to list all children/Case #'s/Referral IDs with the service dates during the Claim period, ensuring no child is overlooked.

By following these guidelines, you help to ensure that the claim process for supporting children through the Family and Children Funds is conducted efficiently and without unnecessary delay or error. Remember, accuracy is key in all areas of completing the State 28808 form.

There are several misconceptions about the State Form 28808, particularly regarding its purpose, the process of completing it, and its requirements. Clarifying these misconceptions ensures that individuals and organizations can accurately complete the form and comply with the regulations. Here are some of the common misconceptions:

• Form is only for foster parents: This misconception arises because the form is often associated with foster care services. However, State Form 28808 is designed to be used by various vendors, including residential care providers, adoption services, and family preservation services, among others. It caters to a broad spectrum of child support services, not just those provided by foster parents.

• Personal Social Security Numbers are widely required: While the form does ask for the last four digits of the Tax ID/SSN, it primarily requires this for individual providers like foster parents. This is a measure to protect personal information while ensuring the identification of the provider for processing payments.

• Invoice number can be any length: There's a specific requirement that the invoice number must be no longer than 8 characters. This is often misunderstood, leading to the submission of forms with longer invoice numbers, which can cause processing delays.

• Submission deadlines are flexible: The form clearly states that invoices must be received within 10 business days of the date of invoice. Some might think this deadline is flexible, however, adhering to this timeline is crucial for timely processing and payment.

• Any ink color can be used for signatures: While the form can technically be signed with any ink, the instructions recommend using blue ink. This ensures that original documents can be easily distinguished from copies, a detail that's often overlooked.

• All service types can be mixed on one invoice: One common mistake is including multiple service types on the same invoice. The form requires that only one overarching service type be selected for all service codes listed in the invoice, to simplify processing and auditing.

• Service dates and claim period dates are interchangeable: The form distinguishes between the claim period—the month being billed—and the actual dates of service. Some providers confuse these two, leading to inaccurately completed forms. It's important to differentiate and accurately enter dates for each.

• Rate adjustments or rebills can include new services: When submitting a rate adjustment or rebill due to denied past invoice lines, the perception might be that additional services can be added. However, these invoice types should only correct or appeal previously submitted information, not introduce new charges.

• Submission guarantees payment: Submitting the form does not automatically guarantee payment. The form undergoes a review process, and discrepancies may necessitate additional verification or lead to denial. Providers must ensure that their submissions are accurate and complete to facilitate this process.

Understanding these nuances is crucial for providers seeking support for children through the Family and Children Funds. Accurate completion and submission of State Form 28808 help in the efficient processing of claims, ensuring that children receive the support and services they need.

When working with the State 28808 form, specifically designed for claiming support of children payable from Family and Children Funds in Indiana, understanding its various components and how to accurately complete it is crucial. Here are ten key takeaways to ensure that the process is both effective and compliant:

• Vendor Information: It's essential to start by providing the legal name of the vendor and the last four digits of the Tax ID or SSN. This information must be consistent with what was submitted via the Vendor Information Form.
• State Vendor ID: The ST number, a unique state vendor ID, is required. It's a six-digit number assigned by the DCS payment system, KidTraks, and helps in tracking the payment process.
• Invoice Details: Each invoice should have a unique invoice number, alongside the date of the invoice. Make sure the date of invoice precedes the submission by no more than 10 business days.
• Complete Address: Provide a full and accurate address for the vendor. This address must match the most recent Vendor Information form on file to avoid any processing delays.
• Invoice Type and Page Number: Clearly indicate the type of invoice being submitted and maintain accurate page numbering, especially if the invoice spans multiple pages, up to a limit of three pages.
• Service Type and Period: Identify the overriding invoice service type for the services being invoiced and specify the period for which the services were provided, using the beginning and end dates.
• Total Claim Calculation: Summarize the total of the claim accurately. This should reflect the total amount due for all services provided within the invoice period and cannot be adjusted once submitted.
• Service Details: For each child served, include the county of service, billable unit referral ID, case ID, and any necessary comments, documentation, or the NPI number of the doctor.
• Financial Details: Each service entry must include the begin and end dates of service, units of service provided, rate per unit, and the total cost calculated. Ensure accuracy to avoid discrepancies.
• Signature and Contact Information: The vendor’s authorizing signature is required on all submitted pages, ideally in blue ink. Additionally, provide a telephone number for billing issue resolution and a current e-mail address belonging to fiscal staff ready to answer any queries.

Following these guidelines will help ensure that submissions to the Indiana Department of Child Services via the State 28808 form are accurate and timely. This process not only facilitates the support of children in need but also ensures that vendors are properly compensated for their services within the scope of the law and the agreed contractual terms.