1. (a)

   1. (1) The following must be obtained from the provider before any services are authorized:

      1. (A) Proof of EIN/SSN;
      2. (B) Signed W-9; and
      3. (C) Signed signature page of TEA-1400.
   2. (2) Services cannot be authorized until all necessary information has been submitted.
   3. (3) Note. New providers must be added to the PEPU (Provider Update) screen on WISE.

2. (b) Provider Service Authorization — TEA-1427.

   1. (1) Form TEA-1427, Provider Service Authorization, authorizes transportation services and provides proof of arrangements via a written and signed agreement between the:

      1. (A) Participant;
      2. (B) Provider; and
      3. (C) Program Eligibility Specialist representing transitional employment assistance (TEA).

   2. (2)

      1. (A) Form TEA-1427, Provider Service Authorization, is the only form that will be used to authorize nonchildcare services by providers paid through the WISE payment system.
      2. (B) TEA will not be liable to pay for any services rendered by a provider without written authorization via form TEA-1427.

3. (c) Beginning date of nonchildcare services.

   1. (1)

      1. (A) The period of authorization for transportation/other services is listed on the TEA-1427 as "for the period ______ through _______".
      2. (B) The service is considered authorized by the local office upon signature on the TEA-1427 by the Program Eligibility Specialist.
      3. (C) Prior to signing the form, the Program Eligibility Specialist must verify the provider has met all requirements in order to be paid by the Department of Human Services.

   2. (2)

      1. (A) The effective date of service for TEA participants begins the first date transportation or other nonchildcare services are required by the participant provided all provider requirements have been met as of that date.
      2. (B) Otherwise, the effective date will be the first date all provider requirements are met.

4. (d) Utilizing the provider agreement/amendment sheet.

   1. (1)

      1. (A) The local office manager or designee will use the amendment to the TEA-1400, Provider Agreement, when it is deemed appropriate.
      2. (B) This includes, but is not limited to, an increase or decrease in the transportation rate.

   2. (2)

      1. (A) The local office manager or designee will use discretion when using the provider agreement amendment as this form is not intended as a means of giving providers rate raises.
      2. (B) See 20 CAR § 503-221(d) for routing instructions.

5. (e) Payments/reimbursements.

   1. (1)

      1. (A) Participants and providers will be required to complete form TEA-187, Billing/Routing Sheet, relative to payment/reimbursement for records of expenses.
      2. (B) Form TEA-187 will be used by participants and providers to document and bill for payment or reimbursement of expenses.
      3. (C) Document the case narrative of any information relative to the method of payment or reimbursement.
   2. (2) Form TEA-187 will be fully completed and signed by the participant and/or provider prior to any payment or reimbursement being made.
   3. (3) Form TEA-1430, Transportation Billing/Routing Sheet, will be completed for transportation reimbursements.

6. (f) Use of the WISE system.

   1. (1) The Program Eligibility Specialist will utilize instructions contained in the online WISE help when authorizing reimbursement payments and generating checks for participants and providers.
   2. (2) If a provider is providing services for more than one (1) participant, a separate entry for each person must be keyed to RSRP (Reimbursement Authorization) in order for a check to be generated.

Codification Notes: “EIN” means employer identification number. "SSN" means Social Security number.