Ticket to Work Program

1. Ticket to Work Program All About Payments

2. Vision of Associate Commissioner for OESP The 5 Cs: • Choice • Capacity • Coordination • Collaboration • Credible Results

3. Course Objectives • Discuss Payments Process • Differentiate between Outcome-only and Milestone/Outcome payment methods • Identify available Phase I Milestone payments using the 18-Month Lookback Tool • Explain exclusions and transitions • Identify resources to aid you in the payment process

4. Payment Process Get Beneficiary to Trial Work Level (TWL) or Substantial Gainful Activity (SGA) Check Ticket Assignability Complete Individual Work Plan (IWP) Be sure to include Certification of Services Submit Payment Request Form Consider Universal Auto Pay

5. Ticket Assignability • Call TASC Helpline at 1-866-949- 3687 • Select Option 1 for automated Ticket assignability information using the Interactive Voice Response or IVR • Have your DUNS number, PIN number, and Ticket Holder SSN(s) available • Check Assignability Via Online EN Portal • Terminology • Assignable • Not In the Database • Not Assignable • Assigned • In-Use SVR

6. Payment Methods • Outcome-only • EN provides the services needed • Beneficiary must reach a consistent earnings level and stop receiving benefits • EN can receive Outcome payments • Milestone/Outcome • EN provides the services needed • Beneficiary reaches certain earnings levels but also receives benefits • EN can receive Milestone payments while beneficiary receives benefits • EN can receive Outcome payments when benefits cease

7. Substantial Gainful Activity and Trial Work Level • Substantial Gainful Activity (SGA) • Substantial • Gainful • $1,040/month for non-blind individuals and $1,740 if blind in 2013 • Trial Work Level (TWL) • Incentive for beneficiaries to work and continue to receive benefits • $750/month in 2013

8. Outcome-Only Payment Method • No payments until • Beneficiary reaches net SGA ($1,040/month for 2013) • Beneficiary stops receiving benefits

9. Milestone/Outcome Payment Method • Payments can occur while beneficiary continues to receive benefits • Payment types • Phase I Milestone • Phase II Milestone • Outcome

10. Phase I Milestones

11. Phase II Milestones • Ticket Holder reaches SGA but still receives benefits • Based on single calendar months

12. Outcome Payments • Zero cash benefit status

13. Milestone/Outcome Payments

14. 18 Month Lookback Rules • Ticket Holder achieved TWL in the month prior to Ticket assignment, Milestone 1 unavailable • Ticket Holder achieved TWL in 3 of the 6 months prior to Ticket assignment, Milestone 2 unavailable • Ticket Holder achieved TWL in 6 of the 12 months prior to Ticket assignment, Milestone 3 payment unavailable • Ticket Holder achieved TWL in 9 of the 18 months prior to Ticket assignment, Milestone 4 unavailable

15. Outcome-Only vs. Milestone/Outcome • Milestone Payments • None with Outcome-only • Available with Milestone/Outcome • Total Payments Available

16. 18 Month Lookback Tool Enter the Ticket Assignment Date Available Milestone payments are shown Enter an X for every month TWL or above was earned Available Milestone payments are shown

17. 18 Month Lookback Tool • Ticket assignment date: January 2013 • Above TWL: August, October, and December 2012

18. 18 Month Lookback Tool • Ticket assignment date: July 2011 • Above TWL: April, May, June 2011; July, Aug., Nov. 2010

19. 18 Month Lookback Tool • TWL: September – December 2011; May, June 2012; July, October, November 2012

20. Exclusions • Vocational rehabilitation (VR) agencies may use Cost Reimbursement (CR) method to provide services. • For CR cases closed successfully, EN cannot collect Phase 1 Milestone payments. • EN can provide continuing services and collect Outcome payments. • 18 Month Lookback not needed with exclusion cases

21. Transitions • Caused by changes in regulation • Prevents duplicate payments • Rules • Phase I Milestones not available if VR agency closed case successfully in 2002 or later • Phase I Milestones are available if VR agency closed case successfully before 2002 • Phase I Milestones are available if VR agency closed case unsuccessfully

22. Reconciliation Payment • Paid to an EN who did not receive all of its available Milestone payments • Available for a Ticket assigned under the Milestone/Outcome payment method • Payment will equal the total amount for the skipped Milestone payments that were available on the Ticket when assigned • Rules • Only Milestones that the EN was eligible to receive • Results of 18 Month Look-back • After 12 outcome payments • ENs paid under Outcome payment system and ENs who received outcome payments prior to July 21, 2008 are not entitled to receive a reconciliation payment • No multiple payments for a single Ticket

23. Resources for Success • Technical Assistance and Support Center, including: • Automated Ticket Assignability Information and Payment Help Desk • Toll Free: 1-866-949-ENVR (3687) • Option 1: Ticket Assignability through IVR system • Other Options: Payment and Systems Help Desks • FAX: 703-893-4149 • TDD: 1-866-833-2967 • Secure Online Provider Portal • Complete Forms • View Reports • Upload and Download Documents • Check Ticket Assignability and Ticket History • www.yourtickettowork.com for training and other resources

24. Resources for Success continued • Monthly calls with Social Security and the Operations Support Manager • All EN Call – First Thursday • All VR Call – Second Tuesday • All EN Payments Call – Last Tuesday • More information at www.yourtickettowork.com

25. Key Points • Payment Process • Outcome-only vs. Milestone/Outcome • 18 Month Lookback tool • Exclusions and transitions • Resources

26. This Completes the Ticket to Work All About Payments training Please fill out our brief evaluation of this training by clicking on the following link: http://www.surveymonkey.com/s/KWDXQKV