On this page you can find answers to frequently asked questions regarding provider payments and the process involved in reimbursement. Currently participating providers can register for Care Connect Web or Mobile here, and download the most current CDE Reimbursement & Fiscal Schedule here (Spanish: Horario Fiscal y Distribución de Reembolso). If you have any further questions, please contact our Payments Department for more help!
How do I get reimbursed for providing child care?
Once you have been issued a Notice of Approval that child care has been authorized and a Provider Payment Request (PPR) or Attendance Record (AR), you are responsible for submitting the appropriate forms to Pathways LA at the end of each month in order to be reimbursed.
How do I obtain a Provider Payment Request (PPR) / Attendance Record (AR)?
If you are signed up for CareCloud it is your responsibility to print out these sheets at the start of every month. For providers who have yet to sign up, the sheets are printed and mailed out monthly. If the PPR/AR is not received prior to the 1st of the month, you may come into the office and pick one up or contact Pathways LA to have a new sheet mailed to you.
What is CareConnect? How do I sign up?
CareConnect is a FREE digital attendance tool that allows you to download and print attendance records, check the status of attendance records submitted for reimbursement, and view and print reimbursement statements online. To sign up, please contact our Provider Unit Department to ensure we have your correct email address so that we can send you an email with log-in instructions.
How do I complete a PPR/AR?
To ensure proper completion please refer to one of these how-to guides for instructions. If further assistance is needed please contact Pathways LA or visit our office and ask for the Payments Department.
- For Stage 1: How To Complete a Stage 1 PPR
- For CDE (Stage 2, Stage 3, & AP): AR Instructions
- For Berendo: Berendo Network AR Instructions
When should the PPR/AR be submitted to be considered on time?
STAGE 1: PPRs should be submitted any time after the care month has ended; they will be processed by the 10th business day of date received. (Note: PPRs can be accepted up to a fiscal year back)
CDE/BERENDO: ARs should be submitted by the due date on the Reimbursement and Fiscal Schedule. Any AR submitted after the due date will be considered late. Click here for the current Reimbursement & Fiscal Schedule (Spanish: Horario Fiscal y Distribución de Reembolso).
If the PPR/AR that was submitted has mistakes will it be returned?
Any PPR with a mistake will be returned to the provider within four business days of being received, along with a letter outlining how to make corrections. Once you have resubmitted your PPR with the accurate corrections, it will be processed 10 business days from the most recent submission date.
Any AR with a mistake will be placed on hold and a Pathways LA representative will reach out to the provider or parent regarding how to correct the mistake. AR’s will not be mailed back to providers, the payments team will contact you to collect a declaration to clarify of any mistakes in the AR’s.
What should I do if I believe that my reimbursement amount is incorrect?
Please contact our Payments Department – one of the Pathways LA payment technicians will be able to assist in reviewing your reimbursement.
Will I be paid for hours that are not authorized by Pathways LA?
No, providers will only be reimbursed for hours that have been authorized through a Certificate of Enrollment from Pathways LA.
Is it okay to make changes or modifications to the PPR/AR by hand (by crossing things out)?
Modifications to the PPR/AR, such as crossing out the month or the name and writing a new one, are unacceptable. Any PPRs/ARs received with such manipulations can lead to voided claims, lost sheets and/or delays in reimbursement. If your PPR/AR contains an error, please contact your specialist. To print out a new sheet, log into your CareCloud account or contact a specialist to get mailed new ones.
How much does Pathways LA reimburse providers?
Pathways LA must observe the reimbursement rate limitations set by California Department of Social Services (CDSS), known as the Regional Market Ceiling (RMC). CDSS may change these rates without notice. To keep up to date with the latest on the RMR and related information, visit the CDSS website.
What if my rates are higher than the Regional Market Ceiling?
When a provider’s rate and other allowable charges exceed the RMR ceiling, the parent is responsible for paying the difference directly to the provider. This payment is known as a Co-Payment. Pathways LA is not responsible for Co-Payment arrangements between parents and providers.
The Co-Payment is distinct from the Family Fee, which is the amount a participant must pay toward child care costs based on income, family size and the fee schedule established by the State. A parent may be responsible for both a Family Fee and a Co-Payment, if they choose a provider whos rates exceed the RMR ceiling.
How is my reimbursement calculated?
Your reimbursement is determined by numerous factors, including the parents’ approved schedule, the child’s school schedule, absences, and other circumstances that may change month to month.
What are my reimbursement options?
Providers have the option of selecting Direct Deposit, Provider Pay Card, or Check for their reimbursement.
- Direct Deposit: Providers who opt into Direct Deposit as their method of reimbursement must have an active checking or savings account. A Direct Deposit form must be submitted along with a voided check or blank deposit slip. Following every disbursement, providers will receive an email notification stating that the disbursement was made. Funds are typically available within 24-48 hours following the disbursement. There are no charges associated with Direct Deposit.
- Provider Pay Card: A Provider Pay Card (PPC) acts like a debit card and offers an alternative to Direct Deposit for providers who do not have bank accounts. Providers can access their child care reimbursements with their PPC at ATMs, grocery stores, post offices, etc. Reimbursement will be automatically added to the PPC and electronically available for use or withdrawal by the provider. Funds are typically available 1-2 business days after the distribution date. PPCs are safer than checks. Because funds are transferred electronically to a PPC, only the cardholder can access those reimbursements with a Personal Information Number or security code of their choice. A PPC also allows the provider to conveniently and safely send money to relatives and/or friends, within or outside the United States.
- Check: Providers who select Check as their reimbursement method must make an appointment to pick up their check in person at the Pathways LA office each month. Presentation of a valid ID is required at the appointment. Checks will not be mailed under any circumstance. Checks are typically available 4-5 business days after the distribution date indicated in our system. The Finance Department will call providers to schedule an appointment once the check is available.
Providers are strongly encouraged to enroll in Direct Deposit to avoid the 4-5 day waiting period and a visit to our office. A provider may set up an appointment to enroll in Direct Deposit with the Finance Department as soon as the provider receives notice of an approved enrollment. Providers who do not select Direct Deposit or a Provider Pay Card at the time they submit a Service Agreement will be automatically enrolled in the Check reimbursement method.
How can I update my rates? And how often can I change my rates?
Providers may change their rates at any given time and to any given rate for their non-subsidized families; however, Pathways LA will only approve and apply one rate change per fiscal year (July 1-June 30) up to the Regional Market Rate (RMR) ceiling. Requests for a rate and/or fee change to Pathways LA must be submitted in writing. Providers must provide documentation proving that the change also applies to their non-subsidized families. Documentation such as flyers, brochures and/or letters with the updated policy are acceptable.
Am I eligible for reimbursement for holidays?
Licensed providers are eligible to be reimbursed for up to ten (10) days of non-operation per fiscal year (July 1-June 30) under specific circumstances. Non-licensed (e.g. License-exempt relatives and TrustLine) providers are not eligible for holiday/vacation reimbursements. Reimbursement will be based on the authorized hours the child typically attends. Licensed providers are not eligible for Days of Non-Operation Reimbursements for children approved on variable schedules.
Am I eligible for reimbursement when a child is absent?
Licensed providers providing care for families approved on a set schedule are eligible for reimbursement when a child is absent from their care. Families approved on a variable schedule and/or using part-time license-exempt services are only eligible to have their provider reimbursed for the actual days and hours of attendance, up to their maximum certified hours. Providers are required to report any child absences that exceed 5 normal days of care to Pathways LA. A doctor’s note may be required if a child is absent from care for more than 5 days.
Am I considered a Pathways LA employee because I get reimbursed by the agency?
No, Pathways LA is not your employer. You are self-employed and sub-contracted for child care services. Pathways LA reimburses you on behalf of the participant enrolled in the program. Because you are not an employee of Pathways LA, we cannot provide employment verification on your behalf for any purposes.