1. PROVIDER NAME (display-only).

2.PROVIDER ID NUMBER (display-only)

CHILDREN

Only authorized children appear on this form. Added children appear the day after the authorization is entered by the DHS office.

3. CHILD'S NAME - (display-only) The full name of each child.

4. CHILD'S ID NUMBER - (display-only) The child's 10-digit identification (ID) number. See the Child Development and Care Certificate/Notice of Authorization (DHS-198).

5. CASE NUMBER - (display-only) The case number or Bridges case ID assigned to the child's family. See the DHS-198.

6. DAILY HOURS - CHILD CARE HOURS - In the box under each day enter the number of hours of care that were actually provided, rounded to the nearest half hour. Enter half hours as .5 (Example: 3.5.). This may be more or less than the number of hours authorized on the DHS-198. Leave blank any days the child did not attend. Enter only those hours of care that you are billing to DHS.

HOW TO ROUND TO THE NEAREST HALF HOUR:
If remaining minutes are 1 - 15, drop them. For example, for 6 hours and 15 minutes, enter 6 hours. If remaining minutes are 16 - 45, round to .5. For example, for 6 hours and 45 minutes, enter 6.5 hours. If remaining minutes are 46 - 59, round to the next higher hour. For example, for 6 hours and 50 minutes, enter 7 hours.

7. ILLNESS/HOLIDAY HOURS - State of Michigan holidays and absences due to the child's illness (not to exceed two consecutive weeks) can be reported if you charge the general public (all families) for the holiday or absences due to illness AND if the child would have normally been in care that day. If you do report child ill/holiday hours, you may not enter more hours than the child would have normally been in care that day. In the box for the day that the holiday or the absence occurred, enter the number of hours being reported, rounded to the nearest half hour. Enter a half hour as .5 (Example: 3.5).

TOTALS

8. TOTAL CARE HOURS - This is calculated by the computer. The computer adds the hours of care for all of the days in the row labeled "Child Care Hours". It rounds up if there is a part of an hour reflected in the total. (Example: 44.5 is rounded up to 45.) You may only bill for care that was actually provided. This may be more or less than the number of hours authorized.

9. TOTAL ILLNESS/HOLIDAYS - This is also calculated by the computer. It adds the hours for all of the days in the row labeled "Illness/Holiday Hours". It rounds up if there is a part of an hour reflected in the total. (Example: 8.5 is rounded up to 9.)

10. TOTAL CHARGES - Type in the total amount, rounded to the nearest dollar, for the total hours you are billing DHS for this two-week pay period for the care of this child. No cents are to be entered, including zeros. (Example: Your charge for full time care is $80.20 per week, and this child was in care full time for both weeks. Enter 160 in this box.) Tip - This is the amount you are charging for the child for the whole two-week pay period. A common mistake is to enter the hourly charge instead of the full, two-week charge. You must enter the full, two-week charge before sending your billing to DHS.

FINISHING YOUR BILLING

11. CERTIFICATION - When you have completed all pages of your billing, be sure you are on the last page. Carefully read the certifications. If you are complying with all of the certifications, click in the check box next to "I certify that," then click on the "Submit to DHS" button. This will send your billing to be processed in the next scheduled payroll batch for the pay period. A printable version of your invoice will then appear on your screen.

NAVIGATION BUTTONS

Use the buttons in the lower portion of the form to move between screens within the billing program.

SAVING YOUR WORK

Selecting any of the navigation buttons, except for the "Cancel and Return to Menu" button will save your work.