Packet Information
Packet IDPKT-2026-07-W1-001
AgencyBright Path Residential Services
Billing PeriodJune 24 – June 30, 2026
PayerMaryland Medicaid (DDA Waiver)
Submission MethodElectronic — LTSS Portal
StatusREADY FOR SUBMISSION
8
Claims
142.5
Total Units
$8,692
Total Amount
100%
Documentation
Claim Detail
| Client | Service | Dates | Units | Amount |
|---|---|---|---|---|
| Johnson, David | Personal Supports (W7068) | 6/24 – 6/30 | 28.0 | $1,708.00 |
| Thompson, Lisa | Community Living (W7060) | 6/24 – 6/30 | 24.0 | $1,464.00 |
| Martinez, Carlos | Personal Supports (W7068) | 6/24 – 6/30 | 20.0 | $1,220.00 |
| Williams, Angela | Day Habilitation (W7069) | 6/24 – 6/28 | 22.5 | $1,372.50 |
| Davis, Robert | Personal Supports (W7068) | 6/24 – 6/30 | 16.0 | $976.00 |
| Brown, Patricia | Community Living (W7060) | 6/24 – 6/30 | 12.0 | $732.00 |
| Lee, Michael | Personal Supports (W7068) | 6/25 – 6/30 | 10.0 | $610.00 |
| Garcia, Sofia | Day Habilitation (W7069) | 6/24 – 6/27 | 10.0 | $610.00 |
| Total | 142.5 | $8,692.50 | ||
Validation Checks
Authorization Coverage✓ All claims within authorized units
Documentation Complete✓ Service notes attached for all claims
Staff Credentials✓ All rendering staff have valid certifications
EVV Verification✓ Clock in/out verified for all visits
Duplicate Check✓ No duplicate claims detected
Generated By
Prepared ByL-OPs Revenue Engine (Automated)
Reviewed ByPending — Billing Manager Review
GeneratedJuly 1, 2026 at 6:00 AM