The In’s and Out’s of Claim
Review and Submission
Becca Cochran, MS, RDN, CACFP
Coordinator
Jennifer Hutchinson, School Meals
Consultant
GoToWebinar Housekeeping
Agenda
• Discuss meal counting requirements
• Define point of service meal counts
• NSLP/SBP Claim Edit Checks
• CACFP Claim Edit Checks
What is Meal Counting?
• The process of accurately collecting and maintaining data at the Point of
Service.
• Food service staff must obtain accurate meal counts so that the
SFA/Sponsor can submit meal count totals at the end of each month for
reimbursement.
– Claims include the total number of meals served or the total number
of free, reduced- price, and paid meal served.
• Staff must understand the importance of checking every participant
who receives a meal.
• Staff need to be able to recognize when a participant has selected or
received a reimbursable meal.
Point of Service is ……
• The point in the food service operation where a
determination can accurately be made that a
reimbursable meal has been served to an eligible child.
• The point of service is always at the end of a traditional
serving line or after all components have been served.
Why are Point of Service Meal Counts so
Important?
• It ensures that each participant has the opportunity to
receive a reimbursable meal.
• It ensures that each reimbursable meal is counted,
allowing the SFA/Sponsor to claim each meal and
receive reimbursement from the USDA to cover the costs
of offering meals to participants.
Unacceptable Meal Counting Methods
• Meal counts taken prior to the meal service or in a
location other than the location where the meal is served
• Based on attendance or enrollment record
• Not performed at the point of service
• “Backed out” (total in attendance minus those observed
not to have a reimbursable meal)
• Plate or tray counts
Counting and Claiming Put into Practice
• When meals are served in a cafeteria setting the point of service meal counts
must always be taken at the end of the service line after the participant has
selected the meal components that will make a reimbursable meal.
– This information can be entered into a computerized Point of Sale System or
can be recorded on a paper roster or spreadsheet.
• For meals served outside of the cafeteria setting, meal count software can be
used to print rosters. Rosters can be sent (and collected) daily with the
meals or can be delivered each Monday for completion during the week.
• Food service staff with computerized point of service systems can receive
and review the completed meal rosters from classrooms and enter that
day's meal counts into the computer.
• If the SFA/Sponsor does not have a computerized point of service,
spreadsheets can be created for use in classrooms.
The Importance of Meal Count Training
• Whether in a cafeteria setting or in the classroom; training staff to
correctly and clearly mark rosters or enter meals into a Point of Sale
System at the point of service is essential for accurate meal counts.
• Food Service staff should be trained on meal collection and
the importance of ensuring students receive the appropriate
meal components at the point of service in order to claim meals for
federal reimbursement.
• If meals are being served in a classroom setting, teachers and
classroom staff will need to be trained on how to take meal counts at
the Point of Service.
• Teachers and other classroom staff might need additional training
on what meal components make up a complete reimbursable meal,
depending on whether students select their meal components in the
classroom or whether all components are already unitized.
School Nutrition Program Edit Checks
• Refers to the procedure used by the SFA to compare each site’s daily counts of free,
reduced, and paid meals and consolidate them into a monthly report.
• This process is required to be completed prior to submitting a claim for
reimbursement.
• Might be an automated process completed by point of service software or manual.
• Must have edit checks in place to ensure accuracy.
• The process will be reviewed by Child Nutrition staff during your Administrative
Review.
• Site managers should provide clear and accurate meal count information to Program
directors. Directors must edit check the information provided to ensure accuracy
before submitting the claim for reimbursement.
• If site managers are entering their own information into the claim system. Program
directors must still review that information and ensure its accuracy before submitting
the claim.
• In the new Harvest system site managers have data entry level permission. Program
Directors and Business managers are allowed authorized rep status to allow them to
submit the claims.
Claim System
• Claims in the Harvest system are not
ready yet
Example 1
Example 2
Example 3
CACFP Reimbursement and Claim
Review and Submission
Requirements
Claims for Reimbursement in CACFP
• Reimbursement funds are made available to States from
USDA.
• Sponsors must have an agreement with the State agency
and must submit claims monthly.
• Claims for reimbursement can only be paid for
approved meal types and must report information in
accordance with the financial management system
established by the State.
CACFP Claim Review Requirements
• Sponsors must have edit checks in place to review
monthly claim information for all sponsored sites.
• Proper edit checks ensure all information submitted to
the State agency is accurate.
• Edit checks also allow Sponsors to correct discrepancies,
follow-up with sites to provide training and technical
assistance and ensure all meals claimed meet meal
pattern requirements.
Federal Regulations
• 7 CFR 226.11 reviews the requirements associated with
program payments to participating sponsors.
– 7 CFR 226.11(b)(1) Prior to submitting its consolidated monthly
claim to the State agency, each sponsoring organization must
conduct reasonable edit checks on the sponsored centers' meal
claims, which at a minimum, must include those edit checks
specified at §226.10(c).
CACFP Claim Review Requirements
7 CFR 226.10(c): At a minimum the Institution’s edit checks must:
• Verify that each facility has been approved to serve the types of meals claimed.
• Compare the number of children enrolled at each facility, multiplied by the
number of days on which the facility is approved to serve meals, to the total
number of meals claimed by the facility for that month.
• All records to support the claim shall be retained for a period of three years
after the date of submission of the final claim for the fiscal year to which they
pertain.
• All accounts and records pertaining to the Program shall be made available,
upon request, to representatives of the State agency, of the Department, and of
the U.S. Government Accountability Office for audit or review, at a reasonable
time and place.
CACFP Claim Review Requirements
7 CFR 226.10(c): At a minimum the Institution’s edit checks must:
• The Claim for Reimbursement for any month shall cover only Program operations for that
month.
• A final Claim for Reimbursement shall be postmarked and/or submitted to the State
agency not later than 60 days following the last day of the full month covered by the
claim.
• Downward adjustments in Program funds claimed shall always be made without FNS
authorization regardless of when it is determined that such adjustments are necessary.
• If audits, investigations, or other reviews, a State agency has reason to believe that an
institution, child or adult care facility, or food service management company has engaged
in unlawful acts with respect to Program operations, the evidence found in audits,
investigations, or other reviews is a basis for non-payment of claims for reimbursement.
Additional CACFP Claim Review
Requirements
• While USDA outlines the minimum requirements edit checks must
include, all information entered and submitted on the claim for
reimbursement must be accurate and must be supported by back-up
documentation.
• Sponsors must review all back-up documentation associated with the
claim for reimbursement to ensure accuracy prior to submitting the claim
for reimbursement.
Claims for Reimbursement in CACFP
All claim forms will, at a minimum, require submission of the following
information [7 CFR 226.11(b) and (c)]:
• Month and year the meals were served;
• Number of days of operation;
• Total enrollment;
• Average daily attendance (the result of each day’s attendance, totaled, then
divided by the number of operating days);
• Total number of meals claimed by type (breakfast, lunch, snack, or supper)
by eligibility category or, where reimbursement is computed by claiming
percentages, the total number of meals served by type;
Claims for Reimbursement in CACFP
All claim forms will, at a minimum, require submission of the following
information [7 CFR 226.11(b) and (c)]:
• For for-profit centers, must report the percentage of Title XX beneficiaries
that month;
• If the State agency elects to reimburse its centers according to the lesser of
rates, the claim form will also require information on operating costs,
administrative costs;
• Certification that the claim is correct, and records are available to support
the claim.
• Total Days of Operation
• Total Attendance
• Average Daily Attendance
• Number of Shifts
Entering Claims for Reimbursement
Total Days of Operation
• The total number of days of operation are the days in
which a site was approved to serve meals, open and
serving and claiming reimbursable meals.
• Sites may not serve meals on days that site is not
approved to provide meals.
• Sites do not include days the site was open but did not
provide meals.
Total Days of Operation Example
Total Attendance
• The total attendance for the month is the number of participants
who attended the site during the month.
• Each day’s attendance will be added together for the total
attendance.
• The total attendance is not the number of participants who received
a meal.
• Programs are required to maintain attendance records separately
from the site's meal count records although they may be
maintained on the same form.
• Sign in and out sheets or daily attendance rosters
Attendance Record Examples
Average Daily Attendance
• The average daily attendance also known as ADA is
determined by taking the total attendance for the month and
dividing it by the number of operating days.
• When manually calculating ADA, the site should round up to
the nearest whole number.
• The claim for reimbursement calculates this automatically for
sites.
Number of Shifts
• The number of shifts refers to whether the site has multiple
meal service shifts to accommodate different meal service
times for different age groups.
• This number is determined automatically by accessing this
information within the site application.
• Meals must be served during the approved meal service
time(s).
• Enrollment information
– Free
– Reduced
– Paid
Enrollment Information
Enrollment Information
• Enrollment information collected annually.
– Enrollment forms
– Income eligibility forms
• Based on current income guidelines established
by the Federal government.
• Use to determine the organization’s
reimbursement each month.
Enrollment Information Example
Entering Meal Counts
• Claiming by Total Meals
• Claiming by Meal Category
Daily Point of Service Meal Count
Examples
Unacceptable Point of Service Meal
Count Example
Consolidated Meal Count Sheet Example
• Operating and administrative costs
Entering Claims for Reimbursement
Questions?
In accordance with Federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and
policies, the USDA, its Agencies, offices, and employees, and institutions participating in or administering USDA
programs are prohibited from discriminating based on race, color, national origin, sex, disability, age, or reprisal or
retaliation for prior civil rights activity in any program or activity conducted or funded by USDA.
Persons with disabilities who require alternative means of communication for program information (e.g. Braille, large
print, audiotape, American Sign Language, etc.), should contact the Agency (State or local) where they applied for
benefits. Individuals who are deaf, hard of hearing or have speech disabilities may contact USDA through the Federal
Relay Service at (800) 877-8339. Additionally, program information may be made available in languages other than
English.
To file a program complaint of discrimination, complete the USDA Program Discrimination Complaint Form, (AD-
3027) found online at: How to File a Complaint, and at any USDA office, or write a letter addressed to USDA and
provide in the letter all of the information requested in the form. To request a copy of the complaint form, call (866)
632-9992. Submit your completed form or letter to USDA by:
1. mail: U.S. Department of Agriculture
Office of the Assistant Secretary for Civil Rights
1400 Independence Avenue, SW
Washington, D.C. 20250-9410;
2. fax: (202) 690-7442; or
3. email: program.intake@usda.gov.
This institution is an equal opportunity provider.
