Medicaid billing allows school districts to receive reimbursements for healthcare and support services provided to Medicaid-eligible students in both special and general education. According to the U.S. Department of Education, Medicaid pays $4-6 billion to school districts for providing school-based services each year and is a large source of funding for many school districts. There’s no doubt maximizing these reimbursements is essential. However, navigating the process can be quite complex and overwhelming.
The good news? There are solutions on the market designed to help schools recover the reimbursement money they are entitled to. They can support program administrators and service providers in helpful ways throughout the reimbursement process, with built-in best practices, tracking, automation, reminders and easy-to-use communication tools.
All this can help streamline processes, energize follow-up, increase program participation and generate even more reimbursements for your district.
Ways school-based Medicaid billing software can help
If your reimbursement process feels like a hassle, the right Medicaid billing software can tackle challenges and help eliminate frustrations. Here’s how:
1. Obtain Parental Consent Easily with Digital Signature Capabilities
A software tool that allows for digital parental/guardian consent can help manage the parental consent process. With the software’s signature capture, parents or guardians can sign their consent on their own device, which updates the system, making it a quick and secure process. You will always know when new parental consent signatures have been added to the system. And with robust reporting functionality, you can run reports to follow-up on those still pending.
2. Learn Which Students Are Medicaid-Eligible in a Snap!
Add all students into your database to learn which of them are Medicaid-eligible at any time. Yep, the right software system does the work for you! Software does it by checking which services are currently approved for Medicaid reimbursement and sending you a list of all eligible students. Even as student eligibility fluctuates, you’ll always have the most up-to-date information right at your fingertips.
💡 Recommended reading: What Factors Effect a Students Medicaid Eligibility Status
3. Improve Communication at-a-Glance with Dashboards
School-based Medicaid billing software usually offers built-in dashboards that can bring high-level transparency into the claims process. Dashboards allow you to see student and provider summaries for activity, inactivity, eligibility, ineligibility, caseloads and more. The user-friendly drill-down data helps keep students, providers and claims on-track.
4. Reduce Errors in Student Data with Electronic File Transfers
School-based Medicaid billing software can pull data directly from your student information system (SIS), minimizing the risk of errors that often occur with manual data entry. Mistakes like typos or missing information can lead to reimbursement issues, but automation ensures greater accuracy. Beyond removing the stress over human errors, the process saves significant time over manual methods.
5. Track All Student Services for Simple Reimbursements and Auditing
School-based Medicaid billing software can also assist the reimbursement process by automatically tracking all services provided to students. This means the software records services for both Medicaid-eligible and non-eligible students, ensuring that you have a clear record of what was provided, when, and to whom.
The built-in tracking and documentation eliminate guesswork and reduce the potential for errors, streamlining both the reimbursement process and audits. Whether you’re following up on claims or preparing for an audit, the software ensures you have accurate up-to-date records on hand.
6. Leverage Reporting to Stay Ahead of IEP, Licensing, and Enrollment Deadlines
When key elements like IEP (Individualized Education Program) service days, provider licenses, or Medicaid enrollment lapse, your school risks losing reimbursement funding. These lapses can occur if deadlines are not tracked carefully. With software that includes powerful reporting features, you can easily monitor the start and expiration dates of all critical items.
The software alerts you when important dates are approaching or when something is about to expire. This means you can be proactive about which items are ending when, and take action to ensure enrollment, service and licensing continues smoothly, year after year.
💡 Recommended reading: Choosing a New Software Vendor: Drop-downs, Default Settings, Customization Options
💡 Recommended reading: 8 Best Practices That Can Increase Your Medicaid Funding
7. Prevent Referral Expirations
Referral expirations is one of the biggest common Medicaid billing mistakes you need to avoid. School-based Medicaid billing services can help take the mystery out of referral expirations, too. Referrals are required for Medicaid services in most states, with some exceptions such as Arizona and Wisconsin. If they’re not signed by the physician or allowable approver before they lapse, your school can lose reimbursement days.
To help prevent this, some software uses a color-coded system to track the expiration dates of referrals in each provider’s caseload. For example, referrals that are nearing expiration are marked in yellow, while those that have already expired are highlighted in red. This gives you an at-a-glance important heads-up on expirations, so follow-up becomes timely and efficient.
8. Harness Electronic Oversight Signoffs to Streamline the Signature-Gathering Process
Software can make getting mentor oversight signatures on services provided by mentees easier. Delays in signatures can mean delays in claims reimbursements. But with electronic service approvals, capturing approvals becomes efficient, without the back-and-forth. The system makes identifying and monitoring missing service sign-offs easy and convenient, too. Everything is right there in the provider’s profile.
The right Medicaid billing softwareMedicaid Billing Software A software solution designed to streamline the submission and management of Medicaid claims for schools, ensuring accurate documentation and compliance with regulations. can empower your districts to optimize Medicaid reimbursements
Professionals in every industry rely on software to streamline workflows and enhance efficiency, and school-based Medicaid billing is no exception. The right software solution can transform a complex, time-consuming process into a much more efficient system.
By leveraging automation, tracking, and reporting features, your district can improve compliance, reduce errors, and maximize reimbursements—ensuring that valuable funding continues to support students who need it most.
Find out how one tool, Go Solutions’ GoClaim can bring improvements to your school-based Medicaid billing program and help your district meet its reimbursement goals.
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