How to Simplify School-Based Medicaid Billing with Software 

 

Medicaid billing lets school districts gain reimbursements for the healthcare and support services they provide to Medicaid-eligible students in special and regular education classes. Across the U.S., school districts receive a total of about $4.5 billion in Medicaid reimbursements each year, with Medicaid serving as their third largest source of funding, behind Title I of NCLB and IDEA.1 Yet, with all the opportunities these reimbursements can empower, the process of recapturing them from State and Federal Medicaid Programs can be complex and might feel a little overwhelming.  

The good news is that there are software solutions on the market designed to help schools get back the reimbursement money they are entitled to for the services they provide. 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.  

Software for school-based Medicaid billing helps you: 

 

Obtain parental consent more easily with digital signature capabilities 

A software tool with digital parental/guardian consent capabilities can help manage the parental consent process. With the software’s signature capture, parents or guardians can sign their consent electronically, which updates the system, making it a quick, online and secure process. With software tracking capabilities, you 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 the consent signatures you still need.  

 

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; the right software system does the work for you! These systems can check which services are currently approved for Medicaid reimbursement and you get a list of all eligible students. And though student-eligibility may fluctuate, the system ensures you always have the most updated information at your fingertips. 

 

Improve communication at-a-glance with dashboards 

Software for school-based Medicaid billing 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.

 

Use electronic file transfer to reduce errors in student data 

Because school-based Medicaid billing software can leverage data downloaded straight from the student information system (SIS), you don’t need to worry about the human errors that can creep in when entering student and services data manually. Plus, the process saves significant time over manual methods!  

 

Track all student services for simple reimbursements and auditing 

A school-based Medicaid billing software system takes the pain and guesswork out of reimbursements and services audits, because the tracking is built right in. By documenting services in the system for non-Medicaid-eligible students as well for as your verified, eligible students, you always know which services were provided and when, and what should be reimbursed at any time, even when eligibility fluctuates. 

 

Leverage reporting to catch potential IEP, license, or enrollment lapses 

Lapsed IEP service days, provider licenses, or Medicaid enrollment mean lost reimbursement funding for your school. But software with powerful reporting can help you manage important start and expiration dates. 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.  

 

Catch referrals before they expire  

School-based Medicaid billing software can help take the mystery out of referral expirations, too. These referrals are required for Medicaid services in all states but Arizona, and if they’re not signed by the physician or allowable approver before they lapse, your school can lose reimbursement days. But software offers a helpful color-coded system that tracks referral expirations in each provider’s caseload — yellow when it’s about to expire, and red when it has expired. This gives you an at-a-glance important heads-up on expirations, so follow-up becomes timely and efficient.  

 

Harness electronic oversight signoff 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 and paperwork involved. The system makes identifying and monitoring missing service sign-offs simple and convenient, too. It’s all right there in the provider’s profile. 

 

The right Medicaid billing software can empower your districts to optimize Medicaid reimbursements 

Getting all the reimbursements your school deserves becomes an easier, more streamlined process when you have the right software to support your district. Find out how one tool, Go Solutions’ GoClaim, can bring greater communication, tracking, documentation and understanding to your school-based Medicaid billing program, increasing the reimbursements that help your district meet reimbursement goals.   

Sources: 

  1. Expanding School Based Services Through Medicaid, Healthy Schools Campaign Webinar, 2020

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