Having set processes in place for Medicaid related documentation is not only great for your peace of mind and it can help your district in the long run in the case of an audit. When billing for Medicaid, there are additional rules involved compared to those already set for the district based on state and federal regulations for public and charter schools. Some extra rules for Medicaid billing for your state may involve getting parental consent to bill for Medicaid, documentation signed by a doctor, extra qualifications to be completed by your providers, and additional supervision of related service providers. If you are not working with a third-party billing vendor like Go Solutions, the best place to get a copy of these rules are commonly found on your state website, the handbooks are usually named something along the lines of (State) School Based Medicaid Services handbook.
Here are some things you can look for in the handbook:
- What provider types are billable?
- How long you have to bill services before going stale dated?
- What often forms need to be signed by providers and guardians?
- What services are billable?
Why is documentation so important? We understand that funding from the government feels very minimal compared to the cost your district incurs providing a quality education to your students. If you are billing for Medicaid reimbursable services, you want to be able to protect your district from ever having to pay back any funds due to an audit finding. From personal experience and talking with customers, here are some of the great ways Medicaid reimbursement is being used: buying extra buses, pay raises for staff, buying supplies for staff, and hiring extra staff. If your district has agreed to pay for extra resources based off of Medicaid reimbursement, the district will want to make sure they continue to receive the funds.
What is the providers’ most important role in the documentation process? Note taking and progress updates! Another requirement of Medicaid billing (doesn’t it feel like the list goes on and on?!) for all states is tracking how students are progressing based on their care plan such as an IEP or 504. The best way to do this is by taking notes for every service provided as well as updating progress on the care plan goals at least quarterly. One bonus of doing this is that your providers can then share this data with parents and guardians on how their student is doing in school as well.
There are considerations to make when deciding where to store your information such as how secure is the information, who all ensures that the district as whole is participating in proper documentation, and who assists in organizing all of the documentation received by various employees and families? Setting up a system may require extra leg work at first, but like students, employees thrive off organization and understanding of expectations.
Here are some ideas of where to get started:
- How to track students and their files
- Tracking consent to bill Medicaid
- Tracking providers licenses and certifications
- Tracking providers trainings
- Clear providers for families and providers for billing