CAM Achievement will review, support and assist your school system or company with collecting and acquiring additional dollars from the Medicaid billing process. CAM Achievement can also assist in providing your district or company with the updated procedures and guidelines that foster support for your SPED and Student Services staff that relate to the billing process.
CAM Achievement will conduct a thorough analysis of all Medicaid procedures used by the district to maximize reimbursement for Medicaid.
SPED Reviews and Assessments
CAM Achievement will review your SPED department for strengths and concerns within your SPED delivered services. Cam Achievement will develop workable and usable recommendations to make IDEA supportive for students, teachers, parents and administrators.
CAM Achievement will review and analyze components including, but not limited to the following:
- Review Fee for Service and Administration claim
- Review job codes and staff codes to ensure all support Medicaid billing
- Review the data system being used to support billing for IDEA and Medicaid
- Analysis of forms being used and how they are linked to the Medicaid billing system
- Review of all the billable services for the district and ensure 100% optimization
- Review required documentation for Medicaid reimbursement: data logs, care plans, service logs, and service minutes.
- Review Medicaid procedures and policies to assure they are linked to school board policies
- Review current in house audit procedures for Medicaid
- Compare the data of staff to the funds received to the number of Medicaid eligible students in the district
- Review of staff funded IDEA vs. general funds and what effect the funding system has on Medicaid billing
- Review and recommend training and professional development of staff (how, when, who)
- Review staff/district concerns and barriers to Medicaid billing in the school system
- Determination of ways for Medicaid to have expansion of services in the district
- Review the 15 most common billing errors that cost school system over 50% of Medicaid reimbursement funds: wrong codes, student or number wrong, no date of service, lack of length of service, frequency and duration of service, individual or group, description of services, signature of provider, credentials of provider, lack of progress to goals, prescription if required for medicine, plan of treatment, diagnostic or ICD code, medication Dosage and Special Equipment
School Transportation and Medicaid Reimbursement Review
Transportation of special needs students can be one of the most costly transportation expenses that a school district incurs. General speaking, school districts are entitled to Medicaid reimbursement if:
- The pupil is Medicaid eligible
- The pupil has an IEP that includes a requirement for specialized transportation services
- The school district is responsible for transporting the pupil either with its own fleet or through a third-party transportation provider
- The pupil receives services included in the IEP at the school on the day the reimbursement is requested
- The school district maintains a verifiable record of the pupil's transportation to and from school for each day