School-Based Claiming

School districts can receive Medicaid reimbursement for health-related services provided to special education students, but they don't often have the internal resources needed to claim those reimbursements. We developed an online application that allows Medicaid providers to complete time studies, document the delivery of health-related services, and submit claims electronically. Our web-enabled school-based claiming application currently supports over 2,500 school districts in 9 states, as well as various state and local agencies.

Since implementing our school-based claiming system in 1996, we have helped local governments in multiple states secure more than $1 billion in federal reimbursement. Our services include:

  • Random moment time studies (RMTS): We were one of the first organizations to provide RMTS to school districts. We now serve over 15 RMTS entities throughout six states, totaling 1,227 clients.
  • Medicaid eligibility matching: Our web-based system compares student rosters with Medicaid enrollment records, validating matches and providing accurate, secure results.
  • Direct service claiming: We enable school districts to obtain reimbursement for allowable direct health care services provided to students.
  • Cost report reconciliation: Using time study data as required by CMS, we enable school districts to obtain reimbursement for allowable direct health care services provided to students through a certified cost report.
  • Administrative claiming: Using required time study data, we enable school districts to obtain reimbursement for allowable Medicaid-related administrative services provided to students and their families.
  • Training: We provide in-person and online training to your staff so that they can easily complete the requirements for reimbursement.

Capabilities include:

  • Easily customizable system to support an individual district/agency’s needs
  • Online reporting to ensure greater accuracy, speeds up reporting times, and eliminates the need for paper records
  • Detailed data access and ad hoc reporting capabilities for quick and accurate responses to audits and requests for information
  • Claiming for Medicaid-related services under a variety of rate methodologies
  • Supporting administrative claims under virtually all methodologies, and complying with all applicable federal security and privacy guidelines