Optimize Medicaid Billing

The reporting suite includes Medicaid billing dashboards and reports that provide instant access to Medicaid eligibility trends, IEP and health service documentation levels, and the status of claims submitted (pending, paid, or denied) and allows you to pivot revenue data by claim, provider type, school building, and more. Additionally, revenue exception reports help you target your efforts at obtaining additional data to drive more revenue.

Medicaid Billing Management automatically performs a complex set of validation routines to ensure only eligible services are claimed. This includes students’ Medicaid eligibility status, IEP authorizations, parental consent, provider license dates, and much more. And if you do need to pull data to defend your district in the case of an audit, you’ll find that it’s easily accessible.

Medicaid Billing Management makes documentation easy for providers while streamlining the entire claiming process for Medicaid billing coordinators. With instant access to IEP and health service documentation, revenue data, and more, Medicaid coordinators can spend less time digging for data and more time focused on maximizing claims. Extensive documentation and billing validations provide peace of mind that only eligible services are submitted for reimbursement, and should the need arise to reverse or resubmit a denied claim, the process is quick, easy, and audit-proof.

Yes. Medicaid Billing Management is part of Frontline’s Medicaid & Service Management solution, and it’s fully integrated with Frontline’s Special Programs Management and School Health Management solutions to identify and validate claimable services, so your data is complete and accurate and serves to maximize reimbursement. Integration is also available with third-party systems.

Frontline offers various training and support options. Training includes best practices for service documentation from an IDEA and Medicaid billing perspective and end-user and administrator system training. Support includes 24/7 Learning Center access, email and web-form ticket submission, and a help line.

Yes. Frontline helps you maximize cost reconciliation revenue by working with you to create a cost report that accurately reflects all state and local costs incurred in the provisioning of Medicaid-billable services.

This includes:

• Initial and ongoing quarterly participant list reviews
• Training support for finance staff responsible for tracking and reporting costs for administrative claiming and the cost report and HR staff responsible for providing participant lists each quarter
• Support in completing quarterly cost sheets
• Policy guidance and support
• Post-submission support including responding to follow-up inquiries from the state Medicaid agency or state and federal Medicaid billing audits

Frontline also runs an Administrative Claiming Random Moment Time Study using our electronic RMTS software. The system is designed to:

• Reduce the workload for district staff and participants with electronic collection and maintenance of RMTS forms.
• Maximize form completion with automatic alerts before a participant’s moment and reminders when forms have not been completed.
• Improve time study results and compliance through the automated corrections process, which ensures only valid forms are submitted.
• Save money by reducing the time and costs incurred in printing, shipping, and collecting sample forms.

With a system built to automate every aspect of school-based Medicaid billing, you can be confident that you are submitting audit-proof claims. Plus you’ll gain data-based insights that will identify revenue opportunities to make the most of district funding sources. And using our Service Tracking solution, you’ll see your district increasing overall service delivery and documentation to impact Medicaid potential.