5 Signs It’s Time to Switch Your Medicaid Vendor


Teacher helping student at desk

In today’s world, schools are tasked with more than just educating the youth. Schools play a huge role in the social, emotional and academic well-being of students. Connecting students to the right services at the right time is a critical and ever-challenging part of schools.

It’s never been more vital for schools to adequately support students and their families. Unfortunately, it has also never been more expensive to support them. In order for your school district to provide the best possible care for the community, you need to ensure you’re not leaving a single Medicaid dollar unclaimed. Doing so can open the door for missed revenue opportunities, administrative inefficiencies, and consequential compliance issues.

While school districts were already facing increasing pressure to better support their students and their families, the COVID-19 pandemic further complicated matters. In a survey we launched in July 2021, we found that 28% of respondents were significantly impacted by the COVID-19 pandemic, receiving half or less Medicaid reimbursement than a normal year. 

Even as COVID restrictions are being gradually lifted and a sense of normalcy is starting to return, school districts are still reeling from the uncertainty and chaos brought on by the pandemic.

In order to stay on top of your Medicaid claims and provide above-and-beyond support for your students, you need a Medicaid vendor at your side that will work with your best interests in mind.

If you find that you resonate with one or multiple of the following indicators, you should start your search for a new Medicaid provider that will elevate your ability to streamline and grow your Medicaid program.

Lack of Data Visibility

Not having direct access to your program data makes it hard to gauge how things are currently performing. Ideally, your Medicaid vendor should make it easy for your team to access insightful data and make sense of it. Visibility into your own data is key and requires multiple requests sent to your vendor (and maybe even additional fees). Your ideal Medicaid vendor will mitigate this and provide this information to your seamlessly with no extra cost.

Infrequent Communication

Being closely aligned on program progress with your Medicaid vendor is vital to ensuring Medicaid dollars are being claimed and revenue opportunities are being seized. You undoubtedly have a wide range of responsibilities on your plate, so finding the time to consistently check in with your Medicaid vendor can be tough. However, your chosen vendor should be the one providing you with updates on program progress and performance without you having to ask them for insights.

Service Providers Can’t Keep Up

Your Medicaid vendor should be able to seamlessly navigate your administration’s data system. If your provider is struggling to adapt to your vendor’s systems, services can be missed during logging, leaving the chance of claims being unsubmitted. If you find that service providers are not logging their services, or there is duplicate data entry taking place, bring both of them together to better understand their challenges. The results of studying your service provider’s logging journey will allow you to continue to advance your workflow and Medicaid outcomes.

Inability to Seamlessly Adapt & Integrate

Your chosen vendor should have the right combination of technologies and services to accommodate your team’s existing systems. The Medicaid space for school districts can be complicated, but having powerful tools to streamline processes and simplify workflows can make all the difference. If your vendor isn’t able to adapt to program changes on your end, then your program performance will likely take a hit.

You Haven’t Explored Other Options

Even if no red flags have popped up with your existing Medicaid vendor, it doesn’t hurt to survey other options and see what else is out there. Take some time to see who other school districts are calling on for their Medicaid needs and gauge whether your current vendor is living up to industry standards.

Don’t Wait to Optimize Your Medicaid Program

Finding a Medicaid vendor that not only provides game-changing tools and technologies, but also personalized support and services, is imperative to keeping your Medicaid program running smoothly. If you’re ready to begin the search for qualified Medicaid vendors that are suited to serve your needs, CompuClaim is here to help.

We provide cutting-edge Medicaid billing software technology in combination with professional support services through experienced account managers and professional Medicaid billers to over 1,100 school districts.

To learn more about making the switch to a new Medicaid vendor — and the questions you should be asking prospective vendors — check out our Vendor Switching Guide. If you have any questions for us or want to see CompuClaim in action, don’t hesitate to contact us today!