School-Based Medicaid: 3 Ways to Create a Partnered Approach Between Service Providers and Districts



Service providers are critical to the success of any school-based Medicaid program. We appreciate and understand that staff are focused on students’ progress toward their IEP goals, and often billing for Medicaid is cumbersome, confusing, and tedious. 

From the time a student is determined eligible, a journey begins in the school district that starts with prescribing a service, assigning a provider and then delivery of service that then gets documented and billed. The goal is to make this a secure, compliant, and simple task for all involved.  

As such, one of the most crucial pieces to this puzzle is service logging. There are many benefits of logging services: 

  • Provides an accurate record of information that can be used for a multitude of reasons 
  • Maintains program compliance and allows for easily accessible supporting documentation of audits 
  • Reduces the burden of claims submission by having logs completed and saved 

However, this process can be laborious for service providers. For example, some district staff still use paper logs to track their services. These paper logs then need to be translated into an electronic system by either themselves or admin. Other districts document services in one platform and then bill in another platform. Not only does this process increase time that these staff already have a limited supply of, but also is often full or errors and inaccuracies. Errors and inaccuracies lead to denied claims, loss of Medicaid revenue and overall program compliance issues. 

The Solution: A Partnered Approach to School-Based Medicaid Documentation and Billing 

If you are noticing a lag in your service logging in your Medicaid program, there are a couple of ways to help strengthen your relationship with Service Providers and create a workflow that is efficient and nurturing to your Medicaid program.  

1. Build Trust to Mitigate Fear  

If a school has never billed for Medicaid before, or is thinking about switching providers, there can be a lot of uncertainty in introducing a new workflow. Service Providers may even be worried about how this could affect their career and their license. It will be critical to make sure you are demonstrating how any 3rd party billing system is secure and compliant with your state’s Medicaid billing policies.  

Service providers will also need to know what pieces of information the program is capturing, how systems are integrated, and how personal student information is being kept secure. Data breaches and fraud are very real concerns. Their names are attached to a Medicaid claim, if they choose to practice outside of a school district, does this affect them in the future? Remember to remind your service providers that the district is responsible for checking all these boxes.  

If you want to evaluate your current Medicaid program or third-party vendor for security and compliance to build trust, ask yourself these questions:  

1) Is there a way that information is kept up to date on all state and district regulations?
2) Is the system HIPAA, FERPA, and SOC2 compliant? 
3) Who will have access to the data and is there a dedicated team to guide me through implementation and data transfer?  

Webinar: School-Based Medicaid & Student Privacy

Join us for a webinar on April 28, 2022 where we will take a non-tech-jargon approach to data security. 

Save Your Spot!

2. Reduce the Time and Effort 

In school administration, paperwork is of critical importance, but can be a major drain on the workday. Service providers are there to support students, but being inundated with paperwork is another reality to their job. Make sure staff know that you aren’t adding another step to their already busy schedules with Medicaid billing. In fact, you can be saving them time by documenting in one place.  

Often service providers are taking soft notes, tracking services on paper, or using a seperate system to log services. By switching to documentation and billing platform, the process is streamlined and more efficient. Imagine—instead of taking notes or logging in multiple systems to track times, summaries, goals, and objectives—all the information can be in input in one place by only several clicks. 

This would lessen the duplication of effort and offer more access to data, and a clearer visibility for providers, administrators, and families.  

3. Training 

Like anything else, lack of training for services providers on their role and responsibilities of participating in the Medicaid program can create a major barrier to success. Clear and concise training ensures that your providers feel confident in their role and are invested in the process.  

Your third-party Medicaid program should have training options available and be able to walk your service providers through each step to ensure they are capturing appropriate information and optimizing for efficiency and ease. This can be done at a district, school or even related service specific level. The “train the trainer” model can be assigned to department heads, coordinators or empower selected providers to learn the system and then teach it to their like-minded peers.   

Throughout the process, there should be a partnership that forms between districts, service providers, and documentation and billing platforms. This collaborative approach to school-based Medicaid mitigates fear, makes jobs easier, and increases visibility and communication.