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10 Common Myths about School-based Medicaid for School Business Officials

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As a school business official, you’re likely always looking for ways to maximize your school’s resources and ensure that all students receive the services they need — to do more with less.
When it comes to Medicaid claiming, there are many myths and misconceptions that can hinder your efforts to do just that. Read on for 10 common myths about Medicaid claiming plus the facts you need in order to make more informed decisions.

Myth 1: You have to be an expert in Medicaid to run a Medicaid program

Fact: No, but you do need a strong partnership between Accounting, Special Education, and a reliable vendor.
One of the key components of a successful Medicaid program is trust between all parties involved. By partnering with a vendor who has expertise in Medicaid, you can have 100% visibility into your program and have access to the data and reports you need to monitor your program.

Myth 2: Districts can only bill for services like speech and occupational therapy

Fact: Many services are reimbursable, including those provided by school nurses.
It’s important to partner with a vendor who understands the nuances of each state’s rules and regulations to ensure that you are billing for all eligible services, and staying compliant in the process. This is where the partnership between business, special education, and the vendor becomes especially critical.

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Myth 3: Audit and cost reporting findings are inevitable

Fact: Although it may seem this way, there are steps you can take to prepare for your audits and cost reporting.
By working with a vendor who provides a comprehensive solution, you can gain greater control over your program and minimize the risk of negative findings.

Myth 4: Medicaid has been around forever and not much is changing

Fact: Okay, for some of you, this may seem obvious that Medicaid regulations are always changing. But for others, it may feel like once you’ve gotten the hang of things, the regulations become second nature.
Yet many states continue to explore Medicaid expansion, and the program remains flexible, allowing states to design their own programs and deliver health care services as they see fit.
By partnering with a vendor who stays up-to-date on changes and updates to the program, you can ensure that your school remains compliant and in compliance with regulations.

Myth 5: Medicaid caps mean that student care should be reserved for doctors and hospitals

Fact: Schools are now on the front lines of providing healthcare services to students in need.
By partnering with a vendor who provides comprehensive support, including a robust documentation program, you can ensure that your school is equipped to provide the best possible care for students.

Myth 6: Medicaid vendors only support interim claiming

Fact: A comprehensive vendor will provide full-service support, including a dedicated Medicaid Services Support Team and a comprehensive documentation program that enables progress monitoring and streamlines the process of documenting services.
This not only makes it easier to track services, but also helps ensure compliance and supports accurate cost reporting.

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Myth 7: Districts have to file their own state Medicaid reports (for example: SHARS in Texas)

Fact: With the right solution in place, you can validate IEP services, parental consent, and more, ensuring audit-proof compliance and minimizing the risk of negative findings.
A comprehensive solution also provides a dedicated Medicaid account manager to help you navigate the process and ensure compliance. Medicaid isn’t something you should have to do alone; your vendor should be there to help!

Myth 8: The special education department doesn’t benefit from claiming for Medicaid

Fact: There are no restrictions on how the funds generated through Medicaid reimbursement can be allocated, and the special education department can certainly benefit from the additional resources.
It’s important to work with a vendor who can help you understand the full benefits of the program and ensure that all parties are comfortable with the arrangement.

Myth 9: You should only use your Medicaid software to capture and document services for Medicaid eligible students

Fact: You should capture services for all students, regardless of their eligibility status, for compliance and to ensure that your program stays up to date with ever-changing eligibility requirements.
One of the biggest challenges schools face when it comes to Medicaid is two-fold: ensuring that they are capturing all of the services they need to while ensuring that all documentation of those services is conducted correctly.

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This can be especially tricky given the variability in eligibility from month to month. By capturing services for all students, schools can ensure that they are in compliance with all of the requirements set forth by Medicaid, while also avoiding any potential issues that may arise from audits and litigation.
A system that integrates service tracking and Medicaid billing is a great option to make sure you’re covering all your bases.

Myth 10: Medicaid is reactive in nature

Fact: Medicaid can be proactive in nature with the right collaboration.
One of the keys to maximizing your school’s Medicaid reimbursement is having a strong partnership in place with your vendor. A comprehensive, full-service vendor that provides support for Medicaid services can be your best asset when it comes to staying ahead of the game. With their expertise in the program, your vendor can provide you with the security you need in forecasting revenue, as well as expected reimbursement.
By debunking these myths and understanding the facts, you can be confident in your ability to run a successful Medicaid program for your school. By establishing a strong partnership with a vendor that provides comprehensive support, you can take a proactive approach to maximizing your school’s Medicaid reimbursement.
Frontline can help you with Medicaid audit protection, service scheduling, and so much more. See the system in action now.