Springland City Schools
How Springland City Schools tracks services, optimizes Medicaid reimbursements, and ensures compliance
Meet the employees of Springland City Schools, a fictional district that resembles many real districts using Frontline Medicaid & Service Management.
- Betty, a Medicaid Director who is always looking for ways to make claiming and reporting easier for everyone
- James, a Special Education Director who (among many responsibilities!) supervises providers and relies on Frontline’s Service Tracking for documentation of related services
- Augustine, a Business Official who understands that Medicaid reimbursements directly impact the district
They are part of a team that supports students with service needs, but these three individuals represent a few key perspectives on service management and the Medicaid process.
If we shine a light on the parts of their days, weeks, and months that directly relate to Medicaid, what does a year in their lives look like?
Back to School Prep
Prepping for new school year and optimizing Medicaid revenue
In the weeks and even months leading up to students returning to the classroom, our Medicaid Director Betty is already meeting with Springland’s Medicaid vendor, Frontline, to discuss ways to optimize reimbursements for the upcoming year.
- Every Frontline Medicaid Billing Management client has regularly scheduled meetings with a designated Medicaid expert, referred to as a Medicaid Client Manager, from Frontline. During these meetings, Betty can bring questions or items for discussion. The Medicaid Client Manager will also work with Betty to review denied claims to identify the cause and how they may be corrected for resubmission when applicable. They will explore various reports to identify areas of improvement in the district’s reimbursement, such as students missing parental consents. Betty’s Medicaid Client Manager will come prepared to talk through the past year’s data and highlight any areas where Betty might be able to claim for additional revenue.
- Betty realized that not all students have parental consent to bill Medicaid for services. Before using Frontline, she had to manually check each student’s form, but with Frontline she’s able to run a report that does the manual work for her.
- Betty’s Medicaid Client Manager is also aware that the beginning of the School Year is when most staff turnover occurs. So Betty is aware of the need to make changes to her staff pool rosters for the beginning of each fiscal quarter in order to get new staff into the random moment time study. That way, their fiscal costs can be included in the relevant Cost Reconciliation and/or Medicaid Administrative Claiming fiscal reports/claims.
This year, Betty noticed that although the district was claiming for some transportation costs, they had an opportunity to claim for almost double what they thought. Now, Betty will take that information and communicate with the bus drivers whose routes include children with service needs.
School-Based Medicaid 101: Enhancing Medicaid Reimbursements for Schools School-based Medicaid claiming programs enable districts to seek reimbursement through three distinct avenues: Fee-for-Service Billing, School-Based Administrative Claiming, and Cost Reconciliation. Understanding the definitions of each program and how they are related are the first steps to understanding how the cost reconciliation process can impact your district’s revenue. Read Now
Proactively maintaining compliance
Scheduling and balancing caseloads is one of the first things on Special Education Director James’ mind in the fall. Why? Not only is a balanced caseload important for James’ staff, but scheduling is also foundational to compliance. And compliance is always a top priority for James and his team.
Frontline’s Service Tracking bakes compliance into every part of service delivery so that you can worry less about ensuring providers are documenting properly.
James has kicked off the year by checking in with all of the providers that work with Springland City Schools. Before the district had Frontline, James had to manually send out information about provider caseloads, and all services were documented on paper. James spent a lot of his time tracking down missing information or correcting inconsistent information.
In Frontline’s Service Tracking software, documentation is clear and easy for providers. All required information for compliance reporting is marked as required for the provider, and with one system across all campuses, documentation is standardized and always ready for reporting and claiming.
With quarterly reporting around the corner, James knows that it’ll be easy for Betty and her team to pull the reports they need.
A Guide to Medicaid Claiming for Schools Want information about cost reporting, Medicaid reimbursements, and more? This Is For You
Everyone at Springland finds their groove in the new school year. Betty finds herself speeding through claims, and is pleased to find that reimbursements make their way back to the district within weeks. When documentation finds its way from providers to her, it’s consistently ready for claiming. Of course, this doesn’t feel out of the ordinary to Betty, but it does give her additional time to look at Medicaid data and spot opportunities for new revenue.
While vendor transparency should be the norm, that isn’t always the case. Frontline’s system offers unparalleled transparency into what happens after you submit a claim. Betty always knows what Frontline is billing to Medicaid, what has been paid and denied, and when she’s missing something holding back services from being able to be claimed such as a missing parental consent to bill Medicaid.
Betty is also focused on cost reporting. While it can be a painful process, Springland has used Frontline for a few years now and has found their rhythm.
Since Betty’s district is in Texas, Frontline helps Betty with everything from data gathering and ratio calculations to submitting the cost report and providing analysis and guidance on who and what can be included. Betty also receives an estimate of her cost settlement, and turned to Frontline for support when the district underwent an audit a few years ago.
Every state is different! Depending on your state, regulations may differ around cost reports and cost reconciliation, so it’s always a good idea to talk to your Frontline representative to get a clear undersanding of what to expect in your state. The nice thing is that Frontline has worked with districts across the country and has specialists in each state who know all of the in’s and out’s of your Medicaid regulations.
Vendor Transparency: Is it Time for a Change? Take this quiz to check how transparent your current vendor is. Take The Quiz
During spring, everyone’s sights are already set on the next year ahead.
James, Betty, and Augustine all work on different parts of the planning and budgeting process for staffing needs. Augustine works on the financial implications of staffing while James ensures the staffing plan will fulfill each student’s IEP requirements.
Year-end progress reporting is well underway, too. What used to take weeks on end to pull together is now a simple report.
Real Districts Using Frontline Medicaid & Service Management
While Springland City Schools is a fictional place, there are many real districts around the country using Frontline Medicaid & Service Management every day. Here are a few case studies to dig into if you’re more into non-fiction reads.
Chesterfield County Public Schools
Located in the Richmond metropolitan area in Virginia, this district has benefitted from a focus on universal documentation and service tracking, regardless of Medicaid eligibility, to ensure equity for all students.
“From an admin perspective, it’s just the access to everything. There’s nothing that a provider does that I can’t look up.”
– Amy Barnett, Medicaid Coordinator
Deer Park Independent School District
Over in Texas, this district eliminated redundant data entry and enhanced their Medicaid reimbursements with Frontline. If you’d like to hear from the business perspective, you’ll appreciate David Edgar’s experience.
“The benefit of entering the data from the service provider once versus twice was a big selling point for us. Special Ed touches the data one time as they’re documenting the services and then the system pick it up. It doesn’t have to be re-input into the billing system.”
– David Edgar, Assistant Superintendent for Business Services
Hampton City Schools
Hampton City Schools in Virginia switched systems they use to document services and bill for Medicaid reimbursement — then switched back again. So they’re intimately familiar with the differences between Frontline’s system and others.
“Because of the ease of using the system, it cuts down on what they have to do day to day. And I’ve heard positive feedback about how grateful they are to have a system that really is user friendly for them as a provider.”
– Zender Parker, Medicaid Specialist