MEDICAID REIMBURSEMENT

Learn how Leader Services assists school districts nationwide to recover funds from Medicaid for providing federally-mandated health-related services to children.

STREAMLINE YOUR PROCESS

Leader develops custom software and provides extensive training materials, plus annual and as-needed training opportunities, as part of the Medicaid Billing process. Accumulated encounter information provided by schools is processed, and submitted for Direct Services reimbursement.

Direct Services Billing

  • Eligibility verification assistance
  • Pre-printed claim forms and digital logs
  • Claim information collection & custom software data entry
  • Electronic claims submission to federal agencies
  • Management reports for schools and LEAs
  • QA reviews, and more...

EXPLORE OUR WORK WITH STATES

PENNSYLVANIA

SBAP-Align

The School-Based ACCESS Program (SBAP) allows Pennsylvania LEAs to receive federal Medicaid reimbursement for providing health-related services to Medical Assistance-eligible children as part of their Individualized Education Program (IEP). SBAP is a cooperative effort between the Pennsylvania Department of Education (PDE), the Pennsylvania Department of Public Welfare (DPW), the federal Centers for Medicare and Medicaid Services (CMS), and PDE’s contractor. Leader Services provides SBAP-Align, a service that captures, validates, and submits data to PDE’s contractor. We offer a number of professional support resources, including web-based data capture/reporting, and more.

Leader and SBAPAlign make my job so much easier. Their website is so user friendly, and this keeps our support staff very happy! They have been open and responsive to suggestions about site improvements throughout the years, and they always come through. Leader’s customer support is second to none! I honestly don’t know that I would be able to do my job efficiently or effectively without Leader Services! -Dorothy Ague, Access Coordinator, Lebanon School District

WASHINGTON

WAMR

The Special Education Medicaid Reimbursement Program is a public/private partnership with the goal of acquiring new funds for school districts. The program provides a process by which to gain Medicaid reimbursements for the cost of providing health-related services to special education students, as part of their Individualized Education Program (IEP) or Individualized Family Service Plan (IFSP). The current reimbursement program resulted from changes in federal law and responses by the Washington state legislature.

Leader Services provides billing agent services to Washington State schools. To participate in the program, school districts must have a current Billing & Collection Services Agreement with Leader Services, as well as all forms currently required by the HCA in advance.

Leader Services has been instrumental in helping to keep our Medicaid records current and processed. They are professional, helpful, and provide instruction/updates in a timely manner. I would highly recommend using Leader Services as a billing provider. -Becky Phillips, Special Programs Secretary, Mount Baker School District
IN 2019

69

SCHOOLS

176,617

RECORDS PROCESSED

$4,029,920.00

FUNDS RECLAIMED

CALIFORNIA

CA STaR & Medi-Cal Administrative Activities

In California, Leader Services works with education agencies across the state to facilitate reimbursement from Medi-Cal through two programs: LEA Billing Option (LEA BOP) & Random Moment Time Survey (RMTS).

The LEA BOP offers reimbursement for schools that provide certain medically-necessary health-related services to students eligible for Medi-Cal. Leader facilitates the process through staff training, online data capture via our Service Tracking and Reporting (STaR™) application, claim submission, reconciliation, reporting, and more. Learn more about STaR.

Leader works with the School-Based Medi-Cal Administrative Activities (SMAA) Coordinator to review staff roles & daily activities for proper placement in RMTS cost pools, and ensure LBO Provider inclusion on the Time Survey Participant (TSP) to verify sources and confirm staff is not 100% federally or Indirect Cost Rate (ICR) funded. We review RMTS coding reports for accuracy and provide verification for the Orange County LEC. In addition, we work with the business office for collection of fiscal data, prepare SMAA invoice + supporting documentation, and review with key staff prior to submission. Ongoing audit files are created and support is provided during audits. Learn more about the MAA program.

After two years of paperwork combined with the state of CA and lots of perseverance, inventive thinking, and a "never give up" attitude, Leader Services got us approved for Medi-Cal billing. The approval process was not straightforward, but Leader kept doing all the work for us. The ongoing training and speedy answers to questions makes working with them pleasurable. I highly recommend Leader Services as a great school district intermediary to the state. -Dr. Jerry L. Turner, Licensed Educational Psychologist
The team at Leader Services has been incredibly responsive and supportive to our LEA program. They have provided informative annual training to all employee groups. Our account team is incredibly knowledgeable and always available to answer any questions. The support we have received with our annual report has been invaluable. We recently had a staffing change, just as everything was due. Leader was available to walk our new employee through each step in a way that supported her growth and understanding. Prior to engaging in our relationship with Leader Services, our district had a revolving door of vendors. We have been incredibly pleased with the outcomes of our work with Leader Services. -Terri Lynne Ricetti, Executive Director- Special Education Services, Napa Valley Unified School District
Leader Services has been providing consulting services to Lakeside Union School District special programs since 2007. The programs they provide services for are very complex with strict guidelines and reporting requirements. Without the expert knowledge that Leader Services has and the attention to detail they provide, successful program participation would not be possible. I highly recommend Leader Services to anyone looking for a company that provides dependability, quality work and excellent customer service. -Amey Brown, SMAA Coordinator, Lakeside Union School District
I have been working with LEADER for about 2 1/2 years. Their staff are top notch professionals who are knowledgeable, skilled, and easy to work with, they will have you trained and billing in no time. They stay up on the current practices, rules, and regulations and will make sure you have that information and provide excellent training for your staff. Miguel and Patti are the absolute best to work with! -Wendi Beatty, Program Technician, Sacramento County Office of Education/SELPA
IN 2019

53

SCHOOLS

898,079

RECORDS PROCESSED

$7,446,061.00

FUNDS RECLAIMED

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