Leader Services assists school districts nationwide in recovering
funds from Medicaid for providing federally-mandated health-related
services to children.
Schools, intermediate units, charter schools, and approved private
schools are generally able to receive reimbursement from Medicaid
for providing services to Medicaid-eligible students, and for administrative
tasks related to providing those services. The two programs that
are available are:
Direct Services Billing
This involves billing Medicaid for direct medical services provided to children. The list of eligible
services varies by state but generally includes speech therapy, physical
therapy, nursing, personal care assistance, physician services, audiology
, interpreter, orientation and mobility, psychiatric, and psychological services,
among others.
Schools provide encounter information, which Leader accumulates,
processes, and submits for reimbursement. As part of this process,
Leader develops extensive training materials and programs, provides
annual and as-needed
training opportunities,
assists in eligibility verification, provides pre-printed
claim forms and digital logs, collects claim information and
enters it
into Leader's custom claim software, submits claims electronically
to federal agencies, provides management reports to schools
and LEAs, performs quality assurance reviews, and a multitude
of other
tasks. More>>>
Administrative Claiming
Outreach activities are defined as staff functions related to
the administration of the federally mandated children’s
health program in your state. The activities
that are reimbursable focus on locating, identifying, and referring “at-risk” children
to appropriate medical providers for care.
These activities generally include:
- Public awareness and information
- Facilitating access to programs
- Identification and referral
- Care planning and coordination
- Client assistance to access services
- Family notification
To receive reimbursement, school district staff generally
complete a Time Study process. Leader captures the time study
results and processes the data against cost information
provided by the school to file a quarterly claim. More>>>
