Services

 

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 services, orientation and mobility services, as well as psychiatric and psychological services.

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, and collects claim information and enters it into Leader's custom claim software. Leader also submits claims electronically to federal agencies, provides management reports to schools and LEAs, and performs quality assurance reviews as well as a multitude of other tasks.

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 members generally complete a time study. Leader will assist and guide the district through the Random Moment Time Survey model. We collect the information necessary to create the invoice. We also maintain the district audit binder and provide consulting services regarding program policy questions and audit support.

Learn more

To learn more about signing up for Leader's Medicaid reimbursement services in your state, please contact us today.