Medicaid Claiming

The Center for Health Care Financing is a recognized, full-service vendor of Medicaid school-based claiming services. Its capacity in this arena is exemplified by the broad scope of activities in which it has been engaged in the more than 10 years since it first began working with school-based claiming programs. The Center’s services in this area include the following:

• Providing a full range of billing support services to school districts for service and administrative claiming initiatives
• Developing training materials used by in school-based claiming programs in multiple states
• Offering the use of a customized web-based system that simplifies the claiming process
• Recommending procedures that reduce the administrative burden on school district staffs

The center’s goal in these tasks is helping clients maximize Medicaid revenue. Its success has required a comprehensive understanding of all applicable rules and regulations governing school-based claiming programs.

Results

In Hawaii: The Department of Education has realized more than $2 million in federal revenue since the Center implemented a school-based service-claiming program in the state.

In Virginia: The Center has processed administrative claims on behalf of all participating school districts, realizing nearly $93 million in federal revenue.

In Massachusetts: As the statewide manager for the Massachusetts Medicaid school-based claiming program, the Center has facilitated the return of well over $100 million annually in federal funds to municipal coffers.