With schools focused on working around COVID-19 and trying to implement telehealth services, their billing may have fallen to the wayside—especially as regulations continue to change and evolve. Reimbursement through Medicaid can be especially complicated if the right steps are not implemented, and all it takes are a few incorrect codes to cause a denied claim. To give some relief and ensure school revenue does not suffer, districts should consider the benefits of outsourcing.

With the right outsource company, the school district should be able to save money easily through improved revenue cycle management and the benefit of paying only a percentage of actual billing revenue generated. Instead of a salaried staff member taking care of billing, often lacking the proper billing education, the schools billing can be secure in the hands of experts. However, it’s not enough to simply working with a medical billing company—the outsource company must have definitive knowledge of school-based medical billing. Any billing company you contract with should include services such as:

Direct Service Claiming (DSC)

  • Student and Provider Eligibility
  • Provider Service Documentation
  • Quarterly (Interim) Billing
  • Direct Service Cost Reporting
  • Training (webinar or in-person)
  • Data Analysis

Administrative Activity Claiming (AAC)

  • Administrative Cost Reporting
  • Medicaid Eligibility Enrollment Reports
  • Random Moment Time Study (RMTS) Monitoring
  • RMTS Quarterly Updates and Licensing Verification
  • Training (webinar or in-person)
  • Data Analysis

Along with knowing the specifics of medical school billing, which will involve Medicaid knowledge, they should also be good with communication and training of providers. State mandated changes and billing issues will arise necessitating a dedicated contact at the billing company to ensure that the billing goes smoothly.

We are proud to be industry leaders of school-based Medicaid claiming and billing, and we help save our clients 15% overall. Give the billing experts at Outsourced Receivables Inc. a call to resolve your issues and improve revenue.


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