aria school billing
TRANSCRIPT
ARIA SCHOOL BILLING:MEDICAID BILLING FOR FLORIDA SCHOOLS
PRESENTER: Scott Dale
SCHOOLS &
FLORIDA MEDICAID
01
SCHOOLS & FLORIDA MEDICAID
Florida Medicaid Match started in
the 1990's
In 2017 charter schools became
eligible to participate
Schools receive a portion of the
federal fee schedule
Procedure rates change annually
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NEW CLIENTS: OFFERED SERVICES
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SoftwareMaintenance & Hosting
Software Support Secure FTPSubscription Enrollment EDI, ERA and EFT
System Setup –Tables & Integrations
Training, and Portal Access
EDI Claims, ERA and Electronic Eligibility
Charge Entry:(Verify Documentationmatches Encounter Billed)Certified Coder, Preventativeclaim edits, Billing/Coding Rules
Claim Creation & Processing - Daily
Payment Posting – Daily
Aggressively Work Unpaid Balances: Insurance: Rejections, Denials & Appeals at All Levels
Reporting Clear Visibility to A/R
02ROLES &
RESPONSIBILITIES
YOUR SCHOOL IS ALREADY:
Patient Registration / Demographic Update /
Eligibility Verification
Document Encounter
Authorization Management
Provider captures CPT & Diagnosis
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OUR RCM TEAM WILL HANDLE:
Charge Entry:Certified Coder – verify documentation supports/matches encounter billed who communicates with practice on missing itemsthat require provider/practice review
Claim Creation/Processing
Eligibility Verification:RCM double checks this on your behalf
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Payment Posting:Fee Schedules
Balancing:Missing Charges, or Payments
Insurance A/R:Denial & Rejection Management, Appeals at all levels
Statistical Reporting
03CURRENT
CMS GUIDELINES
CURRENT CMS GUIDELINES
Must be eligible on date of service.
Have Medicaid services listed in IEP
Qualified healthcare professionals are required.
Be entitled to services under IDEA
Under the age of 21
Each school must be enrolled to participate
Staff training must be conducted
Participate in time studies using samples or time logs (Quarterly)
Cost determination and allocations must be performed
Submit a quarterly Medicaid Administrative Claim
Comply with AHCA and CMS monitoring and audits
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04CGM MediEd:EHR for Schools
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CGM MediEd is a completely secure, cloud-based clinical documentation application that supports schools in collecting Medicaid reimbursement for Occupational, Speech and Physical Therapies, Nursing and Behavioral Health services provided in the school setting, following the student’s Individualized Education Program (IEP).
The ARIA School Billing team of documentation, billing, and revenue cycle experts will help your school to secure all available Medicaid reimbursements for services provided.
CGM MediEd makes tracking and reporting on student goal
progress simpler than ever. See how effective a student's plan is, coordinate strategies with staff,
and keep parents informed.
Seamlessly keep track and report on staff activity as they perform student IEP, IFSP, or
504 Plan services. Easily record activities within CGM MediEd.
Link your school's SIS, or school administration software, with
CGM MediEd to ensure integration and comprehensive data reports. Turn that data into
useful information.
Individualized Educational Plans (IEPs)
Progress Tracking
Student Information Systems (SIS) Integration
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Easy Oversight
Staying compliant with IDEA is easier when you use CGM
MediEd to track your students IEP services, saving your school
time and headaches.
CGM MediEd: MAIN FUNCTIONALITIES
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QUESTIONS?Please reach out if you have any questions orwould like additional information.
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Scott DaleFlorida Sales Consultant
Irvine530 Technology Drive
Suite 100Irvine, CA 92618
Headquarters – Phoenix3838 North Central AvenueSuite 1600Phoenix, Arizona 85012
Owings Mills10065 Red Run BoulevardSuite 150Owings Mills, MD 21117
CompuGroupMedical
US
Columbia246 Stoneridge Drive
Suite 300Columbia SC 29210