aria school billing

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

803-315-0504scott.dale@cgm.com

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