Medicaid Billing

PREP Medicaid billing services collects consent forms, checks Plans of Care (POC), reviews all Medicaid billing paperwork, documents transportation, and submits monthly claims for reimbursement on behalf of each district. PREP handles direct cost reimbursement, and we take care of the cost settlement and Administrative Claiming reports (time-study) for the districts we serve.  PREP does an internal audit to maximize compliance and revenue for the participating districts as well as requesting updated caseloads from district staff every three months. We provide personal training or refreshers to staff as needed.

The Medicaid Specialist offers the following services for participating school districts:

• Reviews billing documentation for accuracy and compliance
• Maintains Medicaid billing data and systems for both direct and administrative claims
• Prepares all aspects of Medical billing, re-billing, and payments in accordance with Medicaid policies and procedures
• Tracks payments for each school division
• If a claim was denied, resubmits where possible
• Maintains tracking documentation reports for accuracy
  • Monitors district eligibility
  • Monitors district billing personnel’s caseload-I request this every 3 months
  • Reviews Plan of Care (POC’s) prior to billing
• Answers questions, provides forms, processes documentation, expedites & resolves problems
• Prepares, inputs, maintains, and reviews all student Medicaid files to process for reimbursement
• Ensures files meet requirements for annual audits or review
• Analyzes documentation in case files for accuracy, follow-up, or changes in status
• Maintains confidentially of student records and personal information
• Reconciles remittance accounts/payments
• Prepares, maintains, and reviews all students Medicaid files
• Maintains/Updates parental consent for billing public insurance forms
• Maintains/Updates participating schools weekly trip log for Medicaid transportation reimbursement
• Attends Medicaid sessions
• Performs eligibility matching update for students
• Prepares and submits cost settlement reports
• Prepares and submits quarterly time study reports
• Provide personal one on one training for staff, when needed
• Sets-up/Updates staff participant list for RMTS quarterly
• Sends out monthly participation reminders to staff on the RMTS list