All too often we hear how districts struggle with Medicaid claiming in their States. Don't let the many facets and layers of Medicaid claiming get you tangled up in a web. Read on as our guest blogger Mike Bodensteiner from Greenbush Southeast Kansas Education Service Center shares his insight and experiences with our readers:

"I was watching paint dry the other day and started to think about Medicaid.  A couple of random thoughts came to mind.  The first involved recent posts from other states regarding the significant decreases in the level of claims being paid.  The posts reminded me of the relatively small role school districts play in the Medicaid world when compared to hospitals and medical services.  The need for strong partnerships with these institutions are absolutely critical, as well as the need to identify common needs relative to shared services.  Change in Medicaid can be extremely slow, and identifying ways to positively impact the entire system is quite a challenge". 

Greenbush staff has created the enclosed flow chart to help administrators and other school staff understand the claiming process.  While specific elements might vary from state to state, the chart illustrates the complexity of the system and the number of conditions that must be met for a claim to be paid.   You can readily view the steps leading to a successful claim and the challenges faced by school districts".  

"The claims you don't receive can be as important as those paid also came to mind.  At times Greenbush and its customers focus way too much time on claims paid, not trying to fully understand why claims are not paid and what can be done to improve.  Now, determining why a claim has been denied is not always easy.  There are any number of reasons prompting a claim denial". 

"Interestingly enough, seemingly straight forward requirements such as parent consent forms can represent some of the biggest difficulty for schools.  This reinforces the need for a systematic and routine approach to each step of the Medicaid process".

"Once a school district categorizes and understands denial factors this will provide the information needed to make a good process even more effective and will show maximization of your reimbursement revenue".

Let us show you how to oversee a successful Medicaid program.