Electronic Health Record and Billing System

The Vendor is required to provide comprehensive electronic health record (EHR) and medicaid billing system for schools that fully integrates with infinite campus (IC), the student information system (SIS) used by agencies.
- The system must eliminate inefficiencies, allow for documentation of all types of health services provided in the school setting, automate medicaid interactions, and ensure that health staff can successfully participate in medicaid reimbursement programs.  
- Statewide, cloud-based interoperable and comprehensive EHR and Medicaid billing system:
• Automates medicaid billing, reducing claim errors and tracking payment status.
• Eliminates redundant data entry by fully integrating with infinite campus.
• Validates claims across multiple eligibility and compliance criteria.
• Provides structured compliance tools to support accurate documentation and audit readiness.
• Supports bi-directional data exchange for optional care coordination.
• Integrates with state WebIZ for real-time immunization record access.
• Ensures compliance with medicaid coding and billing standards, including acts.
• The system shall allow agencies to access their own data directly, enabling them to analyze data by district and print records or reports when requested.
• Ensures that appropriate controls and protections are in place to protect all sensitive data and access is limited to authorized personnel.
- Medicaid billing and claims management
• Medicaid claims are often denied due to missing documentation, parental consent issues, or incorrect service coding. 
• Automating these compliance steps ensures timely and successful reimbursement.
- Validate claims across multiple compliance checkpoints, including:
• Active IEP/health services plan within allowable dates.
• Tracking of parental consent to treat (annual or in the event of changes in plan of care).
• Tracking of parental approval for release of information to medicaid for billing (one time).
• Verification of provider credentials and service scope to ensure rendering provider is working within current scope of practice and licensure/certification; agencies shall continue to be listed as both furnishing and billing provider on billing claim form.
• Enable batch processing and bulk claim submission to maximize efficiency.
• Ensure all medicaid-covered services are documented in an audit-ready format.
• Allow for real-time claims tracking features, including status monitoring and proactive resolution mechanisms.
• Enable integration with the medicaid management information system (MMIS) for seamless data exchange and reporting (DDI phase).
- Medicaid documentation and compliance tools
• Provide pre-configured templates for medicaid-covered services to standardize documentation.
• Automate tracking of parental consent to treat and alert staff when re-consent is required.
• Automate tracking of parental approval for release of information to medicaid for billing.
• Support documentation and compliance tracking for 504 plans, health service plans, and other non-IEP services.
• Include audit-ready documentation features to ensure compliance with medicaid and ferpa (family educational rights and privacy act) regulations.
- Encounter chart templates for efficiency & knowledge sharing
• Allow agencies to create, customize, and share structured encounter chart templates.
• Enable real-time collaboration on service notes across providers and teams.
• Pre-populate key data fields to reduce repetitive entry and improve workflow efficiency.
- Contract Period/Term: 4 years
- Questions/Inquires Deadline: July 14, 2025