School Health and Related Services and Medicaid Reimbursement Services

The Vendor is required to provide school health and related services (SHARS) and medicaid reimbursement services on an as-needed basis under a multi-year contractual agreement.
- Provide SHARS/Medicaid Reimbursement Services as required by commission in the most efficient and cost-effective manner;
- Provide a user-friendly claims submission system that meets partnership requirements;
- Be present and able to assist district staff in the district-wide implementation and training with minimal impact on regular operations;
- Provide timely and dedicated ongoing support for the Provider’s claims submission system;
- Provide commission program support, as needed, for cost report reporting and commission program audits.
- Must have the capacity to accept /process both electronic (preferred method) and paper service tickets for filing claims.
- Must provide relevant training to district personnel as needed to ensure legal compliance and efficient claim processing;
- Must be able to provide billing data reports in a standard Microsoft Excel, “comma separated-values” (CSV) format, or any other information systems standard acceptable to the District to be able to reconcile for each billed session to include—but not limited to—the following fields:
• Student ID
• Student SSN
• Student Medicaid Number
• Medicaid Eligibility as of Date of Service
• Beginning Date of Service
• Ending Date of Service
• Date Claim Submitted
• Date Claim was paid
• RNS Report Reference
• Service Provider ID
• Service Provider Name
• Transaction ID
• Claim Amount
• Reimbursed Amount
• Type of Service
• Amount
• Billing Code.
- Contract Period/Term: 1 year