The vendor is required to provide for Medicaid and student and health related billing services.
- Requirements
• Agency currently files claim for Medicaid reimbursement of services.
• Agency currently is utilizing the services from frontline special education & interventions v3 to provide a platform for billing.
• The district obtains and submits paper logs of personal care services on sped buses for billing.
• Agency currently receives 88% parental consent to bill Medicaid for IEP (individualized education program) students.
• Approximately 2,000 service providers will be billed
• The district currently utilizes frontline special education & interventions v3, eschool plus, smart tag and agency toolkit, the respondent will need to interface with these programs.
• Agency currently documents their services via electronic and paper, the goal is to eliminate all paper logs.
• Agency received the revenue listed below for the last five (5) years from the SHARS billing program (interim, mac and cost report).
• *these totals do not include pending cost report formal reviews:
o 2023: $4,393,535.08 *
o 2022: $3,874,681.79 *
o 2021: $12,972,101.52
o 2020: $7,444,076.04
o 2019: $7,839,679.49
• The district would prefer assistance and monitoring with audits.
• The district’s goal is for the distric software to integrate with the vendor’s billing system to eliminate the administrative burden for providers’ billing.
• Agency currently seeks reimbursements from the state Medicaid program for the below services.
o COTA - certified occupational therapist assistant
o OT - occupational therapist
o SLP - speech language pathologist
o SLPA - speech language pathologist assistant
o SLP intern - speech language pathologist intern
o PT - physical therapist
o DIAG - diagnostician - MAC (Medicaid administrative claiming) only
o LVN - licensed vocational nurse
o RN - registered nurse
o PCSP - personal care service provider
o LLSP - licensed specialist in school psychology
o ARD facilitator - admission review dismissal facilitator - MAC (Medicaid administrative claiming) only
o DNSP-delegated nursing services provider
o BC-behavioral counselor - MAC (Medicaid administrative claiming) only
o pep-pregnancy education and parenting program - MAC (Medicaid administrative claiming) only
o LSSP intern-licensed specialist in school psychology intern - mac (Medicaid administrative claiming) only
o LMSW-licensed masters of social work - mac (Medicaid administrative claiming) only
- Cover letter
• Company background and staffing
• Organization structure/chart
• Project-specific personnel
• Quality assurance/quality control program
• Company’s pricing structure
• Customer service hours
• System functionalities
• A detailed outline of the services your company will provide, including all associated reports.
• District responsibility in the billing process - Software
• Any and all software platforms currently in use are subject to change.
• Respondents are expected to remain flexible and prepared to adapt to new systems as organizational needs evolve.
• Provide either access to a live and in person sandbox environment, and alternatively, a comprehensive video walkthrough demonstrating the system’s functionality, as determined by our team during the evaluation process.
- Contract Period/Term: 3 years
- Questions/Inquires Deadline: May 23, 2025