Medicaid and Student Health Related Billing Services

The Vendor is required to provide for school health and related services (SHARS) medicaid claims processing services and related medicaid consultation and billing services.
- Provide a competent representative to provide direct, on-site counsel to the District staff.
- Services include:
•    Provide administrative, training, consulting, statistical, and audit services as required by the district;
•    Ensure compliance with all applicable local, state, and federal regulations;
•    Ensure accurate and timely administration;
•    Maximize reimbursements received by the district; 
•    Continually explore ways to maximize reimbursements for the districts;
•    Decrease the amount of direct oversight required by district staff;
•    Be completely knowledgeable regarding all state and federal medicaid information, liaisons, and updates; timely and accurate interpretation and application of rules and regulations regarding medicaid reimbursement to schools is expected;
•    Provide training and instruction for school district administrators and case managers as needed by the district; 
•    Provide accurate, dependable, and confidential billing; claims will be processed using the transaction logs generated by the district;
•    Provide for tracking and reconciliation of all submitted claims;
•    Provide regular reports showing the status of all medicaid transactions, reimbursements and cataloguing of transaction logs;
•    Provide special reports as needed by the district;
•    Provide complete resolution of all submitted claims;
•    Advise the district as needed in contract negotiations with non-employees regarding contract sections related to payment terms and proper documentation for billing purposes;
•    Provide in audit preparation and facilitation to ensure proper procedure a rigorous compliance;
•    Interface with state medicaid agencies and state education agencies regarding audit findings, as needed;
•    Provide certification of funds for interim payments; 
•    Provide interface with district’s current special education management software through application programming interface (API), data export, or other similar programming means; and
•    In the event of an audit/review by a state or federal agency, the contractor will fully support the district in preparing necessary documentation, responses, etc.

- Contract Period/Term: 3 years
- Questions/Inquires Deadline: October 31, 2025