Medicaid Billing Services

The Vendor is required to provide medicaid billing includes speech/language therapy, occupational therapy, physical therapy, nursing services, behavioral health services, audiology services, and transportation services.
- Medicaid reimbursement billing services:
•    Secure interface through secure file transfer protocol (ftp) site for purpose of merging and integrating with Schools student information system (including special education application), synergy. 
•    Must be HIPPA AND FERPA compliant.
•    Provide initial onsite training for the implementation of the new platform. 
•    Training shall be delivered to approximately 400 personnel, including but not limited to administrators and end users such as occupational therapists (OT), physical therapists (PT), speech pathologists (SP), nurses, psychologists, social workers, and other relevant staff. In addition to outlining the training approach, schedule, and materials, contractor shall also describe the customer support structure to be maintained throughout the duration of the contract, including response times, support channels, and escalation procedures.
•    Medicaid claim filing to include reworking of denied claims.
•    Provide robust online tracking tools and reporting functionalities. 
•    These tools must support flexible customization and filtering capabilities, including but not limited to filtering by provider type, service type, and other relevant categories. 
•    Reports must be capable of identifying and displaying data such as past due items, missing signatures, absence of an active plan of care (POC), and mismatches in POC type. 
•    Contractor shall include sample reports currently available as part of the proposal response and indicate the availability of additional custom reporting options.
•    Web-based documentation and claims software with scheduling and case-load management features.
•    Quality control through documentation review.
•    Help-desk services
•    System should be integrated with active directory and/or active directory federation services for authentication and authorization
•    Records are the property of city public schools, so please specify in your proposal response how your company will make this information available to the school system after the end of the contract term.
•    System proposed must have plan of care documents and not rely on IEP.
•    System must meet all department agency requirements- include in response how vendor will ensure compliance, anticipate needed changes and describe any costs to be incurred by the division
•    Schools prefers a flat fee structure for medicaid billing services.
- Web-Based Services
•    Provide a web-based billing system that is customized and compliant with school-based
•    Medicaid program.
•    Provide a web-based system with sophisticated and/or custom reports on a variety of data points by provider, supervisor, school location, billing status, and services.
•    Provide medicaid processing services under the terms and conditions specified in the contract.
•    Provide online storage of all electronic data and retrieval of such held in accordance with student record and medical record provisions by the commonwealth.
•    Provide medicaid consultation services which shall consist of technical assistance on medicaid school- based services policy and procedures.
•    Technical assistance and training to include on-going electronic training and telephone assistance.
•    Review of all denied claims received from the state and determine the need for corrective action and resubmission.
•    Regularly scheduled team meetings with project manager. Monthly meetings at the minimum with the option for more frequent meetings during transition.

- Contract Period/Term: 1 year
- Conference Date: November 14, 2025
- Questions/Inquires Deadline: November 25, 2025