Medicaid Services and Support
Full Service Delivery . . .
The services waypoynt™ provides are not limited to claims processing, but also include the provision of materials and forms (paper and electronic) for the collection of data, extensive training to district personnel on all levels of administration and staff, regular meetings and communication with key district personnel to prevent problems and inform of practitioner participation, monitoring and researching of student eligibility, audit preparation and representation, and provision of summary reports at intervals throughout each year to inform our districts of progress and expected results.
Individualized Response to Needs . . .
Our service to a district begins with an evaluation of the current provision of qualifying services and the special education population being serviced. Comparing the resulting data with details of past Medicaid revenue, we strive to determine in what areas the district is not realizing their Medicaid revenue potential, and then implement a targeted plan of action to address and ameliorate those weaker areas, while maintaining or improving the current level of revenue in other areas. Paramount in this process, however, is to ensure that while revenue potential is being maximized, audit exposure is minimized through a focus on regulatory compliance through all stages of the process.
On-Site Training. . .
In an effort to maximize compliancy on all levels, we provide on-site targeted training for all school personnel involved in the Medicaid claims process. Our training content and approach is based on current feedback we receive through regular communication with the respective State Agencies, and is focused on practical implementation of federal and state guidelines, specific to each district, classroom or program situation that we encounter. Our goal is to educate school personnel in both the “how” and the “why” in order to accomplish an effective understanding of how the regulations apply to every practitioner in his or her particular circumstances. Each of our client districts is also assigned an account representative who becomes a dedicated resource through which districts are afforded an ample and timely supply of answers, materials, and guidance.
Monitoring Compliance. . .
Incorporated into the training process is the distribution of documentation materials to our client districts, including templates, forms, transaction logs (paper and electronic) and detailed instructions for providing records of service provision. Informational packets are available to all participating practitioners, case managers, and school administrative staff. All forms and logs provided by waypoynt™ are compliant for school-based Medicaid claims documentation. Given that the basis for submission of school-based Medicaid claims rests in the documented order for services in each student’s IEP, waypoynt™ works closely with schools to assure that services being recorded for a student are supported through specific language in that student’s IEP. waypoynt™ also provides consultation and compliant forms specific to additional required documentation pertaining to orders or referrals for certain services.
Preparation of documentation and pre-audit screening is just the beginning. Our waypoynt™ staff legal counsel is available to work with districts through every stage of an audit to ensure that there are no surprises. After audit findings are presented to districts, we review them and recommend ways to reduce audit exposure in the future. waypoynt™ also prepares responses to audit findings, citing regulatory support or providing further documentation.
Quality Control . . .
All claims that are processed and submitted by waypoynt™ on behalf of school districts are checked for regulatory compliancy through each stage of the process. Our staff examines records before they are processed to make sure that all requisite components are present and that units of service are recorded correctly. Electronic submission of units of service (X-Logs™) is also subject to frequent quality control analysis. Any incomplete or incorrect service records are tracked in our software and sent back to practitioners with a request for records to be corrected and returned to us for processing. Compliant records are stored in the database to be processed for claims creation.
Built into the software is a system of safeguards and checks that help ensure the accuracy of the claims that will be submitted for reimbursement. Our software overlays school calendars and student attendance against all records of service to prevent billing of claims that may have been erroneously recorded by a practitioner when a student was absent or school was not in session. We also employ automatic security measures to prevent over-billing due to recording or entry error. Any claims that show up as abnormal are checked for accuracy and, if correct, are verified with the school district as supported in the IEP of the student.
Proprietary Software . . .
waypoynt™ uses its own proprietary software to process and submit Medicaid claims. Both our database and our claims processing software continually undergo evaluation for improvement and revision that may provide greater efficiency, accuracy and ease of use; and upgrades are implemented regularly toward this end.
Contact waypoynt™ today and start enjoying the benefits of partnering with the Medicaid administration solution that provides you the support to ensure success.
