To get the best results for every student, your district needs to maximize its financial resources and reimbursement. PCG can help—whether it’s claiming data for compliance, processing claims data for reimbursement, assisting with audits or advising on program and policy decisions.
School-Based Medicaid Services
School-based Medicaid programs are a critical way to ensure that children get the health and educational services they need. PCG can ease the administrative burden and help ensure that your school-based Medicaid programs are efficient and compliant, so you can recover the maximum amount of allowable revenue.
PCG is the nation’s largest provider of school-based Medicaid services, providing Medicaid revenue recovery services to more than 4,000 U.S. public school districts. Since 1992, we’ve helped our clients recover more than $5.1 billion in federal Medicaid reimbursements, helping pave the way for countless students to succeed. Our services include:
Medicaid Fee for Service Billing and Medicaid Administrative Claiming (MAC)
PCG can administer your Medicaid Fee for Service billing and (MAC) programs both statewide and at the participating school district level. We implement the technology while providing expertise to make the process easier and more efficient for your staff. The goal: to increase compliance while ensuring you get the maximum allowable reimbursement.
PCG can assist with all aspects of the Medicaid billing process, from tools for capturing the required documentation of delivered services through the submission and processing of Medicaid claims. We can either work with service data you provide us via your existing systems, or we can implement our proprietary EasyTrac™ software—a Web-based tool for documenting service delivery and maintaining compliance data that provides a single data source for your Medicaid process.
Medicaid Cost Settlements
PCG assists state and districts with the design and implementation of the Medicaid Cost Settlement processes. We can assist in the collection of the required financial data, completion of the annual cost report and support for any state or federal reviews.
Financial Services Consulting
Our educational policy and financial services consultants can provide a range of services for your district or state, tailored to your goals and challenges.
- Audit services:In local, state, or federal audits, we can assist with any part of the audit process, including responding to reviews and negotiating financial findings.
- Data analysis/reporting:PCG offers in-depth data analysis and reporting to identify trends, outliers, and possible areas for revenue growth. We can provide information on the Medicaid claiming process to assist school boards, superintendents, or other stakeholders
- Medicaid consulting:Our in-house experts on policy, national trends, program improvements, and pending or recently passed legislation can provide the information you need to successfully navigate changes and requirements.
- Program review:We can conduct a complete review of your current Medicaid program, either at the state or district-level, and provide a written report of recommendations for process or policy improvements.
- Rate setting/cost settlement:PCG reviews and establishes appropriate rates and/or performs a cost settlement process to ensure that all your allowable costs are captured and reimbursed.
- State Plan Review and Amendments:PCG reviews state plans and can assist in the process to amend the state plan.