Jamie Watson, Medicaid

MEDICAID

GOAL AND OBJECTIVES

The goal of the WDMESC Medicaid Services program is to provide timely filings of Medicaid eligible claims for reimbursement on services rendered by our member school districts in hearing, vision, child health services, early and period screening, diagnosis and treatment, speech, physical and occupational therapy.

PROGRAM DESCRIPTION

The Medicaid Program is a state operated program to provide reimbursement for services for low income and the medically needy. In the case of school districts, the program affects children who are being serviced through the school districts for hearing or vision screening, EPSDT screening, diagnosis and treatment, speech, physical or occupational therapy services, and have met all requirements to be eligible for the Medicaid Program. Children enrolled in the Arkansas Kids 1st program are also included in the Medicaid program.

Upon receiving parental consent, the school districts submit records to the co-op, including the Medicaid assigned number, completed IEP, physician referral, prescriptions, reports, history and evaluations for each eligible student. In turn, we must provide information certifying each therapist serving the students to be a Medicaid eligible provider. After all the files are completed, the school districts send all billing information to the co-op on eligible services. The co-op then submits claims electronically to EDS for payment by the Arkansas Medicaid Program.

The co-op sends each school district reimbursement quarterly, after deducting a 10% administrative fee to cover expenses. Each school district must deposit their portion into a federal account and, within one year, spend the funds on Special Education Services. Special Education Services such as speech, physical and occupational therapy, require a state match payment made to the Department of Education for all reimbursement by Medicaid.