Don’t just rely on your REV Vendor for your Child Count Roster

Now is the time to ensure your Medicaid Eligible list contains all students who are eligible. Don’t just rely on your REV Vendors to complete this critical task.

Are you identifying all of your Medicaid eligible student or simply relying on the results sent by your REV Vendor?

For 30 years, we’ve been dedicated to helping Illinois school districts receive reimbursement for all eligible students. But lately we’ve noticed a number of school districts who are simply relying on the Child Count provided by their REV Vendors. In our experience, these counts are never 100% accurate and often miss a significant number of Medicaid Eligible students – which means those school districts aren’t able to receive the proper reimbursements from the State of Illinois HFS. Additionally, many student records that are returned as Medicaid eligible are not eligible for the School Based Fee for Service Medicaid program.

Need some help?

For years, the team at R&G has been painstakingly investigating each student record that comes back as “Not Found” by the state computer. R&G clients can be assured that due to the extra effort we provide, their Medicaid Eligible list contains the additional eligible records.

In an effort to make sure all school districts in Illinois have accurate information R&G will analyze the results returned to you from your service bureau and let you know if you are submitting claims for students who will not generate any Medicaid funds while missing students who are, in fact, eligible for school based services. Simply contact R&G and submit your Special Education roster. We will evaluate the results and provide a summary of any discrepancy to you.

As always, the team at R&G is dedicated to maximizing your funding through smarter claims for Medicaid reimbursements. If you would like to have us review your Roster, call the office at 847-933-9030.

New Requirement for Reimbursement this January

Were you aware that the Medicaid Director of Illinois has instituted a new requirement for NPI (National Provider Identification) Numbers? This NPI requirement pertains to all Speech, P.T., O.T., and Audiology Services.

Starting on January 1, 2019, to receive your Medicaid reimbursement, the ordering, referring or prescribing practitioner much have a valid NPI number and they must be enrolled through the Illinois Medicaid Program Advanced Cloud Technology (IMPACT). This change was documented in the Provider Notice issued on 11/9/2018. Contact our office if you would like a copy of the notice.

System Update

If you are a client of our Fee-for-Service program, we’ll send you sample referral forms upon your request. In addition, we’ve already updated our software to help you be compliant with this new requirement. When a provider is entering the referring physician, the screen now has a required field for adding the NPI number.

 

Who’s missing?

In addition to requiring the provider to enter the information when a session is recorded, we’ve also created a new report that will identify which student records still need to be updated.

As always, the team at R&G is dedicated to maximizing your funding through smarter claims for Medicaid reimbursements. If you have any questions about the new requirement or you would like a sample of our referral form, just email Holly at holly@rgconsultant.net.