Case Studies

Client Profile
ADA: 20,000
IEP Students: 2,750

Virginia school district maximizes IEP compliance and Medicaid reimbursement using Accelify’s end-to-end special education management solution.

PROJECT OVERVIEW

IEPS
CREATED*

> 4,000

PARENTAL CONSENT RESPONSE RATE*

98%

MEDICAID
INCREASES

300%

* Figures represented are for school year 2014-15
** Figures represented are for the average % increase in Medicaid reimbursements for all years working with Accelify compared to reimbursements received prior to Accelify.

Our client was looking for an end-to-end special education management solution when they partnered with Accelify–one that would link the IEP development process, to related service scheduling and tracking, to Medicaid billing.
The systems for managing these processes needed to speak to each other and provide our client several key features and benefits, including:

  • The ability to monitor compliance with IEP timelines and service requirements;
  • Transfer data required for state reporting to their SIS;
  • Support service tracking and Medicaid claiming for all billable service types (the prior vendor did now support billing for all approved services);
  • Perform Medicaid billing validations prior to claiming, including ensuring services were properly authorized in student IEPs; and
  • Report on non-claimable services so that they could take corrective action to maximize claiming opportunities.

In addition, our client was looking for assistance with developing their annual Fee for Service cost reports.

The District took a tiered approach to implementing Accelify’s systems, first implementing Accelify’s Medicaid service tracking and billing systems, including AcceliTRACK, AccelPCS, and AcceliROUTE. Using these systems, the District was able to expand their Medicaid billing program from covering only occupational, physical and speech therapy services, to include nursing, personal care, social work, psychology, and transportation services.

Providers in each area received training specific to their service type and ongoing support to ensure optimal user adoption.

The system also provided the District’s billing staff data related to missing parental consent and provider license dates, allowing them to target their efforts at obtaining missing information for students and providers with the greatest number of services eligible for reimbursement.

The Medicaid systems were initially integrated directly with the District’s third-party IEP system, allowing them to monitor the delivery of IEP services in real-time using AcceliTRACK reports, in addition to validating that all services claimed were properly authorized in student IEPs.

After utilizing the integrated system for two school years, our client partnered with us to build a custom Virginia IEP system to further streamline special education reporting and automate Plan of Care development and validation. In addition to the custom IEP system, the District has worked closely with Accelify to customize its Medicaid systems, including adding e-signature capability, building custom reports to assist with the Medicaid cost reporting and self-audit processes, and other enhancements to ensure continuous improvement to both special education and Medicaid billing operations.

RESULTS

The end-to-end nature of the solution implemented by our client has resulted in improved management of the IEP development process, more automated means for tracking IEP timelines and completing Plans of Care, and better tools for monitoring and documenting services delivered to students with disabilities. This has resulted in more compliant IEP development and service delivery processes, and significant increases in service documentation, which has resulted in increased Medicaid claims.

In addition to documenting more services, Hampton has improved their Medicaid program by utilizing AcceliTRACK’s revenue exception reports and following Accelify’s guidance on making adjustments to their cost reporting process to ensure all costs are accounted for. In total, this work has resulted in a 300% increase in Medicaid reimbursement.