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In response to the "Medicaid School Billing Under Fire" article (June 10, The ASHA Leader), the Medicaid school billing program is a legitimate and important source of funding for schools, because the costs of providing special education and related services can greatly exceed the federal assistance under IDEA. School districts select billing agents to perform a vital function of capturing needed funds.
A good billing agent is hired by school districts to assure compliance with federal and specific state rules and regulations while capturing revenue from billable service encounters. Qualified billing agents will know applicable federal and state requirements, provide technical expertise to determine Medicaid eligibility, maintain relationships with state regulatory personnel, advocate at the state level for clarification of rules and regulations, provide proper staff training on documentation and qualified provider requirements, train district personnel on how to review student records for compliance, and provide support to clinicians when questions arise.
Certified SLPs must adhere to the ASHA Code of Ethics and understand their responsibility as qualified providers. They must have a thorough knowledge of Medicaid rules and regulations affecting their discipline to ensure proper Medicaid billing.
The ASHA Leader article painted a dim picture of the importance and legitimacy of Medicaid school-based billing practices. Through the leadership of ASHA and state speech-language-hearing associations, certified SLPs should be offered educational opportunities to gain a thorough knowledge of federal guidelines and state regulations, as well as a balanced viewpoint of the value of the Medicaid school-based billing program.
Mary Bahr Schwenke
mary.bahr@mjcare.com
Jerry Styberg
jerry.styberg@mjcare.com
Debbie Ogrizovich
debbie.orgrizovich@mjcare.com
Milwaukee, WI
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