Tips and Tricks

Medicaid Toolkit

Stay informed. Read, read, and re-read state Medicaid and/or managed care organization manuals/handbooks/guidelines.

Watch for changes! Sign up for provider emails and frequently check state Medicaid or managed care organization websites.

Know state licensure laws. If licensed in multiple states, maintain separate “requirements” folders for each state and update them at least quarterly. Each clinician is responsible for staying current in every jurisdiction they are practicing in.

Implement internal audit processes:

• Audiology Audit Template [DOCX]
• Speech-Language Pathology Audit Template [DOCX]

Use reliable resources. Use primary, reliable sources for answers—state Medicaid manuals, official provider bulletins, FAQs, and written guidance from the payer—rather than social media groups or word‑of‑mouth. You are ultimately responsible for your own billing integrity, so don’t rely on unqualified people to interpret policy for you.

Some clinicians use AI as an additional tool to compare versions of Medicaid manuals or state licensure to highlight variances and requirements. Confirm any AI-generated information with the primary source.

Four more ways to stay on top of Medicaid policies:

• Establish an open line of communication with the State Advocates for Reimbursement (STAR) for your state. Reach out to ASHA for contact information if needed.
• Contact your state association for guidance.
• Use the Medicaid Toolkit to check for compliance.
• When in doubt, reach out to ASHA staff at reimbursement@asha.org with questions.