Frequently Asked Questions

About Program

• What is Third Party Billing? Third Party Billing is a program that generates Federal Medicaid dollars for the Baltimore County Public Schools. A recovery cost for medically related services is sought "after the fact" for children who meet Medicaid guidelines. These Medicaid dollars are used to supplement health care services currently provided by the schools. Health related services that are reimbursable from Medicaid are identified in a student's Individualized Education Plan (IEP) or Individual Family Service Plan (IFSP). These services include speech pathology, occupational therapy, physical therapy, nursing, counseling, audiology, social work, and psychological services for screening, evaluation, and treatment services. The Office of Third Party Billing is responsible for billing and receipt of Federal Medicaid dollars for services provided to students by Baltimore County Public Schools.
• We have the name of a student on our list that is currently receiving Home and Hospital services. As a result, we are not providing services to the child. What should we do in order to make sure that we are not held accountable for submitting monthly encounter data forms for this student while on Home and Hospital? In this scenario, it is imperative that the IEP Chairperson notifies the Office of Third Party Billing immediately using the Home and Hospital Notification Form when the student begins to receive Home and Hospital services. We will document the student as being on Home and Hospital. The Office of Third Party Billing must also be notified when the student is returned to the regular school program so he/she can be officially added back onto the Third Party Billing monthly reports.
• What is the difference between the Third Party Billing program and our Wellness Center billing program? Third Party Billing is responsible for the billing and receipt of Federal Medicaid dollars for services provided by Baltimore County Public Schools to students. The Wellness Center Billing program bills private insurance companies, Managed Care Organizations, and Medical Assistance to cover services in the Wellness Center. All students are entitled to services provided by Third Party Billing and the Wellness Center in a free and appropriate manner, even if the student does not have insurance or medical assistance.
• We have several children who are in foster care or come to us from group homes. I was under the impression that these students automatically have Medicaid. We do not always receive the Third Party Billing registration form back from the families or the caregivers. What should we do? In this case, I have a few suggestions. You may make another attempt to send the registration form home to the family, or make a list of the students in question, with their social security numbers and names, and forward this list to Third Party Billing. We will verify if the students are eligible for the program.
  
  As for children who are in foster care or group homes, these children receive Medicaid for six months after their placement. After six months, the family or caregivers must renew their Medicaid benefits.
  
• If we look at the free and reduced lunch data, will this help us to identify students who may receive medical assistance? Yes, that may help but you can assist in the identification process of students eligible for Third Party Billing by sharing the Third Party Billing registration forms with parents. For a student to be eligible for Third Party Billing, they must have an active IEP and receive medical assistance benefits.
• We received a student from a school that uses the computerized IEP. How can we ensure that all information is recorded correctly? Call the Office of Student Data at 7846. They will provide you with the appropriate solution.
• How do we notify the Office of Third Party Billing that a student has withdrawn from our school? You do not need to notify the Office of Third Party Billing. The information will then be entered onto the mainframe automatically when the withdrawal is processed by the school records secretary.
• Why can Baltimore County Public Schools bill for services? On July 2, 1988, President Reagan signed Public Law P.L. 100-360, the Medicare Catastrophic Coverage Act. This law permits school systems to recover costs from public health insurance for services in a child's IEP.