Key Goals and Objectives for the Office of Third Party Billing

• Educate school based staff to identify and document services provided to Medicaid eligible special education students who receive speech, occupational therapy, physical therapy, psychological, nursing, social work, audiological, transportation, and case management services in the Baltimore County Public Schools.
• Provide quality technical assistance and training to school-based staff for successful implementation of the Third Party Billing program at each school.
• Provide quality fiscal management for all funds generated through the Third Party Billing program to ensure compliance with Maryland State Department of Health and Mental Hygiene (DHMH), and federal regulations from the Centers for Medicaid and Medicare Services (CMS).
• Collaborate with the Office of Special Education, Office of Grant Accounting, Office of Infants and Toddlers, Office of Psychological Services, Division of Information Technology, Office of Health Services, and the Office of School Social Work Services, in order to ensure the accuracy, effectiveness, and efficiency of the program for all types of customers.
• Assess the program in order to determine if the mission of the program is being met.
• Effectively bill Medicaid and other third party payors for services provided in school-based health centers.
• Effectively administer and monitor the State of Maryland Autism Waiver Program and its implementation and effectiveness in Baltimore County.
• Increase stakeholder and customer awareness and understanding of the Third Party Billing program in an effort to maximize the collection of reimbursable funds.
• Effectively monitor billings to Medicaid to ensure the integrity of the billing system, as well as the accuracy of the data collected.
• Review encounter data forms for accuracy, completeness, and compliance with Federal and State regulations.
• Monitor data and provide timely feedback to schools regarding encounter data submitted.
• Conduct internal audits of encounter and billing data to ensure compliance with Medicaid regulations.
• Increase the research of rejected claims to maximize recovery of funds.