Client Success Story: No Claim Left Behind
November 13, 2014
How implementing AcceliTRACK and AcceliCLAIM to track and claim Special Education health-related services and restructuring operating budgets increased Fee-For-Service (FFS) reimbursements for a large school district.
Our client sought bids from companies that could take over as its Medicaid Billing Agent – and develop an adaptable state-of-the-art information management system for its Special Education program. Although the District received proposals from several companies, one stood out from all the rest – the one submitted by Accelify.
Accelify’s bid stood out from the others because its projections indicated that the District should be receiving $3-$4 million per year in Medicaid revenue. At the time, the District’s total Medicaid revenue was approximately $1.15 million per year. Another reason Accelify’s bid was unique is the fact that its proposed information management system would automate all of the District’s existing paper forms, minimizing the amount of time it would take for the District’s staff to adapt to the new system.
Upon taking over as the District’s Medicaid Billing Agent, Accelify quickly learned that the prior vendor had left behind numerous potential claims that were about to become too old per the State’s Medicaid program rules. Rather than allow these claims to expire, Accelify immediately undertook a labor intensive effort to manually enter every such claim before it “fell off the table” – an effort that produced more than $300,000 of unanticipated revenue for the District.
Throughout the time that Accelify has served as the District’s Medicaid Billing Agent, it has identified numerous strategies to increase the District’s Medicaid revenue. As a result, Medicaid revenue has more than tripled!
Accelify also helped the district restructure its operating budget so that it could take full advantage of its Medicaid claiming opportunities. One example involved the funds the district used to pay for its Special Education buses – and the funds used to pay for its diagnosticians. By changing those funding sources, the district was able to generate approximately $3 million of additional Medicaid revenue without expending any additional local funds whatsoever.