Medicaid Administrative Claiming
Medicaid reimburses school districts and county offices of education (COEs) for a portion of the costs incurred enrolling children in Medicaid and accessing its covered health services. School staff perform these activities daily, so reimbursements for their cost can greatly aid district and COE budgets. Paradigm's extensive history with Medicaid Administrative Claiming (MAC) began in 1998 when it became the first vendor to file a school-based MAC claim in California and the first to develop a web-based time survey method there. Since then Paradigm has developed a range of technologies and services to maximize client reimbursements and minimize program overhead costs.
MAC reimbursements depend on schools’ and COEs’ documentation of the time spent performing eligible activities. Claims are calculated using time data, financial cost (such as salaries and benefits), and relative size of the Medicaid population served. There are no restrictions on how reimbursements received through this program may be spent.
Paradigm secures more than $50 million in MAC reimbursements annually for clients. We support our clients in all aspects of program management, from start-up through audit preparation. Our services include
- consulting services geared to program initiation and optimization
- detailed program training and a library of training materials (including virtual training options) for coordinators and participants
- web-based technology for collecting time data and fiscal information
- fiscal reports to monitor program success
- extensive audit preparation and support for state and federal reviews
- policy efforts at the state and federal level to ensure that the MAC program remains an efficient and stable source of district reimbursements