- What is LEA Billing?
Local Education Agency (LEA) Medi-Cal Billing Option Program offers districts a way to recover the costs of health services provided to special education students.
The purpose of the Local Educational Agency () Program is to:
- Provide comprehensive health services to eligible Medi-Cal students and, when applicable, to their families
- Allow Local Education Agencies to become Medi-Cal providers and bill the Medi-Cal program for the health services provided to students with an IEP by the medical professionals they employ
- Facilitate reinvestment in health and social services for students and their families
Reimbursement is based upon a "fee-for-service" medical billing model.
- How to Participate in LEA
Complete the following forms with DHCS
- Application for electronic claims submission
- Application for electronic remittance advice
- Application for verification of student Medi-Cal eligibility
- Create an LEA Billing Option Collaborative
- Verify licenses, credentials, and educational requirements for district health providers
- Create a LEA Billing Option audit Plan
- Develop a plan for Retro Billing – 12 months prior and one time only
- Develop WEB or paper billing system
- Verify Medi-Cal student eligibility
- Train staff on program requirements and billing procedures
- Submit electronic or paper claims to DHCS for reimbursement
- Prepare annual DHCS LEA Billing Option report
- Prepare annual Cost and Reimbursement Comparison Schedule (CRCS)
- SBR Makes it Easy
What we do at SBR...
- Prepare DHCS forms for district signature
- Train staff on LEA Billing Policies and Procedures
- Program setup for proper documentation
- Perform initial Compliance Review
- Electronic data base management
- Upload facility for legacy data
- WEB/Paper Claims Training
- Identify students Medi-Cal population
- Electronic Claims Submission
- Automatic Claims Reconciliation
- Audit Review
- Assist with preparation of DHCS Provider Participation agreement
- Prepare Cost and Reimbursement Comparison Schedule (CRCS)
- Important Links
Sites you may want to visit...