LEA Medi-Cal

Claim reimbursements for direct health services provided by school districts.

The Local Education Agency Medi-Cal Direct Billing Option (LEA) allows school districts and county offices of education to be reimbursed for their cost of providing selected health services to Medi-Cal eligible students. The program was established in 1993 by the California Department of Health Care Services (DHCS) in conjunction with the California Department of Education. It creates the opportunity for local education agencies to receive reimbursement for certain health and mental health screenings, assessments, treatments, and related transportation services. LEA reimbursements are restricted and supplement existing services schools provide to meet the health needs of their students.

Important Factors for Success:

  • Practitioners – MBT understands the importance of identifying all available practitioners to participate in the LEA program.
  • Training – MBT trains staff on a regular basis to make sure all available claims are captured.
  • Collaborative Your LEA Collaborative can be your advocate…MBT can help make this a valuable part of your program.
  • CRCS  Align your SACS codes now so that preparing this report will be easier at year-end. We’ll show you how!

OptiClaim_Green

OptiClaim is a web-based solution for the LEA program.

MBT is excited to offer OptiClaim to our partners! This cutting-edge web-based software incorporates feedback and suggestions from actual users in the industry. Our goal is for practitioners to spend less time on paperwork and more time providing much needed services to students and their families while collecting reimbursements in a timely manner.

  • Service Tracking OptiClaim stores all data entered by school staff in the cloud, forever. Staff can set up customized student caseloads and track their total number of services, minutes provided, and case notes all in one place, eliminating the need for paper logs and ensuring compliance with sensitive data.
  • Reporting – Make informed decisions with valuable service data right at your fingertips. Directors, LEA Coordinators, and practitioners can quickly access student service information and create customized reports using MBT’s OptiReports application. Coordinators can run Excel or printable PDF reports on staff participation with a few clicks.
  • Administrative Accountability Staying informed on LEA staff participation can’t get any easier for program administrators.

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“I find the OptiClaim software to be the easiest I’ve used so far. I like the drop down menus that allow me to select the students right from the program- rather than type them in. The biggest challenge of LEA billing before was keeping track of every hour that I worked with students. Just being able to check if it is a Triennial or an Initial for testing is a huge time saver. Thank you!”

Anthony D. Phaller

Psy. D., Corona-Norco Unified School District

CRCS

The cost reimbursement comparison schedule (CRCS) report reconciles the interim LEA reimbursements received through out the year against the local education agency’s cost of providing those services. Using salaries/benefits and hours worked information for participating staff, the CRCS report calculates a cost rate and determines if there is an over or underpayment for services. MBT’s priority is to assist our clients in collecting accurate data for the CRCS report to avoid an overpayment situation.

How MBT Can Assist With Your CRCS:

  • MBT Staff MBT’s CRCS specialist works with your business office to collect the necessary data to complete the CRCS report. Hundreds of CRCS reports are completed each year by MBT. We stay abreast of all DCHS CRCS trainings and publications.
  • Analyzing the Data With our depth and breadth of experience we can easily identify discrepancies in data which may cause unfavorable results. Identifying these hidden costs can save your district thousands.
  • Forecasting MBT also performs CRCS forecasting to estimate if your district is at risk for overpayment and recommends actions to avoid.

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