Many school districts receive a substantial lump sum in the spring with their cost settlement. However, some districts find that they owe money back to their state’s medicaid agency.

What should your school district do if you find yourself in a situation where you are required to payback money?

Here are some helpful tips for monitoring Cost Settlements:
1. Carefully read all documentation received from the agency that produces the cost settlement reports as well as any Direct Service and Administrative claims agencies managing revenue receipts- make sure you understand all of the factors that went in to determining your cost settlement amount. This may sound obvious, but it’s easy to skim over documents during busy times, especially with all of the extra work involved in providing services during a pandemic!
2. Always take advantage of any appeal opportunities stated in the communication so you will have time to gather records, examine filings, and correspond with agency support for data that was used in the calculation.
3. Check all communication and reporting websites for support phone and email contacts, and contact them immediately anytime clarification on an issue is needed.
4. If you determine that errors were made by your school district that resulted in over billing or revenue loss, document them fully in a Quality Assurance or procedure manual with steps to be taken to prevent future occurrences.

It’s important to figure out why your cost settlement resulted in your district having to payback money. InfoHandler works with our school districts to help determine why paybacks were necessary and what can be done to prevent them the following year.

If you need help determining what to do to prevent future cost settlement issues, contact us.