IMED Questions and Answers
What is IMED?
The Iowa Medicaid Education Disbursement (IMED) program, sponsored by IASB, assists school districts in obtaining Medicaid reimbursement for students who are Medicaid eligible and receiving special education services. IASB has contracted with ClaimAid, a health-care consulting service, to provide this program to IASB members.
Iowa schools now provide services to students that may be covered by Medicaid. However, many schools don’t seek reimbursement for these costs. This new IASB program can help.
What is Medicaid?
Medicaid is a federal/state program that provides assistance to eligible individuals based upon either income status or disability status. The state pays approximately one-third of Medicaid costs with the federal government picking up the remaining costs.
What is Medicaid claiming?
Medicaid claiming allows school districts to file claims on behalf of eligible students (those eligible for Medicaid and receiving special education services) to get reimbursed for the cost of those services.
Services eligible for Medicaid billing include:
- Physical therapy
- Speech therapy
- Audiology services
- Occupational therapy
- Personal student services such as hygiene and feeding
- Nursing services including medication administration
- Time spent in Individual Education Plan (IEP) meetings
- Services for the visually impaired student
- Behavioral interventions
What will IMED do for your school district?
IMED is designed to take all the red-tape frustration away from your desk yet still allow you to reap the benefits of Medicaid reimbursement. Specifically, IMED:
- files your Medicaid claims with the appropriate Medicaid contractor.
- assists you in determining what services are eligible for Medicaid reimbursement.
- helps you in getting established as a Medicaid provider.
- works with your staff to ensure they know which services are reimbursable and are comfortable documenting the services to be reimbursed.
- works with your staff to ensure IEPs are appropriately written to further document the Medicaid-eligible services.
- investigates and resolves claim denials.
As an additional service, ClaimAid will assist you in determining whether students not currently receiving Medicaid benefits may be eligible for them subject, of course, to parental approval.
What will be your responsibilities?
As an IMED participant, you:
- ensure IEPs fully document all Medicaid-eligible services.
- respond to ClaimAid’s requests for more information when needed.
- document Medicaid-eligible services for each eligible student served.
- train your staff, with ClaimAid’s assistance, so they know what services are eligible.
How does the process work?
School districts contract directly with ClaimAid for services. ClaimAid then trains your staff on their role in the reimbursement process. ClaimAid uses an electronic claims submission process so it is more efficient for participants.
School districts currently enrolled as Medicaid providers can begin submitting services to ClaimAid as soon as a contract has been completed. Medicaid allows providers (school districts and area education agencies) to go back one year for service claiming so you can get two years of reimbursement in the first year!
School districts input their Medicaid-eligible services to ClaimAid through a secure Internet-access form. Once received, ClaimAid will submit and resolve your Medicaid services in a timely and accurate manner. Since the state pays approximately one-third of Medicaid costs, you will be required to reimburse the state its portion. The remaining two-thirds, minus the program’s administration fee, is the school district’s to keep.
How do I participate in IMED?
Contact Mary Gannon at IASB at 1-800-795-4272 x229 or (515) 288-1991.