What student information is shared in the Medicaid billing process?

All Ohio Medicaid School Program claims are transmitted electronically to the Ohio Department of Medicaid for processing. The data that is sent is over 15 lines long and the data is not recognizable to most people. Here is a sample of what this data looks like:

782L1~LX*~SV1*HC:92508*30.43*UN*1***1~DTP*472*D8*20150915~REF*6R*2 508*30.43*UN*1***1~DTP*472*D8*20150929~REF*6R*282393e4202782l3~SE*

When a school district goes through a Medicaid Audit, certain records are verified to make certain that services were provided and documented appropriately. These audits are performed by a CPA firm, or a State or Federal auditor. They include, but are not limited to:

• Verify that the service was properly listed on the IEP.
• Verify that an evaluation was properly completed.
• Verify that the therapist is properly licensed.
• Verify that the IEP was properly signed.
• Verify that the student was in attendance.

Ohio school districts are governed by HIPAA, FERPA, and IDEA, which have very strict rules regarding the sharing of protected health information. School districts and billing vendors work very hard to safeguard all student information.

HIPAA – Health Insurance Portability and Accountability Act
FERPA – Family Educational Rights and Privacy Act
IDEA – Individuals with Disabilities Act

Ohio Medicaid Consumer Hotline 1-800-324-8680

Healthcare Billing Services, Inc. 1-740-639-4218