SCHOOL-BASED ADMINISTRATIVE CLAIMING
YES, EXPERTISE MATTER
What makes us different?
We understand the complexity of how school health programs are funded and operate. Because of this, Paradigm is able to leverage our expertise to ensure your claims are fully optimized, audit-ready, and provide you with the highest level of program management service and support along the way.
Fiscal & Claims Services
Paradigm has the experience and efficacy to perform MAA claims administration cost-effectively for your LEA. Paradigm will:
Extract all relevant participant data from your financial systems and sort through this information on your behalf
Determine Medi-Cal eligibility using our proprietary algorithms and expertise
Create your claims and provide any supporting information that may be requested by regional, state, and federal agencies
Provide regular and dependable management reports for the ongoing analysis of your MAA claims
Offer unlimited access to Paradigm’s Client Care Center for on-demand assistance
Consulting Services
Optimizing your MAA reimbursement potential is nuanced, which can place a high demand on staff time and resources. Paradigm will:
Fully assess your reimbursement potential, including a thorough review of all funding sources for participating staff
Provide best practices training and hands-on support for complying with program rules and regulations
Analyze your quarterly RMTS Coding Reports to identify opportunities for improvement and increased compliance
Provide hands-on evaluations of your audit documentation and preparedness
Offer unlimited access to Paradigm’s Client Care Center for on-demand assistance
As a Paradigm client, you may expect these benefits:
Support
We know how to navigate ever-changing program policy and will provide solutions for operating an efficient MAA program
Time and Cost Savings
We lower your operations and overhead costs by assuming responsibility for all program processes that can be outsourced
Maximum Return
By tapping into your potential, we ensure you are able to leverage all available funding through the program
Accuracy
We ensure your claims are appropriate and audit-ready, and prove you with the detailed backup documentation needed in the event of an audit
Confidence
Your staff can draw on our extensive and accessible knowledge-base; you will not be going at this alone
Security
All of our work is documented for audit purposes, and our services are in keeping with both the letter and intent of MAA claiming regulations
We provide schools the support they need
Our experienced advisors, policy analysts, technology experts, and on-call support team are certain to exceed your expectations. We offer:
Dedicated Program Advisors
Accurate and comprehensive claims processing services (billing)
Innovative “how-to” training
Streamlined participation with our online applications
Enhanced participation and compliance with our custom documentation tools
Sophisticated reporting and program analytics
On-call support for you and your staff
Value-added program advocacy and policy analysis
TECHNOLOGY
Random Moment Time Studies (RMTS)
The nuances of any RMTS application reside in its ability to be user friendly, stable, and to establish a level of confidence that the software will meet all requirements and expectation of all users—Paradigm’s RMTS solution does just that. Our solution is:
Flexible - We can easily and swiftly update our RMTS software to handle changes to the parameters surrounding the definition of the RMTS program.
Functional and Accurate - We are able to change the coding structure and coding requirements; can setup pools of coders at each level of coding; and, can adjust the parameters of the RMTS confidence level and oversampling levels as necessary.
Precise - Our method provides the ability to handle individualized quarterly schedules and our proprietary moment generation script considers every work-minute for every person making each work-minute equally likely to be randomly assigned.
Paradigm RMTS technology provides you a statistically valid sampling and makes it easy to prepare your sample universe, coordinate data collection, and monitor and analyze your program.
Simple participant interface, including online orientation
Built-in notification and messaging system
Customizable sampling and moment classification
Flexible oversight and audit capacity
Integrated compliance monitoring and easy reporting
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Billing for Direct Services
Paradigm supports every aspect of your LEA Medi-Cal Billing Option program, from processing daily billing logs, providing training and customer support to your providers, audit support at every level, and CRCS services.
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Supporting Services for CYBHI
From Medi-Cal billing expertise to Paradigm’s agile Student Health Network (SHN) and Student Wellness Module, discover how Paradigm can provide seamless support for California’s Child & Youth Behavioral Health Initiative.