The District requires the services of a third-party administrator to manage the administration and direct billing of the fee-for-service Medicaid programs. The Kentucky Medicaid Program reimburses the District for school-based child health and administrative claiming services it provided according to its established policy. However, since Kentucky has a statewide contract for School-Based Administrative Claiming, respondents to this Request for Proposal will submit a proposal only for the direct billing of fee-for-service Medicaid programs. The District also reserves the right to continue its existing contract to facilitate any transition period, if necessary. Bidders will be contacted to provide a demonstration of the platform. Be knowledgeable in the area of Medicaid regulations of the State of Kentucky and have provisions for keeping the District apprised of same. Preference will be given to bidders with at least two (2) years of experience as a TPA for Kentucky School Districts. The Supplier shall for School-Based Child Health Services: a. Manage new and existing claims for Medicaid billing. b. Provide a comprehensive web-based service documentation tool, including the functionality to: 1. Maintain security of data from both server and client side as well as mobile devices (smart phones and hand-held devices) 2. Easily create and manage provider caseloads 3. View previously logged services on the main logging page 4. Create groups of students for easy access for logging services 5. Log for students seen in a group setting 6. Log services from a smart phone or hand-held device 7. Manage supervisors and supervisees within the system 8. Allow supervisors to view, approve and reject services provided by those they supervise 9. Service documentation tool must be capable of supporting automated batch imports of District data 10. Easily view/sort service logs by service type, provider and student, with the option of specifying date range 11. Manage reconciliation of prescribed versus provided services 12. Easily view students that require compensatory time for services that were prescribed but not provided 13. Include a spell check/grammar check feature 14. Handle high volumes of traffic with multiple users during peak user times without disruption in service. The supplier should continue to make product improvements to decrease the number of steps required to complete a function 15. A fully functioning graphing system with the option to import goals and see the last three data points from the logging screen 16. A fully functioning calendar that offers pre-population of date, time, group, group number, diagnosis code, or other calendar functionality as deemed necessary for calendar logging by JCPS 17. A system that imports all necessary information from Infinite Campus required to record services and bill Medicaid 18. The ability to create custom goals 19. All of the above requirements should be functional from day one of the contract period 20. A demonstration of the platform will be required
