Specifications include, but are not limited to: A. Must have proven experience and expertise in developing and implementing a direct service SHARS program with a working knowledge of Medicaid rate structures, timelines, regulations, etc. in a school district of a comparable size to the SEISD within the state of Texas B. Must be fully versed in legal requirements of Health Care Financing Administration, Texas Education Agency, Texas Health and Human Services Commission, Centers for Medicare and Medicaid services and/or any other state or federal agencies governing SHARS program and services C. Must be able to comply at all times with all requirements (and any revisions of such) set forth by the HHSC, CMS and any other state, local or federal agency governing the SHARS program and services (including documentation requirements) D. Must have the capacity to fully implement all aspects of the SHARS reimbursement services within the time frame established by SEISD E. Must do all data entry for SHARS claims F. Must have an internal systemic capacity of validating all SHARS requirements for billing to include—but not limited to: a) Parental consent to bill b) Existence of a current Individualized Educational Plan (IEP) that authorizes the frequency and duration of school health and related services c) Verification of licensure and certifications for all service providers d) Verification of prescription for services provided to students e) Medicaid eligibility at different times of the year f) Proper documentation on SHARS G. Must provide relevant training to District personnel as needed to ensure legal compliance and efficient claim processing
