in federal Medicaid reimbursements paid to districts annually
potential annual reimbursement for a mid-size district, most of it uncaptured
states now cover all Medicaid-eligible students, not just those with IEPs
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The money is there, the workflow is broken
Most districts are delivering Medicaid-reimbursable services every single day: speech therapy, OT, PT, counseling, nursing. The reason they are not getting paid is not a lack of services. It is a broken process built on documentation that was never designed for billing.
Providers document for IEP compliance. Medicaid requires different fields that no one maps at the moment of documentation: procedure codes, place of service, and medical necessity language.
Mid-size and rural districts rarely have staff dedicated to Medicaid billing. Nurses and therapists cannot absorb that complexity, and state rules span dozens of pages.
Missing parental consent or unverified Medicaid eligibility makes sessions permanently unbillable, even if the service was documented perfectly. These gaps are common and cannot be fixed retroactively.
August makes session data billable at the point of capture, then handles everything through to submission and reconciliation, so youre providers keep working the way they always have
August verifies Medicaid eligibility monthly via automated checks and surfaces missing parental consent before sessions happen, not after. No more manual portal lookups or mid-year coverage surprises.
NPI numbers, license expiration dates, and enrollment status are tracked per provider. August alerts you before lapses, because billing for an unenrolled provider results in permanent denial.
Providers log sessions the same way they always have, but August adds CPT code selection, place of service, setting flags, and medical necessity prompting inline, so nothing needs to be reconstructed later.
A pre-submission scrub checks every session: Is the student eligible? Is consent on file? Is the CPT code correct? August surfaces errors at the source, so you fix problems before they become denial codes.
If you deliver billable services to Medicaid-eligible students, schedule a meeting with our team and with 4 simple questions we'll calculate how much money you're leaving on the table
