Sivic Solutions Group

Schools are entitled to get reimbursement for certain direct services and administrative costs when serving students eligible for Medicaid. Schools are also eligible for the repayment for certain outreach activities that bring eligible students into the Medicaid program.

It is complicated to track time spent on the delivery of services and a district’s administrative costs. So certain companies specialize in providing software, tools, and consulting to capture the required information to get reimbursed by its state government.

One of these enterprises is Sivic Solutions. It holds a contract with the Monterey County Office of Education to provide Medicaid reimbursement services to school districts. The company won that contract by being the low-cost bidder through a competitive national solicitation run cooperatively with the Association of Educational Purchasing Agencies. Thanks to the MCOE bid, Sivic Solutions can often offer lower costs than those charged by many other providers in California. Using the service is a net win for schools because Sivic Solutions only gets paid, when it returns money back to the school district.

Medicaid is financed jointly by the states and the federal government. It is administered directly by the states. Under federal guidelines, each state creates a state Medicaid plan that outlines eligibility standards, provider requirements, methods of payment, and benefit packages. If a school district records and reports its costs correctly, it can enjoy significant reimbursements, offsetting operating expenses that it would otherwise have to absorb.

About Sivic Solutions

Sivic Solutions Group (SSG) is a national company headquartered in New York. The principals of SSG have a combined experience of more than 60 years in providing end-to-end government solutions, enterprise software development and implementation. SSG is a leader in the implementation of high technology and business applications. Its team has extensive experience in developing and operating large school information systems, Medicaid administration, Medicaid and Foster Care revenue maximization and compliance initiatives, and web-based applications.

SSG offers multiple methods to collect service data required to support Medicaid claim, including web-based, paper-based, and scanning-based solutions. Its foremost tool is the MAXCapture System, a web-based, electronic, and HIPAA-compliant system to capture records of service encounters at the location of service delivery.

The eligible services that successfully pass the state-defined edit rules are translated into Medicaid claims and submitted to the State Medicaid Management Information System (MMIS). MAXCapture is a comprehensive Medicaid claiming and school-data management system. The power of MAXCapture is its integration of all relevant school-child-service-provider data to provide detailed reporting, data matching, and data analysis.

SSG has extensive experience in healthcare, the education (K-12) marketplace, and Health and Human Services.