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Audit Objective

Determine whether the Schuylerville Central School District (District) maximized Medicaid reimbursements by submitting claims for all eligible Medicaid services provided.

Key Findings

The District did not maximize Medicaid reimbursements by submitting claims for all eligible Medicaid services provided.

• Claims were not submitted and reimbursed for 382 eligible Medicaid services provided. Had these services been claimed, the District could have realized revenues totaling $6,375.
• The District lacked adequate procedures to ensure Medicaid claims were submitted and reimbursed.
• Service providers (providers) did not document all service encounters in the Medicaid billing system (system).

Key Recommendations

• Establish procedures to ensure all documentation requirements are met to submit Medicaid claims for reimbursement for all eligible services provided.
• Review all unclaimed services and submit any eligible claims for reimbursement.
• Ensure providers document all service encounters in the system.

District officials agreed with our recommendations and have initiated or indicated they planned to initiate corrective action.