How EmbraceDS® helped TCSEA improve Medicaid reimbursement

Before Embrace®, TCSEA staff struggled to track and access various important documents, such as parental consents, speech-language scripts, and occupational therapy (OT) and physical therapy (PT) scripts.

As a result, they were unable to identify opportunities to increase reimbursement and improve funding.

“I know that last year before we started looking at those metrics, we had a lot of reimbursement that we weren't getting back because we didn't have OT/PT scripts. And so once we started looking at that, we were able to get a lot more funding,” explained Dr. Czerwinski.

It was also important for all districts in the cooperative to receive much higher-quality customer support.

“I do know that we had two of our member districts that still hadn't switched to EmbraceDS® since I have been here. And they did go ahead and switch, and found that there's a lot more support [with Embrace®],” Dr. Czerwinski commented.

One of Dr. Czerwinski’s biggest goals upon entering her role at TCSEA was to advance her knowledge of Medicaid, keep track of staff completing all necessary documentation, and ensure the cooperative remained compliant with billing timelines while securing the reimbursement it was eligible for.

“I just really wanted to learn about Medicaid, learn what I could do to help our cooperative… I've spent some time really exploring all the things that you guys are offering to see how they can benefit us and help our practice get better.”

Access to important administrative metrics

Being able to use the robust reporting dashboard allowed TCSEA to access data that was previously harder to track, which, in turn, helped improve reimbursements as well.

“It's easy to miss something that is required to get reimbursement,” Dr. Czerwinski explained. “And so those admin metrics are allowing me to have one of our secretaries follow up to make sure we're getting the one-time parental consents, to make sure that we have all of our speech-language scripts, to make sure that we have the OT and PT scripts. And then she's able to follow up with all of those and make sure that we're getting all of that information into the computer. And that allows our practitioners to spend time working with kids and not chasing paperwork.”

Keeping track of and storing service logs in one place

According to Dr. Czerwinski, this feature was not only helpful for improving compliance but also enhanced processes and eliminated duplicate tasks from the team’s workload.

“I really do like that, because we now have a law in Illinois that we have to have those service logs available for parents. And so we have asked all of our staff to collect that data on every single child. And that way we have that information available to us for requests,” Dr. Czerwinski explained.

“And then also providers aren't having to do the work twice of keeping a log in one place and keeping the billing in another. You can feel confident that the company [Embrace®] is making sure that we are not submitting claims for those who are not eligible, so it makes us feel good to be able to do all of our service logs in one spot.”

Quick customer support and training videos

Dr. Czerwinski mentioned that she feels the availability of fast customer support, especially via chat, is essential during the training process and throughout the year to address questions without the leadership team having to handle all the requests themselves.

“When I do my boot camp at the beginning of the year to train new staff in how to use Embrace®, how to use the different systems, we actually do the online chat right there during the meeting so that they can see how instantaneously they'll get help.”

“A lot of staff want to contact me for help with Embrace® products, and I try to redirect them straight to you guys because you know so much more than I do, and you can instantaneously get to it. So, if they're in an IEP meeting and they don't know how to do something, they can just type right there, and the virtual assistant will pop up immediately and help them. So, support is so important.”

Dr. Czerwinski also emphasized the importance of the pre-recorded training videos available to all users in the system at any time of day. “The training videos that you guys have on the website, I often refer to those because I want my staff to realize that maybe they don't understand it the first time or don't remember, that that little help is there, ready.”

Monthly accuracy reports and reporting dashboard

The availability of automated accuracy reports and the reporting dashboard allows Dr. Czerwinski and her team to identify any discrepancies or issues quickly and address them on time to avoid compliance issues.

“I have spent some time learning about the accuracy reports, making sure I look at those each month and make sure that our staff is on track with getting those completed because you can miss out on reimbursement if the timelines have changed. Making sure that we're on top of that, so that we not only have our logs completed—our service logs that we need—but we get the Medicaid reimbursement that we need,” Dr. Czerwinski explained.

“I can see now that in our co-op, I've got it pulled up because I was working on this, there are only 20 children that we are missing a parental consent for. And so I can go through and find those children and figure out what the problem is, and on a lot of them it is simply that they are a 504 student, or they're a healthcare student, and the teacher or the director probably didn't know that those are billable now. So it helps me realize so that I can train staff.”