- What is School Health and Related Services (SHARS)?
- School Health And Related Services (SHARS) is a Medicaid financing program and is a joint effort of the Texas Education Agency (TEA) and the Texas Health & Human Services Commission (HHSC). SHARS allows local school districts, cooperatives, and SSA special education programs to obtain Medicaid reimbursement for certain health-related services provided to children in special education. Using existing state and local special education allocations as the state match, SHARS providers are reimbursed the federal share or approximately 60.89% of the established billing rate.
School districts/cooperatives receive federal Medicaid money for services provided to children who meet all four of the following requirements.
These children must:
The services include: assessment, audiology, counseling, nursing services, physician services, occupational therapy, physical therapy,
psychological services, personal attendant care service, speech therapy, and transportation in a school setting. These services must be
provided by qualified professionals under contract with or employed by the school district/cooperative. Furthermore, the school district/cooperatives
must be enrolled as Medicaid providers in order to bill Medicaid.
- Be Medicaid eligible
- Be under age 21
- Be enrolled in Special Education for one or more disabilities
- Have Individual Educational Plans (IEPs) that prescribe the needed services.
- How much paperwork is involved?
- Texas State Billing Services unique offerings are based upon 15 years experience in Texas with a sole business focus on SHARS.
We have worked closely with school administrators and practitioners to design and refine our forms to ensure the best data collection
with the least amount of time spent filling out our forms. We share your commitment to children and ensure that, as much as possible,
your providers' time is spent with children and not paperwork. However, as with any program there is required documentation; Medicaid is no exception. Our clients have found that our procedures and forms are easy to use and require the least amount of time possible. Using our procedures, your providers will need to spend roughly 5-10 minutes every two weeks updating service records for our data processing purposes. As with any Federal program, there are startup efforts that cannot be avoided. However, we have found that once we have your program operational, it becomes fairly transparent to the Special Education Director, and the burden of the administration of the program is minimal. No additional district staff will be necessary, TSBS will process all forms.
- How do we know which children are Medicaid eligible?
- Part of our job as your billing agency is to identify your Medicaid eligible population. TSBS does this through interface with the Texas Medicaid &
Healthcare Partnership (TMHP). TSBS can submit the names of your special education students to TMHP monthly in order to establish the "match"
of Medicaid eligible students. We triple-check for student eligibility by using not just the data provided by the districts but by using internal
systems that submit truncation and alternate spellings of children's names as well as international birth date lookups. Although somewhat laborious,
we have been successful at uncovering nearly 100% of the existing population.
- How do we keep abreast of Texas' school-based Medicaid program?
- A commitment of the TSBS network is the keeping in close contact with Texas Medicaid & Healthcare Partnership (TMHP), Texas Health &
Human Services Commission (HHSC), The Centers for Medicare and Medicaid (CMS), and the Texas Education Agency (TEA) on behalf of the districts
we serve. Our practice for the past decade has been to establish a working relationship with state offices to ensure clear and dependable
dissemination of information to our districts. Part of our contractual responsibility is to act as a liaison between state and federal offices
and the local school district. In short, TSBS stays abreast of Medicaid for you. We provide a quarterly newsletter with Medicaid information
updates or changing policies and procedures. When immediate dissemination of information is required, the news is passed along to the SPED Director
and Staff via phone calls and emails. We will keep you informed.
- Do I have to become a Medicaid "expert"?
- No, that is our role! Texas State Billing Services, Inc. has been established with a leadership team of Medicaid Consultants who
are in their twelfth year of successfully providing administrative services to school districts in Texas. TSBS provides a strong blend
of the two most important experiential levels required for quality school Medicaid administration:
- A solid multi-state exposure to the many applications of federal Medicaid legislation and regulations
- An in-depth record of success and trust whereby school boards and local school administrators have seen legal claims maximized with
energies of district personnel minimized.
- What if we are audited?
- One of the foremost concerns among school districts is the eventuality of an audit. Our successful experience in this arena has proven
invaluable to school districts. The personnel of Texas State Billing Services have consistently and successfully (to the point of no exception)
prepared for and completed audit evaluations for state and federal auditors on behalf of hundreds of school districts over the past ten years.
Our audit experience guides the claims process throughout, and prepares each school district in such a way that no surprises or failures to
comply are ever realized. We see audit-proof performance not as an "add-on" service at the end, but rather as a condition of readiness that
is achieved throughout the TSBS SHARS process.
- What revenue code should be used to document SHARS Medicaid reimbursements in the districts Financial Accountability System?
- It is recommended by the Texas Education Agency (TEA) that school districts should use the revenue code: 5931 Other Federal Revenues.
SHARS Medicaid reimbursements received by school districts is considered vendor payments and do not require separate accountability for audit.
Client TestimonialsI have worked with TSBS since 2013, and without a doubt I can count on them 100 percent of the time to support my many needs. TSBS is extremely reliable, their staff is service-oriented, and bottom line— it is always a pleasure to contact them.
Client TestimonialsWe have utilized TSBS as our Medicaid billing and consulting partner since 2015 and we have had nothing but positive experiences along the way. They have been only a phone call or email away the whole time and always takes the time to answer our questions and review progress as needed.
Big Spring ISD
Client TestimonialsMy TSBS Program Director and her team have been invaluable to us. They assisted greatly in our Cost Report and updating procedures to ensure future ease of completion. Our district underwent a TEA Medicaid audit, a TMHP audit, and a PERM audit, and TSBS provided much needed guidance during and after that period.
Client TestimonialsCass County Shared Services has used TSBS for the last six years. Not only is their customer service out of this world; TSBS continues to increase our claims each year.
Cass County SSA
Client TestimonialsTSBS makes navigating the Medicaid reimbursement process easy and painless. The support and professionalism provided is invaluable! We are a small district, which means small rewards for TSBS, but you wouldn't know it in the way they provide service to us!
Client TestimonialsI switched [to TSBS] as soon as possible, and have not looked back since. It’s been fifteen years now with TSBS and the service is just as great as the first day. If you're looking for someone to handle your SHARS billing, or looking to make the switch; well relax, take a deep breath, and make the call. It’ll be one of the easiest and best decisions you’ll make all year.
Client TestimonialsThe staff at TSBS are easy to contact and always helpful. The revenue brought back to our district this year was spot on with the amount their sales department projected. I am more than thrilled to have chosen TSBS to do our SHARS billing.
Region 15 Education Service Center
Client TestimonialsIt’s always a pleasure to work with TSBS. It is important to us as a district to not only have a reliable company overseeing such a vital aspect of our Special Education program, but to also have friendly reliable people servicing our district that can be counted on at any time to support our staff.
Mt. Vernon ISD
Client TestimonialsWe have worked with TSBS for many years. We have been very pleased with their understanding of Medicaid billing and documentation. The work diligently to assist in recouping as many funds as allowed. Their customer services is outstanding. They are always a phone call away for any question or concerns that we may have.
Client TestimonialsOur district has been billing for Medicaid for many years and has used several different billing companies to assist us over the years. We have been extremely satisfied with billing through TSBS. Their knowledge and customer service has been excellent. They are very compliance driven and focus on keeping us up to date and legal with our submitted data.
Client TestimonialsOur school district has been with TSBS for 6 years and they have consistently provided us with excellent technical assistance and customer service. TSBS goes above and beyond in serving our district and remains transparent in everything they do. Since our switch to TSBS, our recoupment of Medicaid funds has been substantially more.
Grand Prairie ISD
Client TestimonialsWe are so happy we made the change from our previous vendor to TSBS! Their personnel are very knowledgeable and some of the nicest people I have dealt with! Our SHARS desk audits from HHSC used to be a nightmare for us. TSBS has taken over all the headache of those audits. They will go the extra mile, including filing court appeals, to settle cost report disputes.
El Campo ISD
Client TestimonialsTSBS staff is responsive, knowledgeable, and always helpful. I am grateful for their support and professionalism in their support of us and our Medicaid billing needs.
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