SSG Services using MAXCapture® Web System:
SSG offers multiple methods to collect service data required to support Medicaid claim, including web based, paper based and scanning based solutions. We propose to use our 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 will be 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 comprehensive reporting, data matching, and data analysis.
This web-enabled service capture system was designed for the school-based market, which is based on .NET framework. The project required careful consideration of user interface guidelines and standards. It utilizes ASP.NET for presentation with business components built in C#.NET. The development project encompasses security, roster, service capture, claims reprocessing, and Remittance Advice (RA) reporting modules.
MAXCapture has a number of business rules embedded in the system that reduces data entry errors and forces the providers to complete the information required to submit Medicaid claims. This reduces the need for follow-up on missing and incorrect information after the receipt of documentation from the providers. Our system performs the Medicaid policy business rules during the data entry by the providers and also during the generation of the Medicaid claim to be submitted to MMIS in HIPAA compliant 837P claim format. The front-end edit rules will eliminate most of the data related issues. During the claim generation process, if there are any failed services that could not be converted to valid Medicaid claims, our system provides a report of these services. This report will be used to follow-up with the providers to complete any missing or inaccurate information. Once the data in the failed service records are corrected, our system generates the claim for the service during the subsequent claim cycle submission.
Because of these capabilities, we believe that our solution using the MAXCapture system provides the best value for the District in maximizing the Medicaid revenues.
We have highly qualified staff that can assist the District in providing information and in providing advice on any Medicaid policy and procedural changes at the Federal and State level.
Sivic Solutions Group (SSG), a ten year old New York based Limited Liability Company offering full service consulting, systems, and operations support and services, that the School Districts can be assured of a well qualified vendor being available to the District staff and providers to assist them in realizing their revenue recovery goals in Medicaid reimbursements. SSG staff are well qualified in Medicaid cost recovery for schools with a demonstrated base of experience with school districts around the country.