SSG services in Health and Human Services include Federal claiming and regulatory compliance, cost allocation, rate setting, and financial and regulatory healthcare consulting in Medicaid, Title IV-E, CHIP, TANF, SSI, Medicare, and a wide range of block grant funding areas. Our consulting experience includes revenue management services in mental health, child welfare, developmental disability, child care, juvenile justice, and drug and alcohol services. SSG has found that proposed changes in state plans, waiver requests, and other required regulatory documents often attract considerable attention and interest from State and federal officials. We approach the governing federal officials in a cooperative partnership, and do not place our client in any undue risk of future disallowances. Our Team’s comprehensive programmatic and revenue recovery understanding, our experience in other states and our knowledge of what it takes to operate and manage state programs will result in innovative, adaptable, and effective designs. Our Staff: Our team of consultants has delivered services to more than 20 states over the above program areas, resulting in obtaining and protecting hundreds of millions of federal recoveries.
Our Systems: We offer our state-of-the art web-based HIPAA compliant Medicaid Administrative Claiming System (MACS), which collects observation data from program participants using Random Moment Time Studies (RMTS) or Total Time Accounting methods, and offers end-to-end functionality, from collecting roster data to generating the Administrative Claim. Our Price: We offer the lowest prices in the industry, while obtaining maximum revenues and protection for our clients. SSG ensures that the possibility of disallowances is minimized by working cooperatively with federal officials, in conjunction with client staff, and by designing an effective quality assurance program with detailed quality control measure to ensure compliance. Given our quality control approaches and conservative design, we implement programs with minimal or no negative audit findings. It does no good to have a very aggressive project design if the federal oversight agency will not approve the claiming methodology or disallows claims sometime in the future.offers turn-key full service solution for Medicaid Administrative Claiming for School Districts and state-wide services. We rely on the experience of our staff to make sure that adjust for changing federal requirements can change over time, sometime explicitly with very clear expectations, and other times, vaguely with interpretations that must be made by the State using other states’ audits and telephone conversations with federal officials.
We also utilize our Sivic Automated Child Welfare Eligibility System (SACWES) system, a Title IV-E and Medicaid data warehousing and reporting system. This system collects and maintains client eligibility, performs detailed claim analysis and development, develops client eligibility allocations, and provides responsive and timely ad hoc reporting.
Revenue Enhancement
SSG brings a renewed energy, fresh ideas, and a conservative approach to our clients. Our staff have extensive experience in the assessment and documentation of social service federal claiming processes to increase federal revenues and put in place the processes to ensure the increased revenue is protected.
Revenue Management Compliance
Assuring compliance with all applicable federal requirements is of the utmost importance to the success of federal programs. Over the past few years, CMS, ACF, and the federal Office of Inspector General (OIG) have been much more active in their oversight role, with particular emphasis being placed on Title IV-E and Medicaid administration, Medicaid Rehabilitative Option, and TCM claiming. SSG conducts compliance reviews and analysis, and assists States prepare for and manage the federal audit process.