Explaining Parental Consent for Medicaid Billing

Roadblock to Obtaining Consent:

Often, parents are surprised when they are asked during a school meeting if they will grant consent to release their child’s information to Medicaid for billing purposes. The timing and setting seems unexpected for that type of request, and the explanation for why consent is necessary may be confusing or unclear, causing the parent to deny consent.

Tips for Explaining Medicaid Consent to Parents:

Explain that Medicaid allows school districts to submit claims for related services that are included in a Medicaid eligible student’s IEP. By providing written consent, parents can help the district receive reimbursement funds, which help offset the cost of providing services in a school setting

Explain that it is only necessary for the district to obtain parental consent to bill Medicaid one time during the student’s educational experience at that district, which is why the district may request consent during registration or at another meeting the parent attends.

Explain that the district requests Consent to Bill Medicaid from all students, and the majority of staff are not aware which students are eligible and which are not.

Assure parents that signing the consent form will not impact family benefits in any way, and will not limit lifetime coverage, increase premiums, or lead to the discontinuation of benefits.

Emphasize that the district understands that medical and health information is personal, and protecting that information is important. Assure parents that limited student information is disclosed and that the District follows HIPAA and FERPA requirements for maintaining the confidentiality of all medical and health information for the students and families they serve.

Assure parents that if they give consent to share their child’s information with Medicaid, they also have the right to revoke consent at any time (but any services provided prior to revocation of consent will still be billed to Medicaid). Provide all parents with the district contact information where parents may call to change their decision regarding consent.

Accept a parent's decision if they choose not to grant consent to share information with Medicaid. Assure parents that their child will receive the services listed in the IEP, whether consent is granted or not.

Other Strategies To Increase Parental Consent Compliance:

  • Show parents pictures of projects, such as a new sensory room, that were completed due to Medicaid reimbursement funds.
  • To build confidence with providers who will be explaining the consent form to parents, role play the conversation and explanation for why consent is requested.
  • For initial referrals, have a psychologist of social worker contact the parent to give advanced notice that a consent decision will be requested and explain why.
  • Include the Consent to Bill form consent in the district’s registration packet. Follow up on the Consent forms marked “no” and reach out to parents to provide education.
  • Review the denied consent cases on an annual basis. Reach out to parents who have children actively receiving services to educate and ask for consent again.
If you have questions on Medicaid billing within your district, contact our Medicaid Success Specialists to learn about EmbraceDS®!

Subscribe Here!

Ready for a Quick 5 Minute Conversation?