Medicaid Administrative Claiming

PCG works with agencies to administer standalone Medicaid administrative claiming programs in addition to claiming efforts that are part of wider cost allocation plans.

Medicaid administrative reimbursement is available for client-facing activities, including eligibility determinations and care coordination and case management; Medicaid agency functions including those performed by skilled professional medical personnel (SPMP); and other activities performed that are necessary for the proper and efficient administration of the “Medicaid state plan.”

Specifically, PCG has worked to:

  • Implement and operate statewide claiming programs for activities performed by county-based staff on behalf of the state Medicaid agency.
  • Identify and gain approval for Medicaid allowable functions performed by public health agencies.
  • Identify and gain approval for Medicaid allowable activities performed by case workers who work for child welfare and adult protective services agencies who also serve Medicaid eligible clients.
  • Develop processes for claiming costs for integrated eligibility staff, including activities eligible for enhanced Medicaid funding.
  • Develop methodologies for identifying, allocating, and claiming systems costs submitted on Advance Planning Documents (APDs) and coordinating costs with cost allocation plans.


Our Medicaid administrative claiming services include:

  • Review, modification, and negotiation of existing Medicaid claiming programs.
  • Development, negotiation, and implementation of new Medicaid claiming programs.
  • Review and development of inter-agency agreements required to support claiming efforts.
  • Operation and outsourcing of Medicaid claiming programs, often in conjunction with use of AlloTrac™ or EasyRMTS™.
  • Support and hosting for clients that use AlloTrac™ or EasyRMTS™ for Medicaid administrative claiming.
  • Training of staff who administer claiming programs.
  • Focus groups with time study participants.
  • Training of time study participants.
  • Review of administrative claiming reporting on the CMS-64,
  • Assist with other time study platforms used to support claiming.
  • Development and review of procedure manuals.
  • Audit response and support.


Related Products

AlloTrac - 100% Time Tracking Systems

PCG’s proprietary web-based cost tracking tool, AlloTrac is used to track the time of a group of workers where random moment sampling is not feasible. It allows workers to track their time according to specified activities in specified increments. The results are used to allocate the costs of the participating workers.

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EasyRMTS - Random Moment Sampling Software

PCG’s web-based random moment sampling software, EasyRMTS is a proprietary web-based random moment sampling tool that is used to conduct statistically valid random moment time studies (RMTS) of a group of workers. It assigns a user-determined amount of surveys to a group of workers and administers the surveys via email over a sample period. The results are used to allocate the costs of the sampled workers.

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