OCMD_Student Medical Services & Medi-Cal Programs

  • LEA Medi-Cal Billing Option

  • LEA Collaborative Board

  • School Medi-Cal Administrative Activities

  • SMAA/RMTS Step by Step Guides

  • Medi-Cal Reimbursement Programs

    Medi-Cal Reimbursement Programs logoMedi-Cal Program staff manage the LAUSD participation in:

    • The Local Education Agency Medi-Cal Billing Option Program (LEA BOP)
      • Reimbursement is claimed for students who are Medi-Cal eligible and have been provided Medi-Cal covered health services
      • Reimbursement dollars are reinvested in health services and support for students and families


    • The School Medi-Cal Administrative Activities (SMAA) Program-Random Moment Time Survey (RMTS)
      • Selected staff are surveyed to determine the amount of time spent enrolling students in Medi-Cal insurance,referring students to Medi-Cal covered health and mental health services, and coordinating care of studentswho are Medi-Cal enrollees
      • The federal share of reimbursable costs comes to LAUSD without restriction for use in the general fund tobenefit students


    • Third Party Reimbursement under Medi-Cal or other local, state or federal programs through services provided at the District’s school-based health and mental health clinics


    Types of Services

    • Claims preparation and reconciliation for the LEA Billing Option Program, invoicing for the SMAA program, and billing of third-party payers
    • Quality review of Medi-Cal and third party claims
    • Program and policy development for participation in Medi-Cal Programs
    • Roster development and coding for the SMAA / RMTS Program
    • Audit preparation and support