Transforming Medi-Cal with Leading Legacy Center

At Leading Legacy Center, we are highly knowledgeable in operating most County Electronic Health Record (EHR) systems. SmartCare, the EHR system widely used by counties across California, is designed to streamline healthcare management and improve patient care in alignment with the CalAIM initiative.

We offer robust medical billing and claiming support to our clients, utilizing advanced systems and tools for data collection, data entry, and financial reporting. Our services include:

• Productivity & Outcomes Reporting: These reports measure the productive time spent with clients, assess clinical staff effectiveness, and identify attendance and engagement patterns among youth. They serve as valuable management tools to evaluate cost, efficiency, and service delivery.
• Timely Claim Reimbursement: Our structured delivery system supports timely claim reimbursements, which are essential for maintaining the flow of income to support service costs.

We are proficient in both time service entry and batch upload entry methods for claim submission. Most providers enter services directly into the EHR, and we conduct reconciliations before submitting invoices. We work closely with your contract analyst or designee to ensure timely invoice processing and follow up on any outstanding balances.

Our SmartCare claiming process involves:

1. Claim Submission: Electronic claim submission through SmartCare, ensuring all necessary information is included.
2. Claim Processing: SmartCare processes claims for completeness and accuracy.
3. Adjudication: Claims undergo an adjudication process to determine approval, denial, or pending status.
4. Follow-Up: Providers can track claim status and address issues or denials through SmartCare’s reporting tools.

If you use a standard electronic health record, Leading Legacy Center can audit each claim within the system and process invoices to ensure adherence to CalAIM and Medi-Cal billing standards. This streamlined process helps healthcare providers efficiently manage claims and receive timely reimbursements.