Medicaid Integration

SameGoal's Medicaid integration allows districts to automatically transfer information nightly from SameGoal to their third-party Medicaid billing software system.

• Generic API CSV Files
• General Considerations
• Medicaid Billing Providers

Generic API CSV files link

• students.csv
• ieps.csv
• goals.csv
• objectives.csv
• relatedservices.csv
• transportation.csv
• personalcareservices.csv
• nursing.csv
• instructionalaccommodations.csv
• prescriptions.csv
• referrals.csv
• consent.csv

students.csv link

• This file includes one row for every student in the LEA's SameGoal environment.
• By default, results are not filtered by whether the student is currently participating in Special Education because students should be included in the integration:
  • Before they are found eligible, such that evaluation services that are SHARS reimbursable can be documented.
  • After they exit, so their information remains available for past documented SHARS services & historic reference.
• By default, results are not filtered by students' district enrollment status (e.g. enrolled, withdrew, dropped out, etc) so that their information remains available for past documented SHARS services & historic reference.
• Fields:
  • Student ID. Student ID number (eg 555555).
  • State Reporting ID. Student state reporting ID number.
  • Last Name. Student last name.
  • First Name. Student first name.
  • Date of Birth. Student date of birth (MM/DD/YYYY).
  • Gender. Student gender (enum: 'female', 'male').
  • Grade. Student grade.
  • Address. Student address.
  • City. Student city.
  • State. Student state.
  • Zip. Student zip.
  • Building ID. Building ID number.
  • Building. Building name.
  • District Enrollment. Student's enrollment status at the district (enum: 'Pre-Enrolled', 'Enrolled', 'Transferred', 'Withdrew', 'Dropped Out', 'Graduated', 'Inactive')
    • lightbulb Tip
      'Pre-Enrolled' and 'Enrolled' statuses are considered active, all others are considered inactive.
  • Program Participation. Student's participation status in Special Education (enum: 'Not Participating', 'Eligibility Review', 'Participating')
    • lightbulb Tip
      'Eligibility Review' refers to students who have been referred but are not yet deemed eligible/ineligible.

ieps.csv link

• This file includes one row for each IEP marked complete in SameGoal.
• An IEP in SameGoal is a document created using the "Individualized Education Program" form.
• Fields:
  • Document ID. Unique document ID for IEP.
  • Student ID. Student ID number (eg 555555).
  • IEP Meeting Date. IEP meeting date (MM/DD/YYYY). Primary date used to filter results.
  • IEP Start Date. IEP effective start date (MM/DD/YYYY).
  • IEP End Date. IEP effective end date (MM/DD/YYYY).
  • Primary Disability. Two-digit disability code per TSDS C053.
  • Secondary Disability. Two-digit disability code per TSDS C053.
  • Tertiary Disability. Two-digit disability code per TSDS C053.

goals.csv link

• This file includes one row for each goal of an IEP.
• An IEP in SameGoal is a document created using the "Individualized Education Program" form.
• Fields:
  • Goal ID. Unique goal ID.
  • Document ID. Document ID of IEP this goal is linked to.
  • Student ID. Student ID number (eg 555555).
  • IEP Meeting Date. IEP meeting date (MM/DD/YYYY). Primary date used to filter results.
  • Start Date. Goal start date (MM/DD/YYYY).
  • End Date. Goal end date (MM/DD/YYYY).
  • Goal Number. Number of annual goal.
  • Goal Type. Goal type, if applicable (enum: 'Academic', 'Functional').
  • Goal Area. Goal area.
  • Goal Text. Annual goal text.

objectives.csv link

• This file includes one row for each objective (of each goal) within an IEP.
• An IEP in SameGoal is a document created using the "Individualized Education Program" form.
• Fields:
  • Objective ID. Unique objective ID.
  • Goal ID. Goal ID of goal this objective is linked to.
  • Document ID. Document ID of IEP that this objective and (corresponding goal) is linked to.
  • Student ID. Student ID number (eg 555555).
  • IEP Meeting Date. IEP meeting date (MM/DD/YYYY). Primary date used to filter results.
  • Objective Number. Number of objective.
  • Objective Text. Objective text.

relatedservices.csv link

• This file includes one row for each related service indicated in an IEP.
• An IEP in SameGoal is a document created using the "Individualized Education Program" form.
• This file does include services not billable for Medicaid.
• This file does not include transportation, personal care services or nursing (specified in separate, dedicated files).
• Fields:
  • Service ID. Unique related service ID.
  • Document ID. Document ID for IEP this related service is linked to.
  • Student ID. Student ID number (eg 555555).
  • IEP Meeting Date. IEP meeting date (MM/DD/YYYY). Primary date used to filter results.
  • Service Code. State reporting service code, if applicable. See 41163 StudentSpecialEdProgramAssociationExtension. Enum:
    • 'Assistive technology'
    • 'Audiological services'
    • 'Counseling services'
    • 'Medical diagnostic services'
    • 'Occupational therapy'
    • 'Orientation and mobility training'
    • 'Physical therapy'
    • 'Psychological services'
    • 'Recreation'
    • 'School health services'
    • 'Social work services'
    • 'Speech therapy'
    • 'Transportation'
    • 'Interpreting services-oral transliteration'
    • 'Interpreting services-CUED language transliteration'
    • 'Interpreting services-sign language transliteration'
    • 'Interpreting services-sign language interpreting'
    • 'Interpreting services-CART'
    • 'Interpreting services-c-print'
    • 'Interpreting services-type well'
    • 'Interpreting services-deaf-blind interpreting'
  • Related Service. Description of related service.
  • Start Date. Service start date (MM/DD/YYYY).
  • End Date. Service end date (MM/DD/YYYY).
  • Duration GenEd. Time (in mins) in general education setting.
  • Duration Sped. Time (in mins) in special education setting.
  • Frequency Number. Number of times the service should occur within a given interval (enum: '1x', '2x', '3x'..... '10x').
  • Frequency Interval. Service frequency interval (enum: 'daily', 'weekly', 'every 2 weeks', 'every 3 weeks', 'every 4 weeks', 'every 6 weeks', 'every 9 weeks', 'monthly', 'per 6 week grading period', 'per 9 week grading period', 'per semester', 'per term', 'annually')
  • Location. Service location.
  • Goal Numbers. Goal number(s) service relates to in IEP.

transportation.csv link

• This file includes one row for each date range of special transportation indicated in an IEP.
• An IEP in SameGoal is a document created using the "Individualized Education Program" form.
• A student may have multiple date ranges of transportation in an IEP (eg school year versus summer).
• Fields:
  • Transportation ID. Unique transportation ID.
  • Document ID. Document ID for IEP linked to this transportation.
  • Student ID. Student ID number (eg 555555).
  • IEP Meeting Date. IEP meeting date (MM/DD/YYYY). Primary date used to filter results.
  • Start Date. Transportation start date (MM/DD/YYYY).
  • End Date. Transportation end date (MM/DD/YYYY).
  • Specially Adapted Vehicle. Whether the student needs a specially adapted vehicle (enum: 'Yes', 'No')
  • PCS. Whether the student needs personal care services on the bus (enum: 'Yes', 'No')

personalcareservices.csv link

• This file includes one row for each personal care services activity indicated in the IEP.
• An IEP in SameGoal is a document created using the "Individualized Education Program" form.
• Fields:
  • PCS ID. Unique personal care services ID.
  • Document ID. Document ID for IEP.
  • Student ID. Student ID number (eg 555555).
  • IEP Meeting Date. IEP meeting date (MM/DD/YYYY). Primary date used to filter results.
  • Start Date. Personal care activity start date (MM/DD/YYYY).
  • End Date. Personal care activity end date (MM/DD/YYYY).
  • Type. Type of personal care activity (enum: 'ADL', 'IADL').
  • Activity. Personal care activity.

nursing.csv link

• This file includes one row for each skilled nursing task indicated in the IEP.
• An IEP in SameGoal is a document created using the "Individualized Education Program" form.
• Fields:
  • Nursing ID. Unique nursing ID.
  • Document ID. Document ID for IEP.
  • Student ID. Student ID number (eg 555555).
  • IEP Meeting Date. IEP meeting date (MM/DD/YYYY). Primary date used to filter results.
  • Start Date. Task start date (MM/DD/YYYY).
  • End Date. Task end date (MM/DD/YYYY).
  • Task. Skilled nursing task.

instructionalaccommodations.csv link

• This file includes one row for each instructional accommodation documented in an IEP.
• Fields:
  • Accommodation ID. Unique accommodation ID for accommodation.
  • Document ID. Document ID of IEP linked to this accommodation.
  • Student ID. Student ID number (eg 555555).
  • IEP Meeting Date. IEP meeting date (MM/DD/YYYY). Primary date used to filter results.
  • Subject. Subject accommodation applies to.
  • Accommodation. Instructional accommodation.
  • Start Date. Accommodation start date (MM/DD/YYYY).
  • End Date. Accommodation end date (MM/DD/YYYY).

prescriptions.csv link

• This file includes one row for each prescription documented for a given student.
• A prescription in SameGoal is a document created using the following forms:
  • "Prescription - Physical Therapy" form
  • "Prescription - Occupational Therapy" form
• Fields:
  • Document ID. Unique document ID of prescription.
  • Student ID. Student ID number (eg 555555).
  • Prescription Date. Date of prescription (MM/DD/YYYY). Primary date used to filter results.
  • Related Service. Related service the prescription is for (enum: 'Physical therapy', 'Occupational therapy').
  • NPI. National provider identifier (NPI).

referrals.csv link

• This file includes one row for each referral documented for a given student.
• A referral in SameGoal is a document created using the following forms:
  • "Referral - Audiological Services" form
  • "Referral - Speech Therapy" form
• Fields:
  • Document ID. Unique document ID of referral.
  • Student ID. Student ID number (eg 555555).
  • Referral Date. Date of referral (MM/DD/YYYY). Primary date used to filter results.
  • Related Service. Related service the referral is for (enum: 'Speech therapy', 'Audiology').
  • NPI. National provider identifier (NPI).
  • TPI. Texas provider identifier (TPI).

consent.csv link

• This file includes one row for each consent documented for a given student.
• A consent in SameGoal is a document created using the "SHARS Notice and Consent" form.
• Fields:
  • Document ID. Unique document ID for consent.
  • Student ID. Student ID number (eg 555555).
  • Consent Date. Date medicaid consent was granted or refused (MM/DD/YYYY). Primary date used to filter results.
  • Consent Granted. Indicates whether Medicaid consent was granted (enum: 'Yes', 'No'). Refusal is indicated by N.

General Considerations link

• Integration overview
• Completed requirement
• Original IEPs undergoing correction
• IEP review other than annual review
• IEP amendment
• Deleted documents
• Integration timeframe
• Optional service capture in SameGoal

Integration overview link

This integration includes IEPs, prescriptions, referrals and SHARS consents in which their primary date is on or after a specified "cutover" date.

• Information included in the integration is not limited by a student's current Medicaid eligibility status, which can change frequently.
• Related services included are not limited to those billable through Medicaid, such that service capture can be completed for both billable and non-billable services alike.

Completed requirement link

In order for information from an IEP, prescription, referral or SHARS consent to be included in the integration, the respective document must be marked complete in SameGoal.

Original IEPs undergoing correction link

Only IEPs marked complete in SameGoal will be included in integration. If an original IEP was marked complete for some time, then re-marked incomplete to fix an error, the IEP should be re-marked completed as soon as possible. If an IEP was formerly complete, then is incomplete at the time the next integration extract is run, the IEP and corresponding information will be dropped/not included in this integration run.

IEP review other than annual review link

From time to time, an IEP must be reviewed for a reason other than an annual review (eg a teacher requests review, a manifestation determination review requires a BIP is added, etc). A user must choose to initiate a "Review other than annual review" within SameGoal, which creates/initiates a new version of the IEP which is now incomplete to allow edit access.

While this review is being completed, the integration will pull IEP information from the most recent, completed version of the IEP (eg the version completed just before the review). At the point the IEP is re-marked complete, the integration will pull from the most recent, completed version of the IEP (which is now fully up-to-date).

IEP amendment link

From time to time, an IEP amendment is required. A user must choose to "Amend" the IEP within SameGoal, which creates/initiates a new version of the IEP which is now incomplete to allow edit access.

While an amendment is being completed, the integration will pull IEP information from the most recent, completed version of the IEP (eg the original, or most recent prior amendment). At the point the IEP is re-marked complete, the integration will pull information from the most recent amendment.

Deleted documents link

If a document is marked deleted in SameGoal, it will not be included in and/or will be dropped from the integration. Integration only includes non-deleted, complete documents.

Integration timeframe link

Integration records pull from all documents authored in SameGoal by default. However, district administrative users may specify a "cutover" start date, which limits data returned to records whose primary date is on or after this date.

Optional service capture in SameGoal link

Districts may optionally log services in SameGoal, and export these service logs to their Medicaid vendor. In this workflow, an additional servicelog.csv will be exported. Learn more

Medicaid Billing Providers link

SameGoal integrates with district medicaid billing providers.

• SameGoal sends special education data nightly to provider's SFTP server.
• Provider places a medicaid IDs file regularly on their SFTP server for SameGoal consumption.

District integration setup link

Typical setup process:

• District signs a data sharing agreement. Agreement is sent on to provider.
• District confirms data feed from their prior Special Programs vendor has ceased.
• SameGoal assists district in configuring a data export in the SameGoal web application.
• District staff member accepts associated API account TOS.
• Data flows the next night to the provider's SFTP account.

Provider integration setup link

Typical setup process:

• Provider approves data sharing agreement for use with joint clients.
• Provider confirms the API files to include in the nightly integration.
• Provider creates an SFTP account on provider's server for SameGoal.
  • Due to security considerations, SameGoal uses public key authentication exclusively.
  • During account provisioning, please install SameGoal's public key.

Recommended directory structure:

• /upload/[6-digit district ID]/
  • SameGoal creates and writes to subdirectories in /upload/
  • Each subdirectory is named according to the LEA's 6-digit district ID
  • CSV files in each subdirectory are overwritten nightly
• /download/[6-digit district ID]/
  • Provider creates and writes to subdirectories in /download/
  • Each subdirectory is named according to the LEA's 6-digit district ID
  • Provider places an updated medicaid IDs file regularly in each subdirectory
    • Filename: medicaidids.csv
    • Columns:
      • Student ID: Local ID for student
      • Medicaid ID: Medicaid ID for student; leave blank if none