Campus Clinic last month launched a software platform to streamline the payment process for behavioral health services on school campuses.
Campus Clinic, based in Irvine, partners with school districts to provide access to on-campus healthcare for K-12 students ranging from mental health services to outbreak prevention.
Campus Clinic’s Operations and Revenue Suite (ORS) software platform aims to streamline the implementation of the Fee Schedule established by the Children and Youth Behavioral Health Initiative (CYBHI), a five-year, $4.6 billion investment made by the state in 2021.
The Fee Schedule establishes a rate that Medi-Cal and commercial insurance plans must reimburse school-linked providers for behavioral health services.
The Department of Health Care Services (DHCS), in collaboration with the Department of Managed Health Care (DMHC), has also created a separate program under the CYBHI initiative that will provide school districts with grants to become operationally ready for the Fee Schedule.
This is made possible through a $400 million grant that’s divided among 58 counties based on size and population, according to Campus Clinic President Thomas Shaffer.
Campus Clinic hasn’t received any funding as of yet, but is “hopeful” that ORS will become a statewide solution.
“We’re optimistic that they’ll use a portion of that money for the widespread adoption of the ORS platform,” Shaffer told the Business Journal.
First Cohort
The Fee Schedule is being implemented in phases through three cohorts.
It launched its first cohort of school districts in January and applications for the next phase opened this month.
After the third cohort, all schools will be able to join the Fee Schedule on an opt-in basis with registration opening every six months.
Shaffer sees the Fee Schedule as a “sustainable” revenue source for schools.
“I’m feeling really excited about the possibility of sustaining behavioral health services across the state,” he said.
Software Platform
Shaffer said the CYBHI Fee Schedule, while a great opportunity, places an administration burden on schools by making them a healthcare provider like a clinic or hospital.
“Schools don’t really have the software and the infrastructure to be able to handle the complexity of billing all these payers, so that’s where Campus Clinic comes in to fill the gap,” Shaffer said.
Campus Clinic’s software platform has a patient portal for accessing medical records, AI-enabled insurance claims processing and a hub that integrates community providers with existing school counselors.
Shaffer said Campus Clinic is the first to come to market with this kind of solution.
“Campus Clinic is very early in building a platform because this initiative is just being rolled out in schools,” Shaffer said.
Vista Unified School District in San Diego is the first district to implement ORS at its schools, which counts a total of 19,000 students.
