Apollo Claims
School-based Medicaid billing · New York State
Every claim your district submits should be able to explain itself.
Apollo Claims helps New York school districts turn IEP-mandated health services into Medicaid claims that carry their own evidence — eligibility, consent, orders, provider qualifications, and session documentation, assembled and verified before anything is billed.
Money left on the table is a documentation problem
School Medicaid is one of the largest federal funding streams available to districts — and one of the most under-collected, almost always for the same reason: the paperwork behind the claim was incomplete, or the claim was never filed at all.
$4–6 billion
paid by Medicaid to school districts nationally each year for school-based services.
U.S. Dept. of Education & CMS, 2024
$431 million
in special-education Medicaid reimbursement New York City schools failed to collect in just two years — for lack of documentation or claims never filed, per a July 2026 Comptroller audit.
NYC Office of the Comptroller, as reported by The New York Times, July 2026
Six times
more likely: students’ use of mental-health care when services are offered at school. This funding reaches children where they are.
U.S. Dept. of Education & CMS, 2024
What we do
Document
Make the record complete
Therapists and nurses log sessions in minutes — service, time, and progress note — while the details that belong to billing are drawn from the IEP mandate automatically. Missing consent, lapsed orders, and expiring licenses surface before they become repayment findings.
Verify
Check every claim against the rules
Each session is validated against a published library of compliance rules. Every rule cites its source — the SSHSP handbook, NYSED guidance, federal regulation — and every block explains itself in plain language, with the document one click away.
Defend
Keep the proof, permanently
When a claim is created, the evidence behind it is preserved exactly as it stood — and a complete audit binder for any claim can be produced on demand: the record an auditor asks for, ready before they ask.
How it works
One billing cycle, five steps, each visible to the people responsible for it.
- 1
Providers document services
Clinicians record each session with the detail New York requires. The system fills in what the IEP already knows.
- 2
Problems surface early
Anything that would block billing is flagged the day it happens — with the reason, the source, and where to fix it.
- 3
Validated sessions become claims
A coordinator gathers the month’s clean sessions into a batch. The evidence behind every session is sealed at that moment.
- 4
The district submits
A guided checklist walks an authorized staff member through filing with eMedNY using the district’s own credentials.
- 5
Outcomes are worked, not filed away
Payments post against the claim. Denials arrive as a worklist in plain English, with a path to correct and rebill.
Filing, without the burden
Ask a district why reimbursement lags and the answer is rarely a mystery — the filing itself is the wall. Codes, rate schedules, transmission formats, a state portal, and no room for error. So claims wait, and waiting becomes forfeiting.
Apollo removes everything from that wall except the one act that should remain with the district: an authorized person pressing submit. By the time a batch reaches filing, every session in it has already passed validation, the export is generated, and a four-step checklist walks your staff member through eMedNY — no billing expertise required. The submission is timestamped, the outcome is tracked, and a denial comes back as a plain-English worklist item with a path to correct and rebill.
Filing a batch
- 1Download the prepared claim file — already validated, already reviewed
- 2Sign in to ePACES with your district’s own credentials
- 3File the batch following your district’s procedure
- 4Mark it submitted — the audit trail and outcome tracking take over
About five minutes, once you’ve done it before. If you can follow four numbered steps, you can file.
Our compliance posture
School Medicaid billing is audited years after the fact, and the district — not the vendor — answers for it. We build accordingly.
Nothing in Apollo is a black box. The rules that block or allow a claim are published inside the platform, versioned, and traceable to the regulatory documents they come from. Your coordinator can read every one, and their review — not our say-so — is what approves a rule for production use.
A maintained regulatory library
More than a hundred authoritative documents — handbooks, alerts, companion guides, federal guidance — collected from official sources, checksummed, and kept alongside the rules that cite them.
Honest about readiness
We state plainly which review gates are complete and which are not, and production claim submission stays disabled until qualified review, counsel, and eMedNY certification are done.
The district stays in control
Claims are filed with district credentials by authorized staff. We never hold your eMedNY login, and every claim-affecting action is written to a permanent audit log.
Working with us
We are working with New York districts through structured pilots: synthetic data first, your coordinator verifying our rule interpretations against the handbook, and a documented path through the state’s enrollment and certification requirements before a single real claim is filed. If that sounds like the right pace for something that carries audit risk, we should talk.
Contact us