Medicaid and
Medicare Billing
Cloud-Based Medicaid Billing Software
Built for Case Management and
Wraparound Services
Bill Smarter. Stay Compliant. Get Paid Faster.
PlanStreet’s Medicaid and Medicare billing software is purpose-built for human services, behavioral health, and case management organizations. Whether you’re billing for wraparound services, targeted case management, or integrated care, PlanStreet streamlines your entire reimbursement process from eligibility checks to payment reconciliation.
With PlanStreet, you can:
Generate accurate, compliant claims using real-time service data
Automate EDI 837 (claim submission), EDI 835 (payment remittance)
Verify Medicaid eligibility and track authorizations within the same system
Get full visibility into the claims lifecycle through interactive dashboards
Improve cash flow with fewer rejections and faster payments
What is PlanStreet’s Medicaid & Medicare Billing System?
PlanStreet’s cloud-based Medicaid billing system integrates billing directly into your case management workflows. No more disconnected software or redundant data entry, just real-time service documentation converted into compliant, ready-to-submit claims.
You can run Medicaid eligibility checks, apply payer-specific billing rules, manage authorization limits, and automate EDI file submissions (837, 835) all from a secure, centralized platform. Our embedded analytics (powered by Microsoft Fabric, formerly Power BI) gives you a real-time window into every claim’s journey from submission to payment.
Why Public Payer Billing is Complicated.
If you’ve ever struggled with Medicaid or Medicare
reimbursements, you know the frustration of denied claims,
confusing codes, and manual data errors.
Top challenges include:
Rejected claims due to incorrect codes, missing authorizations, or eligibility issues.
Confusion around Medicare and Medicaid billing codes or billing units
Limited visibility into claim statuses and remittance information
Disconnected systems requiring duplicate entries
Lack of tracking for time-based or encounter-based billing.
PlanStreet’s Medicare and Medicaid billing software eliminates these barriers by automating compliance checks, syncing with service delivery, and simplifying the entire claims lifecycle.
Key Features of PlanStreet’s Billing Tools
Real-Time Service
Capture
Capture billable services as they happen, directly in the client’s case file, no delays or missed entries.
Payer-Specific
Logic
Apply the right codes, units, modifiers, and prior authorization rules based on each payer’s requirements.
EDI File Automation
837, 835
Easily generate and manage EDI 837 (claims), EDI 835 (remittance), ensuring seamless electronic billing and payment tracking.
Eligibility and Authorization
Management
Check Medicaid eligibility and manage service authorizations before billing, minimizing errors and rejections.
Billing by
Increments
Bill services based on your program’s reimbursement model whether that’s per 15 minutes, per session, or daily units.
Batch Claim
Submission
Submit multiple claims in a single batch with ease, ideal for high-volume service providers.
Denial Management
and Resubmission
Easily identify, correct, and resubmit denied claims without ever leaving the platform.
Claims Lifecycle
Reporting & Dashboards
Track each claim through submission, remittance, and reconciliation with real-time dashboards powered by Microsoft Fabric.
Why It Matters for Human Service Providers
For organizations that rely on Medicaid billing for case management or wraparound service supports, accuracy and automation are critical to sustainability.
PlanStreet empowers your team to:
Capture every reimbursable service
Submit claims faster and more accurately
Reduce administrative overhead
Maximize Medicaid and Medicare reimbursement
Strengthen compliance and audit readiness