For finance, billing and compliance staff at county-funded agencies
Your county pays for the care. Then it checks.
How county money reaches your agency.
In California, Medi-Cal (the state’s Medicaid) splits mental health in two. Milder needs go through ordinary health plans. Specialty mental-health care, and much addiction treatment, is run by each of the 58 counties.
So the county plays three roles at once. It is the payer: it contracts agencies like yours, sets their rates and pays them. It passes money through: it claims the state and federal share for each service. And it enforces the rules: it publishes documentation and billing rules, reviews charts, and takes back payment for services that fail.
That is the difference from a private practice. A therapist billing an insurer deals with one company, and a paid claim is usually final. Your agency is paid by a government that answers to the state and federal government, so your money stays provisional.
A clinician delivers a service and writes the note that proves it happened and was needed.
Staff enter it in the county’s system LA uses IBHIS, San Bernardino myAvatar, Riverside ELMR. Each has its own deadline.
The county pays or denies it at the rate for that clinician’s type, up to the contract’s yearly maximum.
The state checks it again and when the state denies a service, the county takes that money back from the agency.
The county reviews charts and can take back payment for any service whose note falls short, sometimes years later.
Year-end some contracts and programs settle what was paid against what was owed, and funders want cost reports.
Where agencies lose money they earned.
Not one big loss: small ones at every step, spread across systems nobody looks at together.
1. Before billing
Where money leaks: Wrong staff type, wrong units, time that can’t be billed, the wrong county.
County claim checkReady to pilot2. After the county pays
Where money leaks: Denials arrive as codes in a file. About half are never worked.
Denial queueReady to pilot3. Looking back over the year
Where money leaks: Services never billed, wrong rates, deadlines missed for good.
Revenue checkReady to pilot4. When the county reviews charts
Where money leaks: Any note that falls short can be taken back, years later.
Audit checkReady to pilot5. At year-end
Where money leaks: Shared costs split without a defensible plan; cost reports due.
Cost reportsReady to pilot
Ready to pilot means built, switched on and tested end to end on our live site with a made-up agency. None has run on a real agency’s files yet. What works today
One set of rules per county, dated.
Each county sets its own rates, deadlines, unit rules and forms, and many agencies bill several. Margent keeps every county fact in one place, each with the exact quote from its source and the dates it applies.
- Los Angeles: the most complete. Contract periods, rate bulletins from 2023-24 to 2026-27, and entry deadlines.
- Riverside and San Bernardino: current contract terms. Older years and some details are marked unknown until a pilot agency’s own contract fills them in.
- The same rules feed every tool, so the check before billing and the look back over the year can’t disagree.
- Only a verified rule can add to a dollar total. Our own readings are labelled as such and can only advise.
Five tools, one per step.
Any time: a look back over a whole year
Revenue checkReady to pilotFinds county money you earned but were never paid, and says what you can still fix and by when.
Before you bill
County claim checkReady to pilotCatches county rule errors on each service before it goes to the county.
After the county pays
Denial queueReady to pilotPuts an owner, a plain reason and a deadline on every denial, so none is forgotten.
Before the county reviews your charts
Audit checkReady to pilotReviews every chart the way a county reviewer would, not just a sample.
Month-end and year-end
Cost reportsReady to pilotSplits shared costs to each contract and drafts the cost reports your funders require.
How a pilot works.
We’re looking for a first agency to run Margent alongside its current process.
A call. We walk through the demo on a fictional agency and your counties.
Paperwork first. A pilot agreement and a BAA (the privacy contract US law requires) are signed before we see any client data.
Your files. Your biller downloads one fiscal year of standard reports and uploads them. We map the columns with you.
The Revenue check. You get the ranked report, with every dollar linked to your rows, and we go through it together.
You decide. Your staff fix what’s worth fixing, in your own systems. Then the other tools run alongside your process.
Price. The Revenue check is free. After that, one flat yearly price set by your agency’s size and agreed in writing before you start. Never a percentage of what we find: Medicaid rules restrict percentage fees, and you shouldn’t have to share money you earned.
How we handle your data.
- A signed BAA before any client data reaches us.
- Only the columns a check needs are kept; the rest of each file is dropped.
- Stored encrypted, in your organization’s own space, open only to people in your organization with the right role.
- Revenue check data is deleted within 90 days, and you get a signed deletion certificate.
- Every report carries a signed receipt saying exactly which files and rule versions produced it.
Questions agencies ask.
Yes. Each county’s rules are kept separately, quoted from that county’s own documents and dated, and every service is checked against the rules of the county responsible for it, for its date. Los Angeles, Riverside and San Bernardino are covered today, in different depth: LA most completely; Riverside and San Bernardino from their current contract terms. For a county or year we haven’t covered, Margent says “unknown” rather than guess from a neighbour.