Student withheld · speech
Student identifier withheld · 2025-04 month · Provider withheld
recoverable
Clean claim packet ready for billing
0 findings · complete
ClaimBridge Audit Packet
Sunshine County School District
FL · Florida Medicaid Certified School Match review profile
pkt_sample-FL · redacted export · generated 8/20/2026, 1:30:35 AM
Use browser print to save as PDF.
Export Manifest
Claim lines
20
Claim batches
3
Findings
26
Evidence links
114
Tasks
26
SLA risk
0 escalated
Packet items
72
Evidence source
evidence graph
Rule version
2026-07-28
Rule evaluations
26
Privacy risk
moderate · 50
Data classes
5
Retention
2555 days
Redacted fields: claimRef, studentId, studentName, serviceDate, rideDate, providerName, routeName, sourceRow.
Privacy disclosure
Redacted export minimizes direct identifiers but is not guaranteed to be fully de-identified.
Residual identifiers: student aliases or withheld placeholders, month-bucketed service and ride dates, service types, financial amounts, finding details and rare service combinations.
Use for routine review sharing; treat as education and health-adjacent operational data.
Governance handling
Data classifications: education record, health adjacent service data, financial remittance data, provider credential, audit evidence.
Retention policy: Review evidence and audit packet retention; retain until 8/18/2033; legal hold eligible.
Executive Summary
Claims reviewed
20
Recoverable revenue
$49,590.00
Revenue at risk
$78,490.00
Transport opportunity
$12,980.00
Florida program grounded in Rule 59G-4.035; individual checks are general practice and not yet mapped to handbook sections. Not legal or billing advice.
Claim Packets
Student withheld · ot
Student identifier withheld · 2025-04 month · Provider withheld
at risk
Required claim fields are missing
3 findings · remediation needed
Student withheld · pt
Student identifier withheld · 2025-04 month · Provider withheld
at risk
Provider credential or billable status needs review
2 findings · remediation needed
Student withheld · counseling
Student identifier withheld · 2025-04 month · Provider withheld
at risk
Required claim fields are missing
4 findings · remediation needed
Student withheld · speech
Student identifier withheld · 2025-04 month · Provider withheld
recoverable
Clean claim packet ready for billing
0 findings · complete
Student withheld · psychology
Student identifier withheld · 2025-04 month · Provider withheld
recoverable
Clean claim packet ready for billing
0 findings · complete
Student withheld · nursing
Student identifier withheld · 2025-04 month · Provider withheld
recoverable
Clean claim packet ready for billing
0 findings · complete
Student withheld · behavioral_health
Student identifier withheld · 2025-04 month · Provider withheld
at risk
Medicaid eligibility is missing or inactive for service date
1 finding · remediation needed
Student withheld · ot
Student identifier withheld · 2025-04 month · Provider withheld
recoverable
Clean claim packet ready for billing
0 findings · complete
Student withheld · speech
Student identifier withheld · 2025-04 month · Provider withheld
at risk
Provider credential or billable status needs review
2 findings · remediation needed
Student withheld · pt
Student identifier withheld · 2025-04 month · Provider withheld
at risk
Provider credential or billable status needs review
1 finding · remediation needed
Student withheld · counseling
Student identifier withheld · 2025-04 month · Provider withheld
at risk
Parental Medicaid billing consent is missing or inactive
3 findings · remediation needed
Findings
critical
Required claim fields are missing
$6,420.00
Required claim fields are missing: Missing Medicaid ID for FL-STU-102 on 2025-04-09.
Remediation: Correct the missing claim fields in the source system, attach supporting documentation, and re-stage the claim before submission.
Evidence: service_logs.csv
warning
Claim does not align cleanly to active IEP service terms
$6,420.00
Claim does not align cleanly to active IEP service terms: IEP window 2025-01-01 to 2025-12-31, session minutes 45, group allowed true. Claim has 60 minutes and group size 3.
Remediation: Compare the billed service against the active IEP service grid and correct either documentation or billing units.
Evidence: service_logs.csv; iep_services.csv
critical
Provider credential or billable status needs review
$5,980.00
Provider credential or billable status needs review: Christine Adams has credential PTA, active window 2025-01-01 to 2025-02-28, and Medicaid billable status true.
Remediation: Verify provider credential status and Medicaid billable designation for the service date before resubmission.
Evidence: service_logs.csv; provider_roster.csv
warning
Claim does not align cleanly to active IEP service terms
$5,980.00
Claim does not align cleanly to active IEP service terms: IEP window 2025-01-01 to 2025-03-31, session minutes 30, group allowed false. Claim has 45 minutes and group size 1.
Remediation: Compare the billed service against the active IEP service grid and correct either documentation or billing units.
Evidence: service_logs.csv; iep_services.csv
warning
Required claim fields are missing
$4,110.00
Required claim fields are missing: Missing procedure code, documentation reference for FL-STU-104 on 2025-04-11.
Remediation: Correct the missing claim fields in the source system, attach supporting documentation, and re-stage the claim before submission.
Evidence: service_logs.csv
critical
Parental Medicaid billing consent is missing or inactive
$4,110.00
Parental Medicaid billing consent is missing or inactive: No active consent record covers FL-STU-104 on 2025-04-11.
Remediation: Obtain or renew parental Medicaid billing consent and attach consent evidence before billing or resubmission.
Evidence: service_logs.csv
critical
Provider credential or billable status needs review
$4,110.00
Provider credential or billable status needs review: Angela Davis has credential LCSW, active window 2025-01-01 to present, and Medicaid billable status false.
Remediation: Verify provider credential status and Medicaid billable designation for the service date before resubmission.
Evidence: service_logs.csv; provider_roster.csv
critical
Medicaid eligibility is missing or inactive for service date
$7,120.00
Medicaid eligibility is missing or inactive for service date: No active Medicaid eligibility snapshot covers FL-STU-108 on 2025-04-15.
Remediation: Verify Medicaid eligibility for the date of service and attach the eligibility snapshot before billing or resubmission.
Evidence: service_logs.csv; eligibility_snapshots.csv
critical
Provider credential or billable status needs review
$5,010.00
Provider credential or billable status needs review: Temporary Contractor has credential SLP-Intern, active window 2025-03-01 to present, and Medicaid billable status false.
Remediation: Verify provider credential status and Medicaid billable designation for the service date before resubmission.
Evidence: service_logs.csv; provider_roster.csv
critical
Provider credential or billable status needs review
$6,190.00
Provider credential or billable status needs review: Christine Adams has credential PTA, active window 2025-01-01 to 2025-02-28, and Medicaid billable status true.
Remediation: Verify provider credential status and Medicaid billable designation for the service date before resubmission.
Evidence: service_logs.csv; provider_roster.csv
critical
Parental Medicaid billing consent is missing or inactive
$4,480.00
Parental Medicaid billing consent is missing or inactive: No active consent record covers FL-STU-112 on 2025-04-17.
Remediation: Obtain or renew parental Medicaid billing consent and attach consent evidence before billing or resubmission.
Evidence: service_logs.csv; parent_consent.csv
critical
Provider credential or billable status needs review
$4,480.00
Provider credential or billable status needs review: Angela Davis has credential LCSW, active window 2025-01-01 to present, and Medicaid billable status false.
Remediation: Verify provider credential status and Medicaid billable designation for the service date before resubmission.
Evidence: service_logs.csv; provider_roster.csv
warning
Claim does not align cleanly to active IEP service terms
$4,480.00
Claim does not align cleanly to active IEP service terms: IEP window 2025-01-01 to 2025-12-31, session minutes 30, group allowed true. Claim has 45 minutes and group size 2.
Remediation: Compare the billed service against the active IEP service grid and correct either documentation or billing units.
Evidence: service_logs.csv; iep_services.csv
warning
Claim does not align cleanly to active IEP service terms
$7,660.00
Claim does not align cleanly to active IEP service terms: IEP window 2025-01-01 to 2025-12-31, session minutes 30, group allowed true. Claim has 45 minutes and group size 2.
Remediation: Compare the billed service against the active IEP service grid and correct either documentation or billing units.
Evidence: service_logs.csv; iep_services.csv
critical
Required claim fields are missing
$7,340.00
Required claim fields are missing: Missing Medicaid ID for FL-STU-106 on 2025-04-21.
Remediation: Correct the missing claim fields in the source system, attach supporting documentation, and re-stage the claim before submission.
Evidence: service_logs.csv
critical
Medicaid eligibility is missing or inactive for service date
$6,980.00
Medicaid eligibility is missing or inactive for service date: No active Medicaid eligibility snapshot covers FL-STU-108 on 2025-04-22.
Remediation: Verify Medicaid eligibility for the date of service and attach the eligibility snapshot before billing or resubmission.
Evidence: service_logs.csv; eligibility_snapshots.csv
warning
Claim does not align cleanly to active IEP service terms
$6,890.00
Claim does not align cleanly to active IEP service terms: IEP window 2025-01-01 to 2025-12-31, session minutes 30, group allowed false. Claim has 30 minutes and group size 2.
Remediation: Compare the billed service against the active IEP service grid and correct either documentation or billing units.
Evidence: service_logs.csv; iep_services.csv
warning
Required claim fields are missing
$6,020.00
Required claim fields are missing: Missing procedure code for FL-STU-111 on 2025-04-24.
Remediation: Correct the missing claim fields in the source system, attach supporting documentation, and re-stage the claim before submission.
Evidence: service_logs.csv
critical
Provider credential or billable status needs review
$6,020.00
Provider credential or billable status needs review: Christine Adams has credential PTA, active window 2025-01-01 to 2025-02-28, and Medicaid billable status true.
Remediation: Verify provider credential status and Medicaid billable designation for the service date before resubmission.
Evidence: service_logs.csv; provider_roster.csv
critical
Parental Medicaid billing consent is missing or inactive
$4,290.00
Parental Medicaid billing consent is missing or inactive: No active consent record covers FL-STU-112 on 2025-04-24.
Remediation: Obtain or renew parental Medicaid billing consent and attach consent evidence before billing or resubmission.
Evidence: service_logs.csv; parent_consent.csv
critical
Provider credential or billable status needs review
$4,290.00
Provider credential or billable status needs review: Angela Davis has credential LCSW, active window 2025-01-01 to present, and Medicaid billable status false.
Remediation: Verify provider credential status and Medicaid billable designation for the service date before resubmission.
Evidence: service_logs.csv; provider_roster.csv
warning
Remittance denial can be remediated
$6,420.00
Remittance denial can be remediated: MISSING_MEDICAID_ID: Recipient Medicaid identifier missing from submitted claim.
Remediation: Resolve the denial reason, attach corrected evidence, and prepare the claim for resubmission review.
Evidence: service_logs.csv; remittance_denials.csv
warning
Remittance denial can be remediated
$4,110.00
Remittance denial can be remediated: MISSING_PROC_CODE: Procedure code is missing or invalid for service.
Remediation: Resolve the denial reason, attach corrected evidence, and prepare the claim for resubmission review.
Evidence: service_logs.csv; remittance_denials.csv
warning
Remittance denial can be remediated
$7,340.00
Remittance denial can be remediated: MISSING_MEDICAID_ID: Recipient Medicaid identifier missing from submitted psychology claim.
Remediation: Resolve the denial reason, attach corrected evidence, and prepare the claim for resubmission review.
Evidence: service_logs.csv; remittance_denials.csv
warning
Remittance denial can be remediated
$6,020.00
Remittance denial can be remediated: MISSING_PROC_CODE: Procedure code is missing from PT claim.
Remediation: Resolve the denial reason, attach corrected evidence, and prepare the claim for resubmission review.
Evidence: service_logs.csv; remittance_denials.csv
warning
Remittance denial can be remediated
$5,010.00
Remittance denial can be remediated: PROVIDER_NOT_BILLABLE: Rendering provider was not enrolled or marked billable for the service date.
Remediation: Resolve the denial reason, attach corrected evidence, and prepare the claim for resubmission review.
Evidence: service_logs.csv; remittance_denials.csv
Transportation Review
Student withheld · Route withheld
Claimable
IEP, ride, and same-day service evidence aligned.
Student withheld · Route withheld
Needs review
No IEP service authorization covers the ride date. Same-day service has critical claimability findings.
Student withheld · Route withheld
Needs review
IEP does not document specialized transportation as a related service. Same-day service has critical claimability findings.
Student withheld · Route withheld
Claimable
IEP, ride, and same-day service evidence aligned.
Student withheld · Route withheld
Claimable
IEP, ride, and same-day service evidence aligned.
Student withheld · Route withheld
Claimable
IEP, ride, and same-day service evidence aligned.
Student withheld · Route withheld
Needs review
Same-day service has critical claimability findings.
Student withheld · Route withheld
Claimable
IEP, ride, and same-day service evidence aligned.
Student withheld · Route withheld
Needs review
Ride log does not show both pickup and dropoff. Attendance record does not support student presence for the ride date. Same-day service has critical claimability findings.
Missing Evidence Checklist
Claim 002 · Student identifier withheld
Required claim fields are missing
Action: Correct the missing claim fields in the source system, attach supporting documentation, and re-stage the claim before submission.
Claim 003 · Student identifier withheld
Provider credential or billable status needs review
Action: Verify provider credential status and Medicaid billable designation for the service date before resubmission.
Claim 004 · Student identifier withheld
Required claim fields are missing
Action: Correct the missing claim fields in the source system, attach supporting documentation, and re-stage the claim before submission.
Claim 008 · Student identifier withheld
Medicaid eligibility is missing or inactive for service date
Action: Verify Medicaid eligibility for the date of service and attach the eligibility snapshot before billing or resubmission.
Claim 010 · Student identifier withheld
Provider credential or billable status needs review
Action: Verify provider credential status and Medicaid billable designation for the service date before resubmission.
Claim 011 · Student identifier withheld
Provider credential or billable status needs review
Action: Verify provider credential status and Medicaid billable designation for the service date before resubmission.
Claim 012 · Student identifier withheld
Parental Medicaid billing consent is missing or inactive
Action: Obtain or renew parental Medicaid billing consent and attach consent evidence before billing or resubmission.
Claim 014 · Student identifier withheld
Required claim fields are missing
Action: Correct the missing claim fields in the source system, attach supporting documentation, and re-stage the claim before submission.
Claim 016 · Student identifier withheld
Medicaid eligibility is missing or inactive for service date
Action: Verify Medicaid eligibility for the date of service and attach the eligibility snapshot before billing or resubmission.
Claim 019 · Student identifier withheld
Required claim fields are missing
Action: Correct the missing claim fields in the source system, attach supporting documentation, and re-stage the claim before submission.
Claim 020 · Student identifier withheld
Parental Medicaid billing consent is missing or inactive
Action: Obtain or renew parental Medicaid billing consent and attach consent evidence before billing or resubmission.
Evidence Index
claim line · claim line 001
1 evidence link · source_row
claim line · claim line 002
6 evidence links · iep_authorization, source_row
claim line · claim line 003
5 evidence links · iep_authorization, source_row
claim line · claim line 004
7 evidence links · source_row
claim line · claim line 005
1 evidence link · source_row
claim line · claim line 006
1 evidence link · source_row
claim line · claim line 007
1 evidence link · source_row
claim line · claim line 008
3 evidence links · eligibility_snapshot, source_row
- service_logs.csv: Clean speech service log linked to claim line 001
- service_logs.csv: OT log missing Medicaid ID linked to claim line 002
- iep_services.csv: OT service in IEP linked to claim line 002
- remittance_denials.csv: Denied for missing Medicaid ID linked to claim line 002
- service_logs.csv: PT claim after IEP service end date linked to claim line 003
- provider_roster.csv: PTA credential expired before service linked to claim line 003
- iep_services.csv: PT service ended before April claim linked to claim line 003
- service_logs.csv: Counseling log missing procedure and documentation reference linked to claim line 004
- provider_roster.csv: Counselor not marked Medicaid billable linked to claim line 004
- remittance_denials.csv: Denied for missing procedure code linked to claim line 004
- service_logs.csv: Group speech service ready for billing linked to claim line 005
- service_logs.csv: Psychology service ready for billing linked to claim line 006
- service_logs.csv: Nursing service ready for billing linked to claim line 007
- service_logs.csv: Behavioral health service ready for billing linked to claim line 008
- eligibility_snapshots.csv: Eligibility inactive before April service linked to claim line 008
- service_logs.csv: OT service ready for billing linked to claim line 009
- service_logs.csv: Speech service with non-billable contractor linked to claim line 010
- provider_roster.csv: Temporary contractor not billable linked to claim line 010
- remittance_denials.csv: Denied speech claim for provider enrollment linked to claim line 010
- service_logs.csv: PT service with expired provider credential linked to claim line 011
- provider_roster.csv: PTA credential expired before service linked to claim line 011
- service_logs.csv: Counseling service with non-billable provider linked to claim line 012
- parent_consent.csv: Consent expired before April service linked to claim line 012
- provider_roster.csv: Counselor not marked Medicaid billable linked to claim line 012
- iep_services.csv: Counseling service in IEP linked to claim line 012
- service_logs.csv: Speech claim exceeds IEP minutes linked to claim line 013
- iep_services.csv: Speech service with specialized transportation linked to claim line 013
- service_logs.csv: Psychology log missing Medicaid ID linked to claim line 014
- remittance_denials.csv: Denied psychology claim for missing Medicaid ID linked to claim line 014
- service_logs.csv: Nursing service ready for billing linked to claim line 015
- service_logs.csv: Behavioral health service ready for billing linked to claim line 016
- eligibility_snapshots.csv: Eligibility inactive before April service linked to claim line 016
- service_logs.csv: OT service ready for billing linked to claim line 017
- service_logs.csv: Speech group size conflicts with IEP terms linked to claim line 018
- iep_services.csv: Speech service in IEP linked to claim line 018
- service_logs.csv: PT log missing procedure code linked to claim line 019
- provider_roster.csv: PTA credential expired before service linked to claim line 019
- remittance_denials.csv: Denied PT claim for missing procedure code linked to claim line 019
- service_logs.csv: Counseling service with non-billable provider linked to claim line 020
- parent_consent.csv: Consent expired before April service linked to claim line 020
- provider_roster.csv: Counselor not marked Medicaid billable linked to claim line 020
- service_logs.csv: OT log missing Medicaid ID linked to review finding 021
- service_logs.csv: OT log missing Medicaid ID linked to review finding 022
- iep_services.csv: OT service in IEP linked to review finding 022
- service_logs.csv: PT claim after IEP service end date linked to review finding 023
- provider_roster.csv: PTA credential expired before service linked to review finding 023
- service_logs.csv: PT claim after IEP service end date linked to review finding 024
- iep_services.csv: PT service ended before April claim linked to review finding 024
- service_logs.csv: Counseling log missing procedure and documentation reference linked to review finding 025
- service_logs.csv: Counseling log missing procedure and documentation reference linked to review finding 026
- service_logs.csv: Counseling log missing procedure and documentation reference linked to review finding 027
- provider_roster.csv: Counselor not marked Medicaid billable linked to review finding 027
- service_logs.csv: Behavioral health service ready for billing linked to review finding 028
- eligibility_snapshots.csv: Eligibility inactive before April service linked to review finding 028
- service_logs.csv: Speech service with non-billable contractor linked to review finding 029
- provider_roster.csv: Temporary contractor not billable linked to review finding 029
- service_logs.csv: PT service with expired provider credential linked to review finding 030
- provider_roster.csv: PTA credential expired before service linked to review finding 030
- service_logs.csv: Counseling service with non-billable provider linked to review finding 031
- parent_consent.csv: Consent expired before April service linked to review finding 031
- service_logs.csv: Counseling service with non-billable provider linked to review finding 032
- provider_roster.csv: Counselor not marked Medicaid billable linked to review finding 032
- service_logs.csv: Counseling service with non-billable provider linked to review finding 033
- iep_services.csv: Counseling service in IEP linked to review finding 033
- service_logs.csv: Speech claim exceeds IEP minutes linked to review finding 034
- iep_services.csv: Speech service with specialized transportation linked to review finding 034
- service_logs.csv: Psychology log missing Medicaid ID linked to review finding 035
- service_logs.csv: Behavioral health service ready for billing linked to review finding 036
- eligibility_snapshots.csv: Eligibility inactive before April service linked to review finding 036
- service_logs.csv: Speech group size conflicts with IEP terms linked to review finding 037
- iep_services.csv: Speech service in IEP linked to review finding 037
- service_logs.csv: PT log missing procedure code linked to review finding 038
- service_logs.csv: PT log missing procedure code linked to review finding 039
- provider_roster.csv: PTA credential expired before service linked to review finding 039
- service_logs.csv: Counseling service with non-billable provider linked to review finding 040
- parent_consent.csv: Consent expired before April service linked to review finding 040
- service_logs.csv: Counseling service with non-billable provider linked to review finding 041
- provider_roster.csv: Counselor not marked Medicaid billable linked to review finding 041
- service_logs.csv: OT log missing Medicaid ID linked to review finding 042
- remittance_denials.csv: Denied for missing Medicaid ID linked to review finding 042
- service_logs.csv: Counseling log missing procedure and documentation reference linked to review finding 043
- remittance_denials.csv: Denied for missing procedure code linked to review finding 043
- service_logs.csv: Psychology log missing Medicaid ID linked to review finding 044
- remittance_denials.csv: Denied psychology claim for missing Medicaid ID linked to review finding 044
- service_logs.csv: PT log missing procedure code linked to review finding 045
- remittance_denials.csv: Denied PT claim for missing procedure code linked to review finding 045
- service_logs.csv: Speech service with non-billable contractor linked to review finding 046
- remittance_denials.csv: Denied speech claim for provider enrollment linked to review finding 046
- evidence-link: Finding evidence for remediation linked to remediation task 047
- evidence-link: Finding evidence for remediation linked to remediation task 048
- evidence-link: Finding evidence for remediation linked to remediation task 049
- evidence-link: Finding evidence for remediation linked to remediation task 050
- evidence-link: Finding evidence for remediation linked to remediation task 051
- evidence-link: Finding evidence for remediation linked to remediation task 052
- evidence-link: Finding evidence for remediation linked to remediation task 053
- evidence-link: Finding evidence for remediation linked to remediation task 054
- evidence-link: Finding evidence for remediation linked to remediation task 055
- evidence-link: Finding evidence for remediation linked to remediation task 056
- evidence-link: Finding evidence for remediation linked to remediation task 057
- evidence-link: Finding evidence for remediation linked to remediation task 058
- evidence-link: Finding evidence for remediation linked to remediation task 059
- evidence-link: Finding evidence for remediation linked to remediation task 060
- evidence-link: Finding evidence for remediation linked to remediation task 061
- evidence-link: Finding evidence for remediation linked to remediation task 062
- evidence-link: Finding evidence for remediation linked to remediation task 063
- evidence-link: Finding evidence for remediation linked to remediation task 064
- evidence-link: Finding evidence for remediation linked to remediation task 065
- evidence-link: Finding evidence for remediation linked to remediation task 066
- evidence-link: Finding evidence for remediation linked to remediation task 067
- evidence-link: Finding evidence for remediation linked to remediation task 068
- evidence-link: Finding evidence for remediation linked to remediation task 069
- evidence-link: Finding evidence for remediation linked to remediation task 070
- evidence-link: Finding evidence for remediation linked to remediation task 071
- evidence-link: Finding evidence for remediation linked to remediation task 072