Count the Johnston County Health Department among the medical providers that faced delays in getting Medicaid reimbursements because of a balky computer system.
NCTracks is the new computer system doctors and other health care providers are using to file Medicaid claims. But since its launch in July, the system hasn’t worked correctly for thousands of health care providers.
From July through October, the Johnston County Health Department couldn’t file any Medicaid claims. By the time the system finally let Johnston in, the health department was sitting on $700,000 in claims, said Steve Strickland, assistant health director.
Strickland noted that Medicaid rarely pays a full claim. So of the $700,000 owed to the health department, Strickland expects Medicaid to pay about $200,000.
After months of waiting on NCTracks, the health department was able to file claims for the first time at the end of October, Strickland said. Since then, the department has received June’s reimbursement and just submitted July’s claims last week. Strickland hopes to be caught up by January.
He estimated the health department could have survived until January without any Medicaid reimbursements thanks to about $1 million in cash reserves. The cushion, Strickland said, allowed the department to continue services without interruption, though things got stressful when the federal government shutdown froze other funding.
“In terms of NCTracks, there have been no clients that we serve being affected by not being paid by Medicaid funds,” Strickland said. “Just a little frustration on behalf of the department to not get paid what you’re normally getting paid for.”
As it turned out, the health department couldn’t file Medicaid claims because NCTracks did not recognize it as a real vendor. Instead, the department was still residing in a testing phase of the new computer system.
But Strickland said the biggest problem was communication with the N.C. Department of Health and Human Services and its NCTracks vendor. Strickland said he, the billing staff and health department director Marilyn Pearson made phone calls that were at first returned but later ignored.
“That was one of the more frustrating pieces, just getting someone to return our phone call,” Strickland said.
But in October, he said, the NCTracks staff finally responded and fixed the glitch.
“In reality, it’s just a communication issue with NCTracks looking into where we were and what needed to occur for us to be able to bill,” Strickland said. “The responsibility was on them to change us from a test agency to an actual live agency.”
NCTracks has had a rocky roll-out across the state, with many health care providers unable to file claims. In October, state lawmakers grilled DHHS Secretary Aldona Wos about the glitches.
Ricky Diaz, a spokesman for DHHS, said the department and vendor CSC have continued to work with the more than 77,000 providers who have to use the system. Though glitch-filled at first, the system is now largely working, he said.
For comparison, in 2012, the old system processed $2.3 billion in Medicaid claims in the three months of July, September and October. This year, NCTracks processed $2.2 billion in claims during those same months.
As for not returning phone calls, “unfortunately, I think it was all too common when NCTracks launched,” Diaz said.
The vendor, he said, didn’t have enough customer-service representatives to handle the number of calls coming in. “So what happened was at the beginning, our wait times at the call center were around an hour, and that is indefensible and was not good customer service,” Diaz said.