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Local

Problems reported with new Medicaid billing system

By Lynn Bonner - lbonner@newsobserver.com

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July 01, 2013 08:19 PM

State officials got the bumpy start Monday that they predicted with the new system that pays health care providers for Medicaid services.

WakeMed in Raleigh said the new system was working intermittently, or “going in and out.” Other providers who had gone through the department’s training program said they weren’t able to log in.

Sen. Jeff Tarte, a Republican from Cornelius, was told Monday that a software problem prevented providers who didn’t arrange in advance to use the system from signing on. The problem was with the portal and not the claims- processing system, said Tarte, vice-chairman of the Senate Health Care Committee. Other providers were having their claims approved swiftly, he said.

The state Department of Health and Human Services, which oversees Medicaid and its claims-payment system, said in a statement that “these types of issues are to be expected” during the transition from the retired system the state had been using for 35 years to the new program.

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State officials have said for weeks that they expected “bumps in the road” as they cranked up the new billing system and set up an around-the-clock response team to work on them.

The response team is resolving problems as quickly as possible, the DHHS statement said.

When it gets to full speed, the system will send about $13 billion in payments each year to more than 70,000 health care providers. Computer Sciences Corp. has a $484 million contract to build and operate the system through 2020.

The Medicaid office had been holding onto claims for about a week between the shutdown of the old system and the start of the new.

The new system successfully processed more than 424,700 backlogged pharmacy claims early Monday morning, DHHS reported.

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