Under the Dome

Hearing highlights woes with NC Medicaid claims system

Legislators on Monday heard a familiar litany of complaints about the new Medicaid claims system NC Tracks from a group of medical office managers.

The administrators suggested the company running the system set up a user advisory group to help solve problems.

The common themes were:

•  Problems with the call center where people who answer the calls don't know how to help. The lack of knowledge of call center staff "is frightening," said Kimberly Sparks, a practice administrator at Nash OB-GYN Associates of Rocky Mount.

•  Problems with coding.

•  Providers still waiting for payments.

•  Early training sessions that were largely useless.

"How can I tell you in public what a tragic nightmare I've gone through?" said Teresa Oudeh, administrator of a small medical practice in Dunn, who testified at the legislative oversight committee on information technology.

The state switched to a new Medicaid billing system July 1. It was built and is being run by Computer Sciences Corp.

CSC said in a statement it would help the state Department of Health and Human Services if it convenes a user work group, and will continue to provide in-person and online help sessions.

Oudeh said the help she received to resolve problems was very professional. She said most of the problems were the fault of office staff within her own practice.

The help included an on-site visit from Angeline Sligh, the state employee who managed the CSC contract as the system was being built. Sligh went out of her way to make corrections, Oudeh said.

Some new details about the NC Tracks fall-out emerged Monday’s legislative hearing.

About 350 school children in Cabarrus County couldn't get glasses to begin the school year because of problems processing the proper forms. They waited six weeks, said Christina B. Young, administrator at the Cabarrus Eye Center.

The NC Tracks service center has as "five-and-out" policy for problems that can't be solved by call center staff. That second level of trouble shooters will call a provider five times to offer assistance. If there's no contact by the fifth call, the file is closed.

The problem was the trouble shooters were calling late in the workday and not leaving return telephone numbers.

"I don't understand the rationale," said state Rep. George Cleveland, an Onslow County Republican. "It probably makes your statistics look a little bit better."

Joe Cooper, head of IT for the state Department of Health and Human Services, said under a new policy the calls can not go out after 4 p.m., the supervisors must leave a telephone number, and an email will go out to providers after the fourth call.

The path to switching Medicaid claims systems has been long and rocky, stretching back two administrations, said Sen. Andrew Brock, a Davie County Republican and a committee co-chairman.

"It's a monster," Brock said. "As with Frankenstein, we're teaching it some manners."