Bumpy transition in Medicaid computer system expected

DHHS will launch a new Medicaid claims processing system July 1, and officials said Friday they expect plenty of problems as health care providers learn to use the new system.

Posted 9:21 p.m. Jun 21, 2013 — Updated 9:21 p.m. Jun 21, 2013

Bruce Mildwurf

RALEIGH, N.C. — The state Department of Health and Human Services will launch a new Medicaid claims processing system July 1, and officials said Friday they expect plenty of problems as health care providers learn to use the new system.

The NCTracks system is believed to be the largest government information technology project in state history, and officials tout it as key to Gov. Pat McCrory’s efforts to overhaul Medicaid. But the computer system is launching 23 months late and is tens of millions of dollars over budget, and a state audit released last month criticized advance testing on it.

"We expect, over the first 60 to 90 days, it'll be a rough patch," said Joe Cooper, chief information officer for DHHS. "All of our providers will be learning a brand new system. One of the things we'd hoped for was that we'd have more training that would have taken place by now."

Cooper said at least 80 percent of Medicaid service providers haven't received training on NCTracks in person or online.

"The providers have to take the first step. They've been told about the training," Cooper said. "We've certainly given them ample opportunities to do it."

Providers can still receive training before NCTracks launches, he said, or they can get it once the system is live.

Contractor CSC has expanded its call center, extended its hours and added staff to handle questions and complaints about the computer system. DHHS spokesman Ricky Diaz said some agency managers have canceled vacations to be on hand to assist with problems.

DHHS processes 88 million Medicaid claims each year, handling about $12 billion in payments. Diaz said 1.2 million claims have been run through NCTracks during testing without problem.

DHHS stopped accepting claims under the 25-year-old Medicaid Management Information System on Thursday, and any claims submitted through June 30 will be sent back to providers with a request to refile them after July 1.

NCTracks also will handle claims for state-paid mental health, public health and rural health services.

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