Raleigh, N.C. — Three weeks after the state implemented a new system for handling Medicaid claims, the Department of Health and Human Services has started to cut checks for exasperated providers who complain that they aren't being paid for services provided.
The NCTracks system replaced a decades-old Medicaid claims system, and providers have said it is now more cumbersome to file claims and that reimbursements aren't being received.
Joe Cooper, chief information officer for DHHS, said Wednesday that the agency is temporarily waiving its requirement that all reimbursements be made electronically so that providers having trouble with the electronic transfers can get paid and officials can correct any mistakes in routing electronic payments.
"We're going to send paper checks to them and give them another week or so to get the EFT number correct," Cooper said. "This is about a week's process."
There was no immediate word on how many claims are pending and how much cutting the checks will cost the state.
Cooper said NCTracks has successfully handled more than 13 million claims already, paying out more than $470 million.
"We're making great progress," he said. "We have a team of people that are calling every day to providers that are having issues (with filing claims)."
T'jana Love, who works at Woodhaven Rest Home in Enfield, said she hasn't been paid since July 7, and the facility blames the payroll delay on NCTracks.
"Because of this new system, it is very doubtful that Woodhaven will receive any Medicaid reimbursement for any of the clients we serve," operators said in a July 17 memo to employees. "If this happens, Woodhaven would have to delay payroll until Medicaid payments are received by the state."
Cooper said Woodhaven is among the providers who haven't set up an account properly to accept electronic reimbursements. Although staff has been added and hours extended at the call center, the average wait time remains more than 30 minutes.
"We're going provider by provider, listening to their issues and addressing them," he said. "We get them on the phone, and we work through them. Then, it's usually pretty straightforward getting their problems resolved."
DHHS officials said Woodhaven's problem has been resolved, but Cooper recommended that providers in a similar position work with customer service at NCTracks to resolve payment problems.
"We said (it would take) 30 to 90 days to work through this, and it will be 30 to 90 days," he said. "Other states have taken a year."
Meanwhile, Love said she cannot walk out on her patients, even if it means difficulty making ends meet.
"My brain is telling me to leave, but my heart says stay. So, I got to go with my heart," she said. "I'll have to borrow money to pay my bill. If not, my lights will be cut out on the 29th."