Providers complain about new Medicaid claims system
Posted July 15, 2013
Raleigh, N.C. — North Carolina's new system for handling Medicaid claims is causing problems for providers, who say filing claims is more cumbersome and they often aren't paid in a timely manner.
The $480 million NCTracks system launched two weeks ago, replacing a 35-year-old computer system in what has been described as the largest information technology project in state history.
Joe Cooper, chief information officer for the state Department of Health and Human Services, predicted a rough transition, but he said Monday that things have been running smoother than expected.
"Our call centers are a little overwhelmed right now, but the key is we're processing claims and dealing with the problems as they come up," Cooper said.
Ed Dressen, vice president of Dressen Medical Supply, said problems with NCTracks are a daily occurrence at his Holly Springs company, which provides everything from wheelchairs to oxygen tanks to hospital beds.
"We anticipated that there would probably be some bumps and hills to go through during this whole changeover from the old system to the new system, and we were ready with some of that," Dressen said. "It's more significant that this is a programming issue. It's something that just can’t be changed overnight on our side."
NCTracks uses different identification numbers for various products and services than the old processing system, and the billing software some providers use isn't compatible with the new numbering system. That is forcing Dressen and other providers to manually enter claims into the state system one by one instead of submitting dozens in a single batch.
"It's adding cost to me to get those claims through," Dressen said, adding that some legitimate claims are denied because of the different ID numbers. "It puts a strain on a business."
Cooper said most providers use third-party firms to file their claims and are experiencing no problems because their software is up to date with the NCTracks system.
"The vast majority of our providers are being paid," he said. "We do have some providers that we need to provide some extra support to and that's what we're working on."
More than $137 million in Medicaid claims have been paid through NCTracks since July 1, he said.
Dressen, who is president of the state Association of Medical Equipment Services, said many of the organization's members have complained about billing problems and a lack of help from the NCTracks call center.
"I anticipate there could be some issues with service for individuals needing equipment," he said. "If that money is not coming in, they’re not going to be able to continue."
Cooper said workers were added Monday at the call center to try to improve response time.