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Providers complain about new Medicaid claims system

Posted July 15, 2013

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— 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.

Medical equipment DHHS says most Medicaid claims processed under new system

"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.

19 Comments

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  • productiveplay Jul 17, 2013

    Providers got these ominous announcements before July 1st, asking, "Are you ready for NC Tracks?" The majority of providers received online and/or in person training at seminars across the state. I knew more than some of the call center reps who were supposed to there to guide our agency. It turned out after numerous calls and emails over many frustrating days that NC Tracks had not completed the EFT info so that we can be paid by direct deposit. Many providers have run into the same issue. Providers were told everyone could begin billing 7/1. In reality, it will be next week (hopefully) before our EFT info is processed. It would have saved so many colleagues I know so much time and frustration if we had been told the truth.

  • kermit60 Jul 17, 2013

    I guess some are not getting there free stuff fast enough? As far as the businesses go, update to compatable software or lose the business.

  • kathymtobias Jul 17, 2013

    https://www.facebook.com/groups/289420327868685/ Stop by our group page to talk about common problems.

  • anderson Jul 17, 2013

    It's a major mess...the wait times are ridiculous and when you get an answer there's not really any good help or assistance...NCTracks is a joke

  • shawn36003 Jul 17, 2013

    billO.....SS was paid by the widow's spouses and that was not called MEDICAID...that came along later and that was NOT what SS money was intended for.

  • bill0 Jul 17, 2013

    "The system was put in place by Gov. Bev. Purdue. She and her cohorts are the ones that put it together."

    No, they have been working on this mess for a decade now.

    But yes, it is an embarrassment. They "privatized" the system and outsourced everything to a vendor. That vendor is not responsible to the citizens and is not held financially liable if they don't meet their deadlines or costs.

    "Our SS money was not intended to give to those who never contributed"

    Ugh, yes it was. The biggest group was originally widows. Beyond that, NOBODY in the original group paid a single cent into the system. It has always been a system that support current retirees with taxes on current workers.

  • shawn36003 Jul 17, 2013

    Medicaid is out of control! Our SS money was not intended to give to those who never contributed, which is why so many worry there will be no SS when retirement comes around.

  • trianglematt Jul 16, 2013

    The system was put in place by Gov. Bev. Purdue. She and her cohorts are the ones that put it together. I was hoping that Gov. McC would just scrap it and sue CSC and its minions for the money and start with something new, but my voice was unheard.

  • DaddysAngel27 Jul 16, 2013

    whatelseisnew- So you think that Medicaid should be eliminated? What about the disabled people on SSI that receive it???

  • HeadsUp Jul 16, 2013

    We'll have a good idea by Labor Day how Governor McCrory's "new" half-a-billion-dollar COBOL-based Medicaid payment system is doing.

    The creation of a Facebook page about its problems isn't encouraging.

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