PORTLAND (AP) – There are signs of progress in troubleshooting problems in a new computer system blamed for lengthy delays in Medicaid reimbursements to the state’s health care providers.
Claims had been processed at a rate as low as 40 percent immediately after the January launch of the new $22 million system, but that rate has risen in recent weeks to more than 80 percent.
More than $2 million has been spent so far to fix software glitches and improper coding, an expense that will be shared by the state and federal governments. In the last month, the backlog of unresolved claims has fallen from 440,000 to 343,000, according to the state Department of Health and Human Services.
“It’s not perfect, it’s not as good as it was before, but we’re a little happier with the way things are,” said Dr. Maurice Convey, the president of the Maine Dental Association. He said some dentists have been forced to take out emergency loans to pay their staffs.
Because of the snafu, some providers have stopped taking new Medicaid patients or have limited the number they treat in a week. Medicaid serves more than 272,000 low-income and disabled people in the state.
The state has tried to tide over clinicians with estimated payments based on past volumes of business, but in many cases the compensation has fallen short of the services rendered. Some clinicians were overpaid.
The plan is to reimburse clinicians strictly based on their claims by the end of the year, said DHHS spokesman Mike Norton.
Some 360,000 of the 500,000 claims filed by hospitals since January are still unresolved, said Mary Mayhew of the Maine Hospital Association.
The trade group said that while it appreciates the progress made by the state, more work remains.
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Information from: Portland Press Herald, https://www.pressherald.com
AP-ES-10-06-05 0843EDT
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