Medicaid's computer problems persist

Glitch creates errors, extra work
Jul. 06, 2014 @ 08:23 AM

The N.C. Health and Human Services says that the state is "on its way to having one of the most efficient Medicaid processing systems in the nation," but social services workers in Caldwell County are still working overtime and fighting computer issues that continue to plague processing of Medicaid applications.

The processing of Medicaid applications is slowed by difficulties that the processing system, called NCFAST, has in receiving information from another software program, NCTracks, which handles Medicaid billing. As a result, only four pilot counties -- Carteret, Dare, Johnston and Orange counties -- have fully launched Medicaid through NCFAST. 

Caldwell County has been processing new Medicaid applications through NCFAST since April, but there are more components of Medicaid to be processed. Those will not be added to the system until August or September, said Will Wakefield, social services program administrator for adult and family support services.

"There are still issues between NCFAST and NCTracks that create extra work for us, but it is a mixture of issues across both systems that continue to put a drag on our efficiency as opposed to just one," Wakefield said.

NCTracks processes Medicaid claims and billing for medical providers. Since July 1, 2013, NCTracks has processed 200 million claims and paid $10.3 billion to healthcare providers, a press release from DHHS said. For several months, NCTracks was plagued with persistent problems, with health providers complaining of extreme waits for payment.

NCFAST, for NC Families Accessing Services through Techonology, was designed to replace 19 separate systems used for various social services benefits, including food stamps, Medicaid, Work First and child care services.

NCFAST and NCTracks were designed to provide faster claim processing. Two programs work independently. Data is exchanged between them just once nightly, but DHHS staff can access information in both systems to ensure that the information is immediately available to validate eligibility, said Kirsti Clifford, a press assistant in the DHHS communications office.

"DHHS staff works closely with the county to address any concerns that arise," she said.

But Wakefield said that changing information from one program can incorrectly affect information in the other, which causes delays in processing applications in NCFAST. That's a problem that has existed for months.

"At this point, we are still in about the same situation," Wakefield said. "Our staff has learned to deal with the inconsistencies in the system and have been able to mitigate widespread problems through hard work and extra time. There are still individual cases that must be fixed, and sporadic system problems that do cause some isolated delays."