Hospital weathering problems with Medicaid
Caldwell Memorial Hospital has not yet been hurt by problems plaguing the state's system for processing Medicaid reimbursements, but hospital offices are keeping an eye on the $3 million to $5 million in Medicaid claims currently in the hospital's paperwork awaiting payment.
The state system for processing Medicaid is causing problems for medical providers across the state and was among the topics this week of a meeting of a legislative committee that provides oversight of the state Department of Health and Human Services.
"This is causing heartaches right on down the line," said David Horn, Caldwell Memorial's vice president of business development. "Between 65 to 72 percent of our patients are covered by either state or federal plans. It's very important that we get paid."
NC Tracks, DHHS's new claims system, launched in July to process more than 15 million Medicaid and other claims each week.
At the legislative hearing on Tuesday, health providers told legislators that the system isn't working. Some have been waiting months for bills to be paid.
"NC Tracks has made billing go from complex to borderline impossible," said Sandra Williams, CFO of Cape Fear Valley Health Systems.
The biggest problems are with what are called taxonomy codes, the system of medical codes that NC Tracks uses to determine whether a provider has the proper credentials to bill for the item or procedure on a claim.
Horn says the hospital is banking on DHHS to resolve the issues before the hospital's services are affected.
"We hope the government can get this stuff resolved so we can continue to provide the services we do," he said. "We have a mission to provide care to patients. That hasn't changed."