North Carolina: No 'rosy picture' for new Medicaid system

Friday, August 23, 2013

RALEIGH, N.C. – A new system meant to streamline billing for Medicaid is, in a word, a mess, say providers here.

“We expected glitches, but nothing like this,” said Beth Bowen, executive director of the North Carolina Association of Medical Equipment Services.

The new system, called NC Tracks, was implemented July 1. Since then, HME providers have experienced many technical issues with the system, which uses different product codes than the old system and is, in many cases, not compatible with common billing software used by providers.

“I tried to submit batch claims and they got rejected,” said Kim Lynn, HME operations manager for Carolina Apothecary in Reidsville. “We are hand entering claims patient by patient.”

That’s a time consuming and expensive proposition, especially for providers who lost Medicare business in Round 2 competitive bidding areas July 1, they say.

“We are running half staff now and may have to lay off more people,” said Paula Hardison, office manager for Carolina Diabetic in New Bern. “We are taking it one week at a time.”

Providers also report difficulty getting through to the Medicaid call center, and difficulty getting paid.

“We get on the line and it takes an hour to get the answer,” said Clark Robichaux, president of Oxy Care Equipment in Wilmington. “We haven’t received any payments since they turned over to the new system. We’ll probably end up suspending Medicaid patients.”

NCAMES has been in constant contact with Medicaid to try and get issues resolved, says Bowen, who has been providing near-daily updates to her members.

“I think what’s really frustrating for providers is that NC Tracks is touting (how great) their system is,” she said. “It’s not a rosy picture at all.”