Colorado providers experience Medicaid reimbursement difficulties after software transition

Colorado Medicaid providers say they still face billing problems following the state's move to a new software system, reports The Denver Post.

Here are five things to know.

1. Roughly two months ago, the state Medicaid department transitioned to a new software system run by contractor Hewlett Packard Enterprise, according to the report. The software is meant to facilitate the reimbursement of Medicaid providers, including physicians and those who care for the disabled, the report states.

2. Providers from medical clinics, children's mental health centers and therapists contend they haven't been reimbursed for care they provided during the state's software transition. They've reached out to lawmakers, including the Democratic Colorado Gov. John Hickenlooper Jr.'s office, state Medicaid officials and the computer system's help line about the issue, reports The Denver Post. Some providers are reportedly facing potential closure or the possibility of eliminating services, according to the report.

3. The state's Department of Health Care Policy and Financing attributes the issues, at least in part, to operator error, saying time was allotted for training and documenting changes prior to the system's implementation, according to the report.

4. Additionally, the department noted improvements have been made since March 1, when the system was first implemented. Department spokesman Marc Williams told The Denver Post the system paid 60 percent of claims submitted last week, compared to 48 percent of claims that had been paid by the end of March. Ultimately, Mr. Williams told the publication, the department aims to see the system pay 85 percent of claims.

5. Meanwhile, the state is making efforts to help providers, the report notes. For instance, Mr. Williams told The Denver Post the call center has added 36 additional agents since March 1 and added hours.

Read the full report here.


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