Stuart-based Positive Behavior Support claimed the piloted system, or someone with access to it, is altering submitted behavior-analysis claims, rendering them invalid and resulting in reimbursement challenges, according to Health News Florida.
Though providers legally have the right to correct and resubmit claims within a certain time frame, attorneys for the company said that right has been removed, as resubmitted claims are being flagged by the new Medicaid system as duplicates of the originals and denied, the article said.
“Remedying errors that the system itself has caused falls outside of the agency’s promulgated requirements for providers and results in improper delay in reimbursement for their services,” the attorneys wrote in the complaint obtained by the publication.
Positive Behavior Support requested an administrative law judge issue an order to stop the Agency for Health Care Administration’s use of the new system, the article said.
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