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NCTracks: Another example of how poorly government runs a business

July 21, 2013
We've said it before, often, and we'll say it again. Government does very little well. While not perfect syntax, it is a profound truth. And it matters not whether the people at the top are Democrats or Republicans. And it certainly does not matter what they say in press releases, speeches or in campaigns. Government just does not do good work when it comes to operating as a business should operate. And the reason is inherent. The bureaucrats get paid from someone else's money, not matter how poorly they perform.

The biggest business the State of North Carolina operates is but another example. The moniker is "NCTracks." The Governor and Secretary of Health and Human Services say it is an improvement. The people working in the trenches say it is a debacle. A customer that does not pay his bills in a timely manner.

The N.C. Department of Health and Human Services, however, is releasing statements that say most payments are going through, and ahead of time. On July 8, a release said, "NCTracks is working so well after its first week in operation, we will pay many claims a full week ahead of schedule," according to Joe Cooper, Chief Information Officer for the DHHS.
Anna Harvey, writing in the Carteret County News-Times has the story:
NCTracks, the state's new computerized Medicaid billing system, has been touted by state officials as a great improvement over the old system since its release three weeks ago, but area healthcare providers strongly disagree.

"If this keeps up, offices may have to close in the next month or two," said Laurie Whitt, R.N. and practice administrator at Carteret Clinic for Adolescents and Children.

Since the new Medicaid system went live on July 1, replacing the former Medicaid Management Information System that was in place for 35 years, numerous issues have cropped up, slowing down workdays and hindering patient healthcare, said Ms. Whitt.

According to several Carteret County doctors and office administrators, NCTracks refuses to let them search for patient or doctor information in the system, does not recognize many Medicaid-certified healthcare providers, cannot file billing claims through the computerized system and is unable to provide references for specialized help elsewhere in most cases.

Another big issue is the taxonomy codes, or numbers that identify specific practices and doctors, that are necessary to file claims. Tammy Lenharat, with A+ Medical Business Services Inc., said the codes are wrong or can't be accepted in most claims.

A+ Medical Business Services Inc. is a medical practice consulting firm based in Morehead City that helps with the billing processes and coding training.

Even if a billing claim manages to pass the initial filing step, Ms. Lenhart said in most cases the office soon receives pages of denied claims, with each page citing dozens of patients whose claims cannot be processed. This means offices are not receiving payment for services provided.

Linda Jarvis, an office administrator for A+ Medical Business Services Inc., summed up her frustration with the faulty system. "It's broken before it even begins," she said Thursday.

According to Dr. Margaret Merrick, one of five pediatricians at the Carteret Clinic and President of the Carteret County Medical Society, Medicaid insures at least half of her young clients. When claims cannot be processed this leaves a shortfall of money. Dr. Merrick said offices are getting hurt on both ends with the NCTracks issues not making payments in most cases, while office expenses and salaries continue.

Dr. Merrick said she has heard from nearly every healthcare provider in the county about major problems with the system. "Everyone is in crisis over this," she said. "No one could get this to work, because it doesn't work."
The combination may lead to drastic measures in the near future if claims cannot be processed and paid. "In my 33 years of practice I have never seen such a fiscal disaster as this, with no end in sight to the problems" said Dr. Merrick.

The Carteret Clinic for Adolescents and Children held claims for a week before NCTracks began, so their unpaid claim amount is not as much as others in the county may be facing. Still, it has racked up to more than $60,000 in unpaid services in the past month, according to Ms. Whitt.

Although the new system started July 1, some claims after June 22 with the old system were held over until NCTracks was engaged. This means the majority of claim payments for nearly a month have not been paid to healthcare providers who have Medicaid patients.

The N.C. Department of Health and Human Services, however, is releasing statements that say most payments are going through, and ahead of time. On July 8, a release said, "NCTracks is working so well after its first week in operation, we will pay many claims a full week ahead of schedule," according to Joe Cooper, Chief Information Officer for the DHHS.
Click here to go to the original source to read the rest of the story.

  1. reply print email
    July 22, 2013 | 07:10 AM

    Alot of Medical offices with Medicaid clients are just not getting paid offices will have to close soon no money is coming in and the bills are still coming in. I have Hiv Case Management company in Fayetteville NC and cliams are still being denied. Great article.

    Linda McPhatter
  2. reply print email
    NC Tracks - Continues to FAIL
    July 22, 2013 | 08:45 PM

    After 3 weeks of working every business day trying to resolve even the simplest task, like updating the information NCTracks requested Providers to update when the system went "Live" or I should say on Life Support - You still get a call back later message or have to wait over and hour just to get a person to inform you they will escalate the request - in a 3 day span I had a reference number increase by over 3,000 (got to wonder if the issue those in numerical sequence and there have really been 3,000 tickets issued.
    If NCTracks were dependent on getting their pay using this system, maybe it would get fixed.
    Frustration does not even begin to describe our work day.

    Monty Jenkins
  3. reply print email
    Situation Worse Today.
    July 24, 2013 | 10:12 AM

    As of today still no payment. When you call, not even placed on hold - just told "we are not able to take your call at this time" and system hangs up. Bills due, payroll due, need to order more supplies for next month.

  4. reply print email
    July 24, 2013 | 11:49 AM

    NCTracks is run by CSC a private company. I get better and more efficient service dealing with Medicaid directly. CSC has been a joke since they started taking over credentialing 3 years ago.

    Selam Bullock
  5. reply print email
    July 25, 2013 | 04:28 PM

    Thank you for covering this debacle. We're a mental health provider relying on our HealthChoice reimbursements through NCTracks. Everything the other posters have said is true and then some. The sad part is that there is no light at the end of this tunnel. If something doesn't change for the better really quickly a lot of Medicaid providers of all types will be going under. And by the way, if they can't implement this, there's no way they can implement Medicaid reform in 2015!

  6. reply print email
    July 25, 2013 | 10:06 PM

    Do you want to know what the providers are calling with questions like.
    Q1. What are 3rd part insurance payer code to put on the claim? Really, You mean you don't know that an insurance company like BCBS has a payer id. Have you used google before?
    Q2. What is the difference between Billing provider, rendering provider, referring provider? Are you serious.
    Q3. I forgot my password and I CANNOT remember my 3 security questions that I CHOSE. Do you really think I know your password?
    Q4. Pharmacy calls, why is it paying less than our cost? Well, haven't you heard of the federal upper limit, it's Medicaid. Google it. And yes they get Birth Control on your tax dollars.
    Q5. Because you did not get your EFT in early your claims will be paid on the next checkwrite. Seriously, your practice is going to go under because your paid 1 or 2 weeks late then I have a bridge to sell you.

  7. reply print email
    hey JT
    July 31, 2013 | 02:06 PM

    I do know the answers to your questions 1-4. Its all the other questions that have to do with secondary claims/ authorizations (oh yes the new forms ) that do not show you the required fields you can fill out as a provider. Oh and how do I correct the old authorization forms from the previous vendor? I've had a helpdesk ticket in now for 12 days. on hold for 65 mins only to be told : Cant help you !!! been in the business for 20 yrs -

  8. reply print email
    August 01, 2013 | 10:45 AM

    Sort man but somebody else posted the above comment as me.

    It's not my post.

    Can't help ya

  9. reply print email
    Actually learn to read the billing and fee schedule
    October 04, 2013 | 03:22 PM

    please actually read what's been put on the DMA website. the old system you were running on and getting paid 95% of the bill by medicare, then an additional 70% by Medicaid merans you were getting almost twice as much as you should have gotten. i know medicaid is a lucrative business but you do need to follow rules. the is a HIPAA link right next to the fee schedule. you got paid zero for a reason. because you shouldnt be reimbursed for it. the reason your state is so much in debt is because of the over billing and the sucking of Medicaid/Medicare funds. trying to kill your budget but increasing your debt, spinning in circles. wake up. you ARE NOT GETTING THE AMOUNT YOU USED TO BE GETTING because you were overpaid before. get ready for the audits in November. the IRS and uncle sam are gonna come knocking, so whatever little money you get will be taken. and thats not nctracks. nctracks doesnt have that authority. it comes from the government of the country you live in. dont like it, leave. the laws have been in place. the old system just didnt follow it. too bad so sad

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