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Medicaid announces delay in provider payments

October 25, 2010 By Ben Sclair

By Jennifer M. Gau, Public Affairs, Department of Social and Health Services

The state’s Medicaid program sent an advisory to its health care providers on Friday, Oct. 22, letting them know that a faulty information exchange would delay the program’s weekly cycle of payments.

The upshot is that payments normally received by providers on Monday will not arrive until Wednesday or Thursday. It was the first time the cycle of payments has been delayed since the new Medicaid payer system, ProviderOne, went on line May 9.

“We apologize for this delay and are making every effort to address the issue for future payment cycles,” said Rich Campbell, director of the Division of Systems and Monitoring in the Medicaid Purchasing Administration. “This will be an inconvenience to many providers, but it will probably impact smaller provider shops more than our large vendors and providers.”

Campbell said the delayed reimbursements include some for managed care plans and Regional Support Networks around the state, although the current cycle does not include the large monthly per capita payments for health plans.

He said the delay was caused by a processing problem within the state’s data exchange infrastructure as information passed from ProviderOne to the financial computer system that actually distributes state checks and electronic fund transfers. Neither of the computer systems was to blame.

Although the payments are delayed, providers will be able to access Remittance Advice and payment amounts in the ProviderOne system on Monday.

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