News Column

Critics continue to complain about new Medicaid claims portal in Oklahoma

January 31, 2014

By Paula Burkes, The Oklahoman, Oklahoma City

Jan. 31--At least one clinician claims Oklahoma's launch last week of an enhanced Internet portal for health services providers to file Medicaid reimbursement claims was as disastrous as the rollout of the new federally sponsored health insurance marketplace

Meanwhile, the chief executive of the Oklahoma Health Care Authority has issued a statement, apologizing and asking for providers' continued patience.

In the statement, authority Chief Executive Nico Gomez said he understands the frustration of those trying to use the new system.

"It should be working correctly for the benefit of our providers and it simply is not. It is my responsibility to make it work right. I apologize to our providers for their difficulties and ask for their continued patience," Gomez said in the statement.

In an email to The Oklahoman this week, Cindy Majors, chief operating officer of Morning Star Mental Health Services in Henryetta, said, "I can't believe the state is doing the exact same thing the government did with Obamacare."

"They have spent millions to convert to a better upgraded system, only to exclude small business and (launch) a failing website," Majors said.

The authority paid HP Enterprise Services$1.3 million to update its portal, which is used by about 37,500 clinicians who provide medical services to some 803,000 needy Oklahomans.

Health Care Authority spokeswoman Jennie Melendez said enhancements, among other things, allow clinicians to search for specialty providers and avoid faxing claims. Before the recent changes, no significant enhancements had been implemented to the portal since 2003, she said.

A dental provider in Miami, OK, and clinicians in Antlers and Stillwater so far are less than impressed. An employee at the dental office spent two hours and 13 minutes on hold with the authority last Friday, when the enhanced site went live, before finally giving up, he said. Meanwhile, Patricia Corn, of Edwin Fair Community Mental Health Center in Stillwater, said she unsuccessfully tried more than 30 times Monday to connect.

The Antlers provider, who asked not to be named, said he also hasn't been able to use the site for its regular services, including checking client eligibility, submitting claims, submitting billing and downloading remit files.

"When an agency cannot bill, they cannot pay their clinicians," he said.

Opponents criticized the authority for not testing the enhanced portal externally before launching it, and choosing not to introduce an automated secure file transfer protocol (FTP) system to its web-centric system, which requires a double-authentication login and manual uploading of files.

Melendez said the site on Wednesday was handling 75 percent of its normal claim volume, and that the authority had extended the paying cycle for all providers from noon Wednesday to 5 p.m. Friday.

"The site is experiencing difficulties that are being worked through at HP," Melendez said. "They've brought in the very best and brightest from around the country," she said. "Each day gets better as claim volume and file uploads increase."

Clyde Wafford, president of OrionNet Systems LLC, attended the authority's medical advisory committee meeting Thursday to voice concerns. Wafford's firm provides behavioral health agencies with practice management software that, before the system upgrade, allowed customers to quickly and automatically file claims.

He and others were disappointed, he said, to learn only medical advisory committee board members -- primarily health professionals with little knowledge of information technology -- were allowed to ask questions of health care authority staff.

Gomez, in his statement, said agency employees were working with the vendor and with providers to improve the system's performance and ensure claims are filed.

"I understand the frustration that our providers are experiencing with our new claims portal that became operational last Thursday. Our providers have a reason to be upset," he said in the statement. "We have set a high standard in being able to support our providers that serve our SoonerCare members and our being the most efficient payer in the market is the standard."


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Source: Daily Oklahoman (Oklahoma City)

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