Medicaid providers in the Piedmont are trying to stay in business as they wait for the state to send reimbursements through NC Tracks.
NC Tracks is North Carolina’s new online Medicaid billing process which replaced a decades-old outdated system starting July 1.
DHHS reports more than $750 million in claims were paid out since NC Tracks went live, but not all providers are seeing timely reimbursements.
Frank Wolff and his wife Leslie own Community Access Therapy Services, a group helping kids with physical, occupational and educational therapy. They are based in Greensboro but serve about 200 children all over the Triad.
“I speak a lot for those of us who provide service for children,” said Leslie. “We don’t have the luxury of having saved up 90 days worth of funds to weather it.”
Right now, the Wolffs are still waiting to hear back about $50,000 worth of Medicaid claims they’ve submitted from NC Tracks.
While they have received some payments, it’s not enough to make ends meet unless their claims are properly approved.
“In their favor, I would like to say someone from NC Tracks called yesterday and talked us through some of our billing issues,” Leslie added. “I’ll know by Saturday how much to expect next week.”
DHHS said they have customer services agents reaching out to providers on a daily basis.
Leslie joked she might have more luck of a payout by buying a lottery ticket. “I wish they had taken different steps in implementing it more incrementally,” she explained. “Why didn’t we phase this in?”
The Department of Health and Human Services has said all along NC Tracks would have a 60-90 day rough patch. They are transitioning more than 70,000 providers to the new system statewide.
Barbara Reece owns Touched By Angels Home Healthcare in Winston-Salem. The majority of her clients are on Medicaid.
Reece has been waiting for $150,000 in reimbursements since June. For her, the issues have become more than an inconvenience; this is a crisis.
“We have probably enough funds to last through the end of August. After that there’s not going to be enough income coming in to meet payroll,” Reece explained. “That’s not to scare my employees, but I had to start borrowing money from the bank.”
By the end of the month, Reece will be at the end of a $100,000 line of credit from her bank. She says she is still “in the hole” $27,000.
After hours on the phone with customer service agents for NC Tracks, Reece is still not getting payments she needs. “Right now I’ve been told, ‘We have no idea what the problem is.'”
The hardest part, Reece explained, is that she’s maintained a reputable business since 1998, never missing a payroll or bill. “Here I am struggling, and it’s not even my fault,” she said.
It’s not just patients in our area who could suffer if providers like the Wolffs and Reece have to shut down, permanently or temporarily.
Reece employs 160 people. “Mainly they are young, single moms. And they’re gonna be without a job. I think it’s really sad somebody at the state level can’t see the importance of it.”
Leslie and Barbara both said they will do whatever it takes to meet payroll and stay in business, but the money has to come from somewhere soon.
The state has 1.5 million patients in the Medicaid program, which provides health insurance for low-income individuals and families. North Carolina pays about $13 billion in Medicaid reimbursements annually.
NC Tracks is posting Frequently Asked Questions and webinars on their website.