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Critics continue to complain about new Medicaid claims portal in Oklahoma

Providers statewide report continued trouble filing claims, checking patient eligibility on enhanced Medicaid claims portal. Meanwhile, Oklahoma Health Care Authority chief Nico Gomez apologizes, accepts responsibility and pledges to resolve issues soon.
by Paula Burkes Published: January 31, 2014

“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.”

by Paula Burkes
A 1981 journalism graduate of Oklahoma State University, Paula Burkes has more than 30 years experience writing and editing award-winning material for newspapers and healthcare, educational and telecommunications institutions in Tulsa, Oklahoma...
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