Georgia Claims Processor Gets Cutting Edge

Atlanta

After a year of waiting for the state’s Medicaid contractor to launch a state-of-the-art Web portal, providers now have a cutting-edge system that sources say is a model of efficient claims processing.

According to Jason Rogers, vice president of Care Medical in Athens, Ga., and president-elect of the Georgia Association of Medical Equipment Services (GAMES), the new Web portal, developed by Dallas-based Affiliated Computer Systems, gives providers “an immediate response as to whether a claim is paid or denied” for certain claims. The system immediately catches common errors — such as incorrect birth dates or change-of-service information — that can cause lengthy payment delays, he said. It also allows providers to submit prior authorization applications online, streamlining a process that has traditionally “been a mess with Medicaid in Georgia,” Rogers added.

The solution was a long time coming. In April 2004, ACS launched the Web portal, but “it just didn’t work,” Rogers said. “The links didn’t function.” Earlier this year, the company finished debugging the system. “Now that it’s over,” he said, “we’re in a very good place.”