Since April 2003, Georgia providers have been filing electronic
Medicaid claims based on ANSI standard HIPAA-compliant software.
Unfortunately, receiving payment for such claims has been anything
but smooth, according to Mike Hamilton, executive director of the
Georgia Association of Medical Equipment Services (GAMES).
Last month, Phoenix-based consultants FourThought Group reported
to the state's Department of Community Health, which administers
Georgia's Medicaid program, that not all claims were paid correctly
and payments were not sent to the correct providers. The state has
a contract with Dallas-based Affiliated Computer Services to
process Medicaid claims.
If a percentage of unpaid claims on-hand is significantly higher
than paid claims for a given week for a particular provider, state
claims processors have sent that provider payments equal to those
received at the same time during the previous year, Hamilton said.
“It gives you some cash,” he added, “but you
don't know where to apply it. It's an accounting nightmare. For a
new or rapidly growing company, those interim payments are going to
be far short.”
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