Mike Randol and Christiane Swartz from KDHE hosted a meeting last week to update us on the progress they are making with the Medicaid backlog, advance payments, areas of improvement at the Clearinghouse, and plans for the future.
- Medicaid backlog – Mike Randol stated that the Medicaid applications are now at a “steady state”. Their statistical reports indicate that they have caught up. They are having an issue with their reports picking up old dates for applications that have been denied and have new information received. They are working on this issue.
- Advance payments – Mike feels that the advance payments are winding down with the backlog decrease. To date they have received 1,123 requests. They have responded to 753 and approved $1.7 Million of payments. Recoupments have just recently been started, however they anticipate few of these.
- The Clearinghouse – Christiane reported on essential areas of improvement that they are working on. These include:
- An escalation process for critical items. The Customer Service line at the Clearinghouse will be trained to better identify critical issues through a standardized script. This will help them serve the callers better and direct them to the right personnel.
- Sequencing. They are working on a prescreening tool for Clearinghouse personnel processing claims so that they ask for the documents they need up front.
- Online application. The Clearinghouse is working on putting measures in place to assist with the use of the online application. In the past there were issues with limitations on the size of file attachments that were sent with the online application. This has been addressed and larger files can now be attached. They feel the online application lends itself to faster processing.
- Outbound Calls. The Clearinghouse is piloting a process of now making outbound calls to applicants and families to clarify what is needed to complete an application. This is in addition to written communication. The issue they are having is that they usually have to call numerous times. We asked whether they are going to call the facility if they have the release of information on file, since the facility is often assisting with the application. Christiane indicated that family would be called first and then the facility.
- Application changes. KDHE and Maximus (the contractor operating the Clearinghouse) have conducted an analysis on the application to realize that it is cumbersome. They will be working on modifications, however this will take time, as CMS will have to approve changes. In the meantime they are developing a Companion Guide to accompany the application that they hope will help the process.
This meeting was initiated by KDHE and was a further step forward in improved communication and transparency by the Agency.
