Medicaid Mess
Medicaid Mess Save Email Print
Posted: 6:02 PM Jul 18, 2008
Last Updated: 11:01 PM Jul 18, 2008
Reporter: Josh Gauntt
Email Address: joshua.gauntt@wjhg.com


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Dr. Fernando Malamud, a Panama City oncologist, and Jim Richmond, a financial consultant for Gulf View Family Medical Center in Panama City Beach, have been having problems with Medicaid.

"I have not seen a check from Medicaid or we have direct deposited in four weeks," Malamud said.

"I guess the fact that we haven't been paid three out of five times is disturbing because we have to use our own money," Richmond said.

Our investigation found Medicaid isn't the one to blame; it's their new computer system, Electronic Data Systems, or EDS, based in Plano, Texas. The company was awarded the $308 million, 81-month contract three years ago, but now there have some glitches in their system here in Florida.

When you finish visiting the doctor, he or she fills out the claim either online or by phone. With the high volume of traffic, EDS can't respond fast enough to the claims.

"Quite frankly, I can't understand why Medicaid would turn this operation to a company that wasn't prepared to operate right away," Richmond said.

EDS said the system is brand new and they’re having some growing pains. They said the system is very complex and there are millions of lines of coding. They are adding more phone lines and fixing their online site.

"So down from the providers submitting claims all at once, this time things got tied up. However, the system is working through the claims and the whole change in process is it's really a learning curve for providers," Fernando Senra, press secretary for the Florida Agency for Healthcare Administration, said.

And it's that change state Rep. Jimmy Patronis says is expected to help the state tremendously.

"Part of maximizing that reimbursement rate is to try and institute as much technology as possible, and it's a tough transition," Patronis said.

He says with anything new you have to give it some time to work properly.

"It's a tough spot they’re in right now, you know. The state is being very sympathetic, but again we also have to be responsible that we're doing the absolutely best job for the taxpayers," Patronis added.

The new system is supposed to allow providers to keep track of their records in real-time while they are being processed. EDS is trying to reach out to some of the doctors who are being affected by this.

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Posted by: Zil Location: NE on Jul 19, 2008 at 01:45 PM
This is actually par for the course for EDS. What do you expect? States trust way too much in EDS and apparently do not look deeply into the company record. FL woes are more common than not.

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