Medicaid Payment Problems Continue For Colorado Doctors

By Karen Morfitt

DENVER (CBS4) – The trouble with Medicaid claims is continuing in Colorado.

CBS4 first reported about how doctors were struggling to get claims paid a few weeks ago. Some doctors told CBS4 they were worried they would have to close their doors.

After more than 30 years delivering babies in Denver, Dr. Michael Hall recently told CBS4 he didn’t think he could continue.

hall 2 Medicaid Payment Problems Continue For Colorado Doctors

Dr. Michael Hall (credit: CBS)

“I have given up my time for so many years and I keep getting stabbed in the heart,” he said.

His latest wound came in March when the state launched a new Medicaid payment system. Since then, thousands of health care providers stopped being paid.

“That filters down and I can’t pay my bills. If I can’t pay my bills, I had to take a loans to pay the overhead and the payroll,” he said.

After hearing from several other doctors over the last month, CBS4 asked Parrish Steinbrecher, a spokesperson with Colorado’s Department of Health Care Policy and Financing what was behind the delay. He narrowed it down to one main issue.

parrish steinbrecher Medicaid Payment Problems Continue For Colorado Doctors

Parrish Steinbrecher (credit: CBS)

“Whether you’ve been a provider for two years or 20, you have to re-enroll and re-validate and it’s different now then it was before,” he said.

Those same doctors say it goes beyond enrollment issues, saying they have seen coding problems, issues with group practices and split billing. Which means submitted claims are denied.

The state says it has already paid 3 billion in claims and urges those having problems to call their help center.

Hall and his staff say they did every month for 6 months. Instead of a fix, they got multiple denial letters.

hall Medicaid Payment Problems Continue For Colorado Doctors

(credit: CBS)

“They just kept not answering our questions so we couldn’t get through to them to find out what the problems were,” Hall said.

Now he says his time and his patience have run out.

“We can’t keep our doors open. How can we?”

But after six months of attempting to re-enroll, Hall was approved. As of Monday, he can begin submitting the hundreds of Medicaid claims he couldn’t before.

The state does offer hardship payments for the providers who are struggling financially. For more information, visit colorado.gov/hcpf.

Karen Morfitt joined the CBS4 team as a reporter in 2013. She covers a variety of stories in and around the Denver metro area. Connect with her on Facebook, follow her on Twitter @karenmorfitt or email her tips.

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