Paper: The Top Enemy of Efficiency

I sat through a briefing this morning on “Provider One,” the state’s new $200 million Medicaid claims processing software implementation exercise. We expect to go live with the software on May 6th, after 12-18 months of delay rolling the product out. I believe the implementation will mostly work at that point (this is a big improvement over 6 months ago) but that many, many medical providers will not have engaged in the work necessary to get connected to the new way to pay their claims.

For example, only 1100 of 2900 “key” submitters have even started testing their connection. Since it takes 4-5 weeks to get working, lots of people are going to be very frustrated on May 7th when they can’t get paid for Medicaid work they have done. The 1100 represent over 70% of the claims volume, but we will still have a big problem. Just so you have some context, billions and billions of dollars flow through this system annually.

What I expect to happen is that they will submit their claims on paper instead of electronically. Arghhh.

Today about 5% of claims volume is on paper. If this goes up to 10% the cost to the state will be horrendous. Even the 5% we have today cost us a huge amount of staff time scanning the forms, typing numbers into the computer, sending it back and forth and finding something to do with it when it’s processed.

We have to go paperless. This will be painful for some people who file infrequently, but they can get paid faster if they just type the answers into a website instead of onto a paper form. The same thing is true in the Dept. of Revenue. Last year we switched all monthly tax return filers over to electronic submission, and I think we need to move everyone over.

I intend to file legislation next year that will start this process in several key areas. Tax returns, Medicaid payment claims, any other high-volume communication area in the state. I’m open to suggestions.

About the Author

Ross
I am the Director of the Department of Early Learning for Washington State. I formerly represented the 48th Legislative District in the State House of Representatives, chairing the Appropriations committee and spent many a year at Microsoft.