Monday, July 15, 2013

NC MEDICAID: No psychiatric providers available and NC Tracks does not work to provide payment

I don't know how many other ways NC Medicaid can screw up.  The list seems limitless.

I called Western Highlands Network LME (going out of business as of October 1, 2013: HOORAY!; to be taken over by Smoky Mountain Center LME) to say that my client could not find a psychiatrist that would take Medicaid as a secondary payer (for dually eligible clients Medicare is primary; Medicaid is secondary; some psychiatric providers have simply thrown in the towel and just forget the Medicaid payment; others do not).  So I asked: "Please give me the name of a psychiatrist that takes Medicaid under the WHN LME catchment area."  Answer: "I can't do that.  But here is the name of a 'center' that may take it: Mood Disorder Clinic over in Fletcher."  I advised the client to call that clinic on Monday.  If they don't take it, I'll create a stink all the way to Raleigh.

But I digress.  This blog is about the mess w/ NC Tracks which is yet another tier of mess re: NC Medicaid. It seems they get threw screwing up some part of NC with the LME's....then they purposefully tackle another part to screw up.

I am not receiving but part of my Medicaid payments.  I use a biller.  This is my letter to NC Tracks today:

"Marsha V. Hammond, PhD
Clinical / Health Psychology
NC Licensed Psychologist
cell: 828 772 5197

Dear NC Tracks: 

When I call your 1 800 number given to providers in your e mails, I am told: "Your call cannot be answered at this time.  Please call back at a later time." 

This is unacceptable. Put some more people to work answering these important calls. 

I am calling to find out if you have my taxonomy code correct---the one I have used for 10 years---or if I am supposed to have some other taxonomy code.  My taxonomy code is: 103TCO700X. 

IS THIS THE CORRECT CODE? My understanding is that this is the code for doctoral level psychologists.  I am one of those.  

I also note that though Medicare no longer requires Place of Service, your recent note to providers indicates that POS IS REQUIRED. IS THIS THE REASON MY BILLING IS BEING DENIED? "


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