Online plan cuts Medicaid sign-up time

A pilot online system has drastically cut the time it takes to get Oklahoma newborns enrolled in the state's Medicaid program, resulting in quicker access to medical care for infants and faster reimbursement for hospitals and physicians, hospital financial counselors say.

"What this has done is cut the process time by more than half," said Karlene Gillespie, financial counselor coordinator for Hillcrest Medical Center.

The Oklahoma Health Care Authority launched the pilot project in April to help speed claims processing for the state's hospitals and to provide the baby a separate Medicaid number under the mother's existing case. The authority administers Oklahoma's Medicaid program, which is called SoonerCare.

Hillcrest Medical Center and St. Francis Hospital were the first Tulsa hospitals to use the system as part of the authority's pilot project. In Oklahoma City, Mercy Health Center, Integris Baptist Medical Center, OU Medical Center and Deaconess Hospital also were part of the pilot initiative.

By late July, the authority opened the system to all hospitals, of which 49 have signed on.

Before the pilot project, the process of getting newborns assigned their own SoonerCare identification number could take up to three weeks because it was all done through paperwork, Gillespie said.

"The majority of the time now, we have our newborns put on Medicaid before they're even discharged from the hospital," she said.

Since April, 4,261 babies have been added to SoonerCare through the new system, said Richard Evans, the authority's automated eligibility data integrity manager.

Not only have enrollment times been reduced drastically, but the system allows mothers to choose their infant's primary care physician right away.

"It's a wonderful thing to get those newborns on quicker and to get them a medical home," Evans said.

Each mom gets temporary identification for her baby immediately and a permanent identification card for the infant is mailed in three to five days, he said.

"It has made the job for us much quicker. It takes maybe five minutes now," said Trish Jones, manager of St. Francis Hospital's financial counseling and admitting departments. "It's very user-friendly."

Janet Scott, a data processing analyst and programming specialist at the authority, said it took a year to create the program. "It's so easy and flexible that even smaller hospitals can do it," she said.

The authority is implementing the system in other hospitals as quickly as possible. Southcrest Hospital is using the system, and both Oklahoma State University Medical Center and St. John Medical Center have shown interest, Scott said.

By October 2009, the authority hopes to expand the service to allow mothers who have given birth to apply for SoonerCare at the hospital and receive real-time eligibility determination and case creation, Evans said.

The enhancement would allow the mother to apply for SoonerCare while in the hospital. If approved, delivery costs and medical care for the newborn would immediately be eligible under the plan, he said.

Nearly 39 percent of the 4,021 babies born at St. Francis Hospital in fiscal 2008 were born to mothers on SoonerCare. Eighty-one percent of the 3,618 babies born at Hillcrest Medical Center that same period were born to SoonerCare mothers.

Oklahoma's Medicaid program covers more than half of all births in the state, said authority spokewoman Jo Kilgore.

"You can just imagine the impact this will have," she said.

Kim Archer 581-8315
kim.archer@tulsaworld.com

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Online plan cuts Medicaid sign-up time

A pilot online system has drastically cut the time it takes to get Oklahoma newborns enrolled in the state's Medicaid program, resulting in quicker access to medical care for infants and faster reimbursement for hospitals and physicians, hospital financial counselors say.

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