COLUMBUS, Ohio — Healthcare providers in Ohio are searching for answers today, as to when they will get paid for their services.
According to a local home health nurse, they have been waiting weeks to receive payments from the Ohio Department of Medicaid (ODM).
The delay is in part because of the recent transition from ODM to their new OMES system. OMES stands for Ohio Medicaid Enterprise System. The new program went live on February first and has been plagued by problems, delays, and backlogs.
In an email provided to the Guardian, Rhino Bill, a medical billing company said, “We share your frustration and anger about your unpaid ODM claims. ODM’s transition to their new OMES claims processing system is obviously not going well.” The billing service went on to explain some of OMES’s problems in an email to a local provider.
“The first issue affecting many billers is that starting February 1, ODM required all ODM and Managed Care claims to have a slightly new format. Some billers were able to make these changes in time, and others were not. The second major issue is that the OMES system is not keeping up with the number of claims sent to it each day. This is affecting all billers and clearing houses including claims entered through the MITS portal.”
Providers told the Guardian that most claims submitted to the OMES system since it went live on February 1 have not been processed, leaving many providing services for free.
The state has not commented on the delays or what they are doing to correct the issues.
One person said, “A before this week’s paycheck was supposed to be paid, still nothing from ODM.”
The Guardian will continue to investigate these issues and provide updates as more answers become available.