Maryland adds e-gov features to its Medicaid system

Maryland adds e-gov features to its Medicaid system

Maryland’s Health and Mental Hygiene Department went live last week with its eMedicaid system to streamline the Medicaid process and reduce the paperwork burden on its 56,000 health care providers.

USinternetworking Inc. of Annapolis, Md., is rolling out the eMedicaid system, which will be used by hospitals, doctors, dentists, pharmacists—“anybody who bills the Medicaid program,” said Alan Shugart, director for systems and operations for the department’s Office of Operations and Eligibility-Medical Care Programs.

USi’s one-year contract is worth $612,000 for the first year with an option for renewal for another year.

Providers can enroll via a Web site secured with Secure Sockets Layer encryption and passwords.

The system’s privacy safeguards will also help the state comply with the Health Insurance Portability and Accountability Act of 1996, Shugart said. Privacy of patient health data “was one of the big concerns about putting it on the Web,” he said.

The site uses middleware and USi’s AppHost service to access the state’s legacy DB2 database, which resides on a mainframe.

Participants will be able to find out if their Medicaid claim will be paid or denied when it is processed, without having to wait for a paper notice in the mail, Shugart said.

The focus of eMedicaid is better customer service, Shugart said. It will give health care providers around-the-clock accessibility, he said. And because users won’t have to spend so much time tracking documents, they can spend more time working on larger problems, such as why claims are denied.

The eMedicaid system is not about billing or claims submissions, Shugart said. It’s a communication tool. It’s also part Maryland’s larger plan to ensure that 80 percent of all state government services are online by 2004.

The state processes more than 36 million Medicaid claims each year, Shugart said.

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