Press Release

CNSI’s response to the Seattle Times article on Washington State’s Medicaid payment system

Publish Date
12/06/2010
Author
CNSI

Rockville, MDCNSI is thoroughly disappointed in the Seattle Times for publishing the article “New Medicaid computer system plagued with glitches” on December 5, 2010. This article mischaracterizes the facts, performance, and capabilities of the State’s new Medicaid solution (ProviderOne). Contrary to this article, the ProviderOne implementation in Washington has been the most extensively tested Medicaid system in the country.

Rockville, MDCNSI is thoroughly disappointed in the Seattle Times for publishing the article “New Medicaid computer system plagued with glitches” on December 5, 2010. This article mischaracterizes the facts, performance, and capabilities of the State’s new Medicaid solution (ProviderOne). Contrary to this article, the ProviderOne implementation in Washington has been the most extensively tested Medicaid system in the country. In fact, the system was validated with the provider community for over 6 months before going into production and all of the known deficiencies were corrected to ensure a successful transition from the previous system. As a company known for innovation and customer focus, CNSI has been working in the Medicaid market for over 10 years.

In addition to the state of Washington, CNSI has also successfully implemented the Medicaid system for the state of Michigan within the last 15 months. The lessons learned from all previous implementations were incorporated in this project to reduce payment risks and service disruptions.For decades, providers were used to submitting claims to a 32 year old system that simply did not have the capability to catch many of the potential errors or inaccuracies of a claim. After spending significant amounts of time and resources in design, development, and testing, the current ProviderOne system was implemented in May 2010. ProviderOne is doing what it is designed to do and is operating with no critical or major defects.

This system is performing better or at par against key business metrics such as weekly paid dollar amounts, suspension rates, and denial rates. 97% of submitted claims are being adjudicated correctly as the business-rules in place ensure only accurate and complete claims are paid. Many of the suspended claims are duplicate paper claims while others are suspended due to errors with the claims themselves.The article failed to mention the new system’s long-term cost saving benefits such as a modern managed care solution, a real-time rules engine to implement policy changes, and enhanced fraud and abuse detection tools. A clear indication of a successful Medicaid system implementation is the fact that DSHS has already initiated the process of system certification which is executed by the Center for Medicare and Medicaid Services (CMS) to ensure continued Federal support of the ProviderOne system. “CNSI is extremely proud of the 21st century Medicaid system we implemented for the state of Washington.” said Creighton Carroll, Director of Government Affairs, Olympia, WA. “We remain committed to working with DSHS in a changing healthcare landscape to deliver high quality healthcare in the most cost effective fashion.”For more information, please contact Kaksha Merchant at (301) 634-4570 or kaksha.merchant@cns-inc.com