By Dave Ranney
KHI News Service
TOPEKA, Feb. 12
The managed care companies administering the state”s HealthWave programs are behind in their payments to health-care clinics for the poor and uninsured.
“As of yet, we”ve not been paid by Family Health Partners,” said Dave Sanford, executive director at GraceMed Health Clinic in Wichita.
“UniCare has made a couple payments, but they”ve been short of covering the services provided,” he said.
The clinic had been receiving between $20,000 and $25,000 each month.
UniCare Health Plan of Kansas, Inc., and Children”s Mercy Family Health Partners took over the HealthWave contracts Jan. 1, replacing FirstGuard Health Plan of Kansas.
Prior to Jan. 1, FirstGuard had been paying the clinics weekly.
FirstGuard bid on the five-year contracts but lost to UniCare and Family Health Partners.
“They really had a system that was fine-tuned,” Sanford said, referring to FirstGuard. “I can”t say that for the system we have now.”
GraceMed”s situation mirrors those at other charity clinics:
*
“We”ve been paid some from UniCare, none from Family Health Partners,” said Lougene Marsh, executive director at the Flint Hills Community Health Center in Emporia.
*
“HealthWave has been our best payer. Obviously, when your best payer isn”t paying, it”s a problem,” said Jason Wesco, chief operations officer at the Community Health Center of Southeast Kansas.
News of the glitches surprised Family Health Partners. “I”m not aware of any providers or group of providers that have not been paid,” said Taira Green, the company”s director of government relations and public affairs.
Green said the clinics” concerns would be investigated today.
“We”re very sensitive to the funding issues facing our providers,” she said. “We very much want to work with them.”
If the clinics haven”t been paid, Green said, it”s likely due to errors made during the billing process.
“We”ve been making payments,” she said. “The first one was Jan. 19, the second one was Feb. 2. The next one is set for Feb. 16 ? in other words every two weeks.”
Kansas Health Policy Authority spokeswoman Megan Ingmire said the clinics” concerns were being monitored.
“Our goal in the managed care transition was to ensure there were no gaps in service for beneficiaries, and we have accomplished that,” she said, referring to Family Health Partners and UniCare”s efforts to recruit enough clinics and physicians to care for the HealthWave”s 280,000 patients.
“We will continue to monitor the progress and address issues and concerns as they arise,” Ingmire said.
Sanford said he”s not aware of any billing errors. “We track that very carefully,” he said. “If something”s kicked out, we rework it and resubmit it right away.”
Sanford said efforts to “work our way up Family Health Partners” chain of command of supervisors” had not generated much response.
“Basically, they couldn”t give us a date as to when we”d be paid,” he said.
Leslie Porras, a spokeswoman for UniCare, said she, too, was caught off-guard by the clinics” concerns.
“I”ve checked and our people say all claims have been paid on time,” she said. “But I”ll look in to this some more.”
Dave Ranney is a staff writer for KHI News Service, which specializes in coverage of health issues facing Kansans. He can be reached at
dranney@khi.org
or at 785-233-5443, ext. 128.