Integrated Treatment Services was having serious problems trying to get reimbursed from one of the MCO’s subsequent to providing services to clients. We had sent numerous emails to our supposed contact person, only to receive misinformation or they failed to respond to the emails. We had left numerous phone messages with our contact person. We rarely received a call back. We sent certified letters and other means of communication seeking to resolve our concerns and were consistently given the run around. Whenever we were finally contacted by the MCO’s their response was that our agency had failed to provide proper documentation. When asked what documentation we failed to submit, they requested paperwork that had been re-submitted on numerous occasions.
After being directed to submit claims using the format they prescribed, the issue was not resolved. We spent hours submitting and resubmitting claims, only to be told time and time again that our protocols were erroneous. After exhausting what we considered to be every option to get paid for services rendered, we contacted Rep. Greg Heartsill. Once Rep. Heartsill took up our cause, things began to happen to resolve our complaints. I want to thank Rep. Heartsill for his intervention on this matter.
Though we are still in the process of resolving these issues, had he not intervened on our behalf, we would still be in the same boat, spinning our wheels and not getting anything accomplished. Again, thank you Rep. Heartsill. There are so many providers out there that are experiencing nightmarish problems with these MCO’s and the privatization of Medicaid. I hope they can contact someone like Rep. Heartsill to help with their concerns.
Terry Sallis
Newton