Medi-Cal’s enrollment system for doctors and other health care providers, long criticized in the medical community for being complicated and slow, is getting an overdue transformation.
Paper is out, computers are in. That means doctors and other medical practitioners who want to become Medi-Cal providers — or simply need to update their existing information — will finally be able to do it online.
It is an important change, especially since the Affordable Care Act has tightened provider-monitoring requirements, said Tanya Homman, head of the Provider Enrollment Division at the Department of Health Care Services, which manages Medi-Cal.
However, the new system is only for use in fee-for-service Medi-Cal, which represents a shrinking proportion of the program as the state pushes it increasingly toward managed care.
The current provider enrollment system is all paper, and applications are lengthy — sometimes more than 100 pages. That’s a hassle for health providers, and it’s difficult for Homman’s staff to keep up, since the division receives about 1,400 applications a month, she said.
When she first took charge of the division four years ago, Homman was surprised to learn the system was so antiquated.
The new system is expected to be available July 29 for physicians, surgeons and nurse practitioners, among others. Early next year, it will be open to other kinds of providers.
Kristine Marck, associate director of the California Medical Association’s Center for Economic Service, said medical providers find the paper system confusing, and many complain it’s hard to contact Homman’s enrollment office.
“From what I’ve seen, (the new system) is so much more intuitive,” Marck said, after attending a demonstration of the new portal presented by the DHCS last week. It shows “respect to the user” by recognizing “that their time is valuable,” she said.
When it comes to technology upgrades, the new system is something of a face saver for DHCS, which suffered a setback earlier this month when it was forced to abandon a project with Xerox Corp. that would have renovated its decades-old Medi-Cal claims processing system. The termination of the $179 million agreement with Xerox means the department’s existing, creaky claims system will remain in place until further notice.
The new web portal is expected to speed things up considerably. Currently, 70 percent of paper applications are returned to applicants because of incomplete information, Homman said, and even when everything is filled out correctly, it can take months to approve an application.
The portal should also make it much easier to comply with an Affordable Care Act requirement that the enrollment of Medi-Cal doctors and other practitioners be revalidated every five years, Homman said.
To date, the DHCS has invested $5 million in the system upgrade using a combination of state and federal dollars. DHCS officials said they couldn’t provide a figure for the total cost of the new system, which is still being assessed, a department spokesman said.
The portal will also be accessible through mobile phones. Rohit Agarwal, CEO of Digital Harbor, the company contracted to help develop the system, said the company and DHCS are inviting comments from providers to help fine tune the system before its summer release.
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