County Medical Billing System Crawls
A $17-million computer system to submit medical bills for Orange County’s indigent patients to the state is expected to be running in April -- nearly three years late.
The computer system, designed by Cerner Corp. of Kansas City, Mo., was supposed to have begun sending medical bills for state reimbursement in July 2002. Glitches postponed its start-up until September 2003, when the system finally debuted and immediately malfunctioned.
The county has since been forced to prepare medical bills for its healthcare services by logging information into an outdated and faulty computer system.
David Riley, chief compliance officer for the county’s Health Care Agency, said Tuesday he didn’t know how much the nearly 30-month delay had cost the county for software, equipment and billing delays. He said hiring extra workers to compensate for the loss of the computer system had cost $500,000 -- about the same figure his office provided in March when asked the same question.
Chief Information Officer Dan Hatton praised Cerner officials before the Board of Supervisors for meeting a new schedule devised earlier this year to get the system de-bugged and revised. The work -- including two months just to create the revised schedule -- indicated a far broader effort, essentially creating a new system, with multiple versions of software, and installing upgraded equipment.
The first successful “mock” bill was sent through Cerner’s system Friday and accepted by the state. Full testing will run from January through March, Hatton said, and will determine whether the system can handle as many as 50,000 claims a month.
Supervisor Chris Norby rejected the notion that Cerner had complied with any aspect of the contract. “I know you’re trying to rescue a bad situation,” he told Hatton, “but Cerner is not on time.”
Cerner makes clinical, financial and managerial software for healthcare organizations, but this was its first venture into public health systems. Much is riding on a success in Orange County. In 2003, the company entered into a joint partnership to provide electronic patient scheduling services in Great Britain.
Orange County bought its system in January 2001, with the promise that it would integrate patient record-keeping and submit bills electronically to the state for Medi-Cal reimbursement. Since then, using the old billing system, the county has run two to five months behind.
Indigent patients in Orange County receive care at contract hospitals throughout the county. Their bills are sent through the county to the state for reimbursement.
The Health Care Agency has blamed some of the problems with the new computer system on requirements in the Health Insurance Portability and Accountability Act of 1996, which mandated better privacy protection for patient medical records.
The state now requires Medi-Cal bills to be sent in a new format, one that neither the old computer system nor the Cerner system could produce until it was reprogrammed.
