Petition to Gov. Perdue - OPT visits remaining
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Petition to Gov Perdue and the North Carolina Division of Medical Assistance (DMA) to supply Medicaid Provider organizations the Mental Health Outpatient (OPT) authorizations (visits remaining) status for consumers that are in treatment with the Provider organization.
Consumers are granted 26 unmanaged OPT visits for children and 8 unmanaged visits for adults. However the Provider organizations are unable to predetermine the visits remaining until the Provider submits a claim and the claim is paid or denied. When accepting a new consumer the Provider does not know if the consumer is eligible for services.
Provider organizations are forced to unnecessarily write off ten of thousands of unreimbursed services each year needlessly. This has forced several independent Medicaid Providers to stop accepting Medicaid patients, weakened the provider network and denied access to services.
Sponsor
NC Medicaid Provider
There are political representatives that will support providers if there are sufficient numbers of Providers to validate that this issue is significant for the provider community.
NC DMA has acknowledged the issue but refused to take any action stating that the issue is 'isolated' to a few providers.
Highly Recommend you also contact the Governor directly (see sample letter below):
Governor Bev Perdue
Office of the Governor
20301 Mail Service Center
Raleigh, NC 27699-0301
Phone: (919)733-4240
Fax: (919)733-2120
governor.office@nc.gov
submit online to Governor at:
http://www.governor.state.nc.us/eTownhall/suggestionBox.aspx
SAMPLE LETTER:
Governor Perdue,
Small businesses need your help.
The North Carolina Division of Medical Assistance (DMA) has refused to supply Medicaid mental health provider organizations the Outpatient (OPT) authorizations (visits remaining) status for consumers that are in treatment with the Provider organization.
Consumers are granted 26 unmanaged OPT visits for children and 8 unmanaged visits for adults. However, the Provider organizations are unable to predetermine the visits remaining until the Provider submits a claim and the claim is paid or denied.
Provider organizations (usually small businesses)are forced to unnecessarily write off ten of thousands of unreimbursed services each year needlessly. This has forced several independent Medicaid Providers to stop accepting Medicaid patients, weakened the provider network and denied consumers access to services.
This policy is unfair to the licensed providers and unjustly penalizes the provider that simply wants to get reimbursed for the services that they deliver.
I request that you consider the fairness of this policy and its implications for how this policy reflects on the fairness and support for small businesses in North Carolina.
Your attention to this matter would be greatly appreciated.
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