A state backlog in processing identification numbers for Medicaid patients is causing headaches for Illinois mental health and substance abuse service providers that need those numbers to pre-authorize certain services and get paid.
The Illinois Department of Human Services blames the backlog on a series of employee retirements in the unit that processes recipient identification numbers, or RINs, which reduced the staff by half, from nine people to four, said spokeswoman Meghan Powers.
The agency has implemented a temporary staffing plan that will more than quadruple the current staff working on the issue and anticipates the backlog will be eliminated in two to three months, she said.
In a Dec. 18 letter to mental health providers, Human Services Secretary James Dimas had blamed an October conversion to a new computer system for some delays in the assignment and processing of the recipient numbers, which providers need to bill for services.
That letter came as the department worked to restore food stamp benefits to more than 40,000 Illinois households that lost them as a result of issues with the new computer system, which was built by Deloitte and is intended to improve efficiency. Some caseworkers blamed computer glitches, but the state said the new system was operating fine and the problems resulted from poor communication and missed deadlines as workers learned how to use it.
But this week Powers said it turns out the delays are not caused by problems with the integrated eligibility system, which is used to administer entitlement benefits including Medicaid and food stamps.
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“We know that the primary reason for the backlog in RINs is due to the sudden staffing shortage and not IES,” she said.
Without a patient’s ID number, providers risk giving treatment without getting paid for it, said Marvin Lindsey, CEO of the Community Behavioral Healthcare Association of Illinois. It isn’t clear how many people in the state are affected by the delays, but he said he knows at least two large providers that each have 350 patients in their systems awaiting RINs.
At Haymarket Center, a 385-bed addiction treatment center in the West Loop with at least 70 percent of its patients on Medicaid, the delays have made extra work for staff as they try to chase down patient RINs, said Jeff Collord, vice president of operations.
Sometimes that can take several days, so the center runs the risk of not getting paid for patients who leave before their ID number is created, he said. Still, Haymarket treats anyone who walks in the door.
Sara Howe, CEO of the Illinois Association of Behavioral Health, which represents 60 mental health and addiction agencies and 8,000 clinicians, praised DHS for responding within minutes to her calls seeking help for providers running into hurdles registering patients.
Some services need pre-authorization, such as residential psychiatric treatment or methadone treatment for opioid users, and the agency has put a process in place to expedite ID numbers for urgent cases.
Another concern for providers is that they only have a limited time to bill for services that they provide, which they can’t do without a patient’s RIN. The state has said it will waive the deadline in cases where the backlog is causing billing delays.
“At least for right now we have some of the workarounds in place,” Howe said.
Even so, the workarounds take a lot of time, Lindsey said. He said one provider in central Illinois told him it takes half an hour per patient to get approval to have the filing deadline waived.
“I know they are probably doing all they can,” Lindsey said of the Department of Human Services. Still, he said, “there has to be a way for the state to communicate a problem and be transparent about the problem.”
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