Claims format blamed for Medi-Cal payment problems

Ventura County Star, April 9, 2012

Some of the molasses-slow payment problems blamed on a local Medi-Cal plan are caused by billing middlemen still adapting to new claims requirements, said the plan's claims officials. The staff at Gold Coast Health Plan and the company it contracts to process claims, ACS, are reaching out to billing companies to try to resolve lingering complaints about payments that appear to be months behind. Ken Dixon, account executive for ACS, said some of the problems have been triggered by the federal government's mandate that electronic claims be submitted on a new format called 5010.


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