Opinion: Improving Support for State’s Behavioral Health Care Providers
The COVID-19 pandemic continues to highlight the behavioral health challenges facing many of our Maryland neighbors. As someone who has lived and worked in Maryland for much of my professional career, I agree with many of my colleagues in the behavioral health community these challenges will only increase as we emerge from this global pandemic.
This is why Optum Maryland is deeply committed to support providers’ work in delivering vital care to their patients. As the contractor tasked to deliver the Maryland Medicaid and state behavioral health plan claims payment system, our mission is to ensure that care providers can get paid quickly and accurately for the services they deliver to some of our most vulnerable who live in our community.
As a Marylander, I shared the frustrations when our payment platform initially didn’t live up to anyone’s expectations. But a year later, the status of our system has dramatically improved while we continue to make additional enhancements to ensure the system works better for everyone and that providers are accurately paid for the services they provided.
Today, the vast majority of providers are successfully submitting authorizations and claims and are getting paid for the vital services they provide. More than 98% of all authorizations for care are successfully being submitted through the provider portal.
Optum Maryland is also paying an average of $34.5 million a week to providers based on actual claims for care – more than $825 million since the system was relaunched in August 2020 through January 2021. Overall, 99.8% of all provider claims are being adjudicated within 14 days. Both these numbers are consistent with the experience with the old payment system.
Throughout this process, we’ve worked closely with the provider community and have incorporated their feedback to improve our processes and operations to better support them.
For example, we agreed with the provider community to have an extended, transparent and hands-on process with one-on-one support to reconcile last year’s estimated payments to ensure our records were accurate. We’ve also improved our customer support dramatically by changing how we support Maryland’s providers. Most importantly, we will continue working with our partner providers with same level of collaboration going forward.
I’m not here declare that everything is perfect. We still have more work to do to improve our system and processes to ensure it is easier to use for all providers.
I remain committed to assuring access to care for those we serve and have great respect for the professionals committed to providing care that helps our neighbors and families live happier and healthier lives.
–SCOTT D. GREENE
The writer is the CEO of Optum Maryland.