I am collecting complaints from providers about service problems with Texas Medicaid & Healthcare Partnership (TMHP). So far, I have heard complaints that TMHP does not return telephone calls and that processing Electronic Data Interchange Agreements has been unduly slow, causing unconscionable delays in Medicaid payment to contractors for services they have provided.
I have heard, from more than one source, that the delays have been blamed by TMHP supervisors on the illness and absence of ONE employee. What kind of business are these people running? One that is understaffed? What happens to providers when they are understaffed? Will DADS surveyors give you a break when MDS forms are not properly filled out because your MDS nurse is sick?
Further, I’ve heard, from more than one source, that the instructions on the EDIA are confusing, and don’t give sufficient detail as to what address needs to be given on the form. If a provider hazards a guess and is wrong, the EDIA is kicked back , further delaying payment. That is lousy communication. In the real world, the business responsible for bad communication is usually the one who suffers the consequence. At least, that’s the way it should be.
From one source, I learned that providers were intially told that the form would be processed 10 to 15 days after receipt, then the source learned that the 10 to 15 days was from the time the processor received the form from the TMHP mailroom–not from the time TMHP receives the form. Then, the source was told by a supervisor at THMP that the State has actually granted TMHP thirty days to process the form. No word on whether the 30 days is from the date THMP receives the the form–or from the date the TMHP mailroom distributes the mail to the processor.
TMHP is a contractor with the State of Texas, just like you are. When was the last time DADS let you get away with excuses for understaffing or bad service? What would happen if the Administrator of a Nursing Facility neglected to return calls to the family members of residents?
Why is the State of Texas letting TMHP get away with bad service? Surely DADS and HHSC realizes that to give good service, you have to get paid within a reasonable time. Don’t they? Perhaps a legislator would like to investigate this. How much is the State of Texas paying TMHP? Given what I am hearing about TMHP’s lack of efficiency–it must be too much.
I invite you to send me your horror stories about TMHP by e-mailing me at jward@garloward.com. I want to collect these stories in order to recount them to the governmental relations people at DADS and HHSC–or, if they brush me off–I will send them to a legislator.
If you wish to remain anonymous, let me know.