Access to Health Care; Safety Net
The District of Columbia Department of Health Care Finance (DHCF), like other state Medicaid agencies, is constantly challenged to improve service delivery and reimbursement for Medicaid services. In the District, several governmental agencies ("Partner Agencies") play an instrumental role in Medicaid – either as a Medicaid provider or in operating a Medicaid program. Today, each Partner Agency may retain its own system and process for claims submission, provider enrollment, and administrative claiming as it relates to Medicaid. For these reasons, the DHCF initiated an assessment of the Medicaid claims processes for Partner Agencies. The purpose of the assessment is to identify areas of duplication and inefficiencies and recommend a solution(s) to the DHCF to improve efficiency and customer service.
The central recommendation arising from this assessment is that the District of Columbia procure the services of a single administrative services organization (ASO) to perform billing, claims submittal, and related administrative functions for the identified DC agencies examined as a means of achieving greater efficiency and improved customer service.
Improving Medicaid: Assessment of District of Columbia agencies' claims processes and recommendations for improvements in efficiency and customer service. Washington, D.C.: Department of Health Policy, School of Health and Health Services, The George Washington University, 2008.