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DMAS: provider focus group meets monthly to address denials, billing and behavioral health updates
Summary
DMAS told providers the agency’s provider focus group meets monthly, routinely reviews claim denials and billing issues, discusses behavioral health initiatives and large IT implementations, and invites providers to a focus-group meeting scheduled the coming Monday.
DMAS staff told providers at a stakeholder meeting that its provider focus group is a monthly forum for flagging claim denials, discussing billing and provider enrollment issues, and receiving detailed feedback on major implementations such as the Medicaid enterprise system.
Tia Lewis, division director for program operations at DMAS, said the group now meets monthly and that agenda items typically include claim denials, behavioral health updates and upcoming implementations. She described an example implementation from November 2023 that combined medical and behavioral health service authorizations and said provider feedback helped DMAS identify system and rollout issues.
"The lift is on DMAS, which is the way it should be," Lewis said, explaining that providers should not face undue work when they raise issues and that DMAS will take responsibility for coordinating fixes and resources. She said the focus group routinely draws roughly 200 attendees and that providers with questions can contact the group by email (the agency supplied a provider-focus-group email during the meeting).
Lewis invited providers and MAC members to share topic suggestions for future agendas. The agency said it will share meeting materials and contact information as part of post-meeting resources.
