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Friday, January 15, 2016

Unique clinic at Anderson County Health Department, started to help Medicaid patients, risks closing due to Medicaid's slow pay

The Anderson County Health Department's walk-in clinic, the only one of its kind in the state and maybe the nation, might have to close its doors if it doesn't resolve its financial deficit by March, reports The Anderson News.

"No health department in Kentucky has a walk-in clinic similar to the one here in Anderson County. In fact, it doesn’t appear there is another like it anywhere in the country," the newspaper reports.

Although the clinic takes all types of insurance and self-pay clients, it was created in response to a need in the community after one of the only two local medical offices that accepted Medicaid closed, leaving hundreds of poor, disabled and young patients without care. The clinic opened in November 2014.

But a year later, the department as a whole was running a $200,000 deficit, caused mostly because of non-payment of funds owed by Medicaid, private insurance and self-pay clients, Director Tim Wright told the county health board at its Jan. 5 meeting. Wright also noted that the staff was working to improve their coding skills to make sure the clinic is appropriately reimbursed for services rendered.

“We have done services and billed for an additional $230,000 that has not been collected in Medicaid and private insurance,” Wright told the newspaper after the meeting. “Plus, we have $15,900 outstanding from patients that owe us their part of a co-pay, deductible or something along those lines. We’ve only collected 19 percent of our Medicaid funds. That’s the biggest reason this is behind.” Medicaid claims are paid by managed-care companies that contract with the state.

Wright said he expects to collect about 40 percent of the $230,000, which would be an additional $92,000. "My concern is, when is it coming?” he said. “I don’t know, they don’t know and we can’t keep putting the health department potentially in the red, anticipating that money is coming."

After the meeting, Wright told the newspaper that new figures just approved by state health officials in Frankfort show the department is now projected to end the year just over $100,000 in the red. He said there was enough money in a budgeted reserve account to pay for that.

The newspaper reported that several board members expressed their concerns at the meeting, all saying they wanted the clinic to succeed, but not if it needed continued support from local tax dollars. Wright agreed, and told them that he is working on several solutions that were too premature to share.

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