COEUR d'ALENE - A new Medicaid claim processing system is causing big headaches for many Idaho health care providers.

Idaho Medicaid went online June 7 with Molina Medicaid Services, a new contracted vendor in charge of claim reimbursement for the entire state.

The change came just as health care providers were entering a three-week period in which all claim payments were being delayed so the Idaho Department of Health and Welfare could balance its Medicaid budget for the last fiscal year.

Many service providers are still waiting for payments, or confirmation of pending payments, and they blame glitches in the new reimbursement program.

"Basically, we have been since the second week of June with no reimbursement, nothing," said Jodi Smith, the director of Family Support Services of North Idaho in Coeur d'Alene.

The biggest problem, Smith said, is that provider agencies like hers haven't been able to enroll in the new system, a requirement to be able to submit claims and receive payments.

Smith said her agency followed the directions given to them by Idaho Health and Welfare, and applied for enrollment before the April 30 deadline.

They received conflicting information about the process from Molina representatives, Smith said, and had their application denied once. After they were told a rep would "manually put it through," they were still unable to submit claims.

Some of Smith's clients are being, she believes erroneously, deemed ineligible for Medicaid. Since there is a chance the denial of eligibility is due to a technical problem, Smith said her agency is still assisting these clients "because they need it."

"What it boils down to is limiting access to services that should be covered," Smith said. "It affects Idaho citizens who should be getting services."

Smith's office provides mental health and developmental disabilities support programs to about 250 clients.

"We have 60 staff members who continue to need to get paid while we're not getting reimbursed," Smith said. "We're fortunate. We had some additional reserves and some income that doesn't come from Medicaid."

Not all providers are in that position.

"We're looking at closing our doors next week if something doesn't change," said Stephanie Spencer Whipps, director of the Idaho Center for Autism in Boise.

The majority of her agency's claims have been pending, and she has been told by Molina that it will take until August to settle them. They signed up with Molina prior to the April deadline.

Whipps has 15 staff members serving about 60 clients, mainly covered by Medicaid.

Banks and credit unions have turned down her requests for a loan or line of credit to help cover the gap because they can't loan money on future income.

"I've talked to 40 different agency owners all over the state, and they're all in the same position," Whipps said.

Kelly Keele, with Transitions, Inc., an Idaho Falls agency that provides life skills training and children's support and mental health services, said his company will be in the same boat by the end of July if the state doesn't pay at least 50 percent of his agency's claims.

"I probably wouldn't be able to do anything other than close my doors. We can't just work for free," Keele said. "We've already carried the state for three weeks."

In addition to not receiving payments, the problems have doubled the amount of staff time needed to submit claims.

"That's just added expense," Keele said.

Emily Sinmitt of Idaho Health and Welfare said many of the delayed payments are because providers did not complete their enrollment applications by the deadline.

For those who did apply in time, Sinmitt said it's likely taking longer because individuals and providers are going through the system for the first time, and there are extra steps.

"We haven't seen any major problems with the new system but there are a few issues that are being worked through right now, and hopefully will be addressed as everyone gets used to operating with a new system," Sinmitt said.

Of the 14,000 Medicaid providers in Idaho, Sinmitt said 2,000 did not file their enrollment applications by the deadline.