60 kids on Medicaid no longer getting therapy due to billing dispute

LITTLETON, Colo. -- A Littleton pediatric clinic that provides occupational and speech therapy to kids has stopped accepting Medicaid patients. Randy Stewart, the CEO of Blue Horizon Therapy, told the Problem Solvers the state's new billing system has been a nightmare to navigate.

"Over the last three months they have yet to pay us hardly anything. As of Monday I had to call them and say I cannot take Medicaid children anymore because I can`t afford to pay my staff," said Stewart.

Stewart estimates his decision affects about 60 patients at his clinic. "It was very hard for me to pull that trigger. We opened this company because children weren`t getting served and now I`m having to turn children away and it breaks my heart."

The move by Blue Horizon Therapy has left moms like Melyssa Wilson scrambling, "Terribly heartbreaking, terribly stressful. It`s very hard to find a good provider, to find somebody who doesn`t have a wait list and to find someone who can coordinate the care of four kids."

Wilson has two sons diagnosed with autism, another son has anxiety and obsessive compulsive disorder and her daughter may soon need speech therapy.   She has Blue Cross Blue Shield as her primary insurance but was using Medicaid as a secondary insurance to cover co-pays and deductibles because therapy was so expensive. "It’s $210 per week for four kids," even with her primary insurance said Wilson. Without Medicaid, the Colorado Springs mom said she can't afford for her children to get therapy.

FOX31 contacted Children’s Hospital Colorado and found out it is still accepting Medicaid patients. But a spokeswoman for Children's said, "However, we understand multiple primary care providers across the state are experiencing challenges."

A spokesman for the Department of Health Care Policy and Financing, which administers Medicaid for the state of Colorado insisted the dispute with Blue Horizon Therapy is an isolated issue.

State spokesman Marc Williams told the Problem Solvers Blue Horizon Therapy wasn't properly submitting claims that could be coded by the state's new billing technology. "We have provided written guidance to Blue Horizon Therapy with the necessary steps to resolve their billing issue. We will continue working with them to assist with any future billing issues they encounter," Williams said.

But Williams added the state doesn't want to see Medicaid patients turned away and still hopes to resolve any miscommunication issues Blue Horizon Therapy may have with the state's new billing vendor.

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