It's been a year since Frank Anselmo was introduced to the state's new mental health billing system, and to say it's been a headache would be an understatement.

From botching billing transactions to spitting back data, the system is costing providers what could amount to millions, he says.

"It's a mess,'' says Anselmo, CEO of the Springfield-based Community Behavioral Healthcare Association. He says his association's 80 or so members were "guinea pigs" in the push to introduce a new billing system for the state's mental health providers.

Anselmo and other providers who attended a joint meeting of the state House and Senate Human Services committees last week say that the new system, introduced in July, is handcuffing mental health providers.

Anselmo told the Daily News that billing data entered by clinical staff is returned by the state's system, which indicates reports are inaccurate or missing data.

Without the correct data, providers won't get paid in a timely way.

The joint legislative committee met last Wednesday at the Thompson Center, amid reports that Chicago's city-run mental health centers were having billing problems of their own.

The timing was coincidental, according to legislators, but it underscores the struggles of many mental health providers to adjust to a new fee-for-service payment scheme implemented by the state over the past two years, in which  providers are reimbursed monthly for services they provide.

In the past, providers were funded by grant money determined at the beginning of a fiscal year, which begins July 1.
 
Providers are frustrated by the system, Value Options, which they say gobbles up information, but doesn't provide any explanation for the problems.

"Historically, our error rate is relatively low, and the number of rejections are low, and this year (the rejection rate) is higher," says Tony Kopera, president and CEO of the Community Counseling Centers of Chicago.

He says his organization is waiting on more than $550,000 in payments connected to bills it began submitting in July.

Steve Anderson, a spokesman for Virginia-based Value Options, Inc., says the company was unaware of provider complaints until a Daily News reporter contacted him. He says the software was working properly to his knowledge, and customer service representives speak with providers weekly.

But, to be on the safe side, he says, "We’ll look at the claims data from the past several months to see if there’s an issue."

John Troy, chief administrative officer for the Community Counseling Centers of Chicago, says he estimates the organization has spent between $1,000 and $1,500 a week in salary while navigating confusing data reports, trying to decipher why individual billing records were rejected.

The system, they say, doesn't specify why records are being rejected, forcing providers to backtrack through thousands of billings. In some cases, Troy says, reports have been returned in a digital copy too large for their computers to open.

Department of Human Services spokesman Tom Green says while some mental health providers in Illinois are having difficulty converting to the new system, most are billing at a higher level through fee-for-service than they were before the conversion.

"Overall we feel the new data system has been successful," he says. "But as with any new system, we have tweaked things in response to feedback from the end-users as issues have been identified."

But Anselmo says the system is not working, and it's costing mental health providers money.

"We never had problems with the grant system. This is all part of this fee-for-service transformation," he says. "It's a failure."

Troy worries the problems could jeopardize clinics' funding for next year.

"What they were saying is that they were going to base the 2010 contracts on what the accepted billing rate was as of March 2009," he says. "They have us billed at 67 percent."

Troy says his organization has submitted all of its bills, but the system is rejecting a hefty chunk of them.

Green says providers are not at risk of losing funding, as Chicago's clinics did, as long as they work with the agency to identify and fix their billing issues.