Medicare quit paying my clinic at the end of July, on the 31st.
I was still halftime in clinic, we were interviewing a new receptionist as my receptionist of five years wanted to retire by August first. We got some sort of notification from medicare, but their letters are very cryptic.
My new receptionist was needing orientation and help and I was really tired after July. I saw patients in the morning but the interviewing and choosing a person and training them took all day. I redid the medicare application and sent it in. We continued to see medicare patients and turn in the bills.
Medicare sent us a mystifying letter saying that something was wrong with the application. This was, mind you, a renewal. I had been seeing medicare patients for five years in my clinic.
And it's not medicare. It's Noridian in my area: that is the private company that medicare contracts with in my area.
I call them. I am given a name and a number to identify the call. I have two Ptan numbers, one for me as a physician and a second for the clinic. The first call said that my personal Ptan application was correct but the clinic one wasn't.
I did it again and mailed it. Second day air. He said that our payments should be released in 10-14 days.
Ten days. Nothing. Fourteen. Nothing. I am pulling from savings to run the clinic. I call a second time. Again I am given a name and a number. She said I had to CALL to get paid once the application was received. I said the first guy didn't say that. She said another 10-14 days.
We wait. After ten days I call. A third number and person. Once again I have a bizarre email. I ask about the PTan number on the email, which is not my clinic's Ptan number. Oh, says the man, that is what is wrong with your application. He says to do form (numbernumbernumber B) not form (numbernumbernumber A). And it will be 10-14 days after they receive it.
I do it AGAIN. I do notice that all of the old copies of the form in our file have the PTan numbers wrong. Weird. They have been paying me for five years.
Ten days. I call a fourth time. She says that it will be 30 days not 10 to 14 until medicare lets me know if my application is correct. Or they might pay me after 10-14 days. They aren't, so I argue that something must still be wrong. What is it? She can't tell me. I want a supervisor. She says that I can talk to a supervisor in 10-14 days. I want to scream and hammer the phone into the wall. We figure out that the Ptan number on the application is correct. I say, "I am writing my congresswoman." and hang up.
So I do. I find my Senator's email and I write to her. I have been a rural family practice doctor for 25 years and I saw a 98 year old yesterday and a 91 year old today and I LIKE my elderly patients, but I have HAD it with medicare. I list the phone call dates and names and identifying numbers and I say FIX IT because otherwise I am for the first time in 25 years seriously considering quitting medicare.
Two days later medicare sends an email saying they are releasing my payments.
The next day we get a direct deposit for $9000.00. That is a START.
One week later we get a call from medicare explaining what is wrong with our application. Not just one thing. Medicare doesn't seem to have a copy of our business license from five years ago. We have to put the personal Ptan on page xgyb-14. They want details about the nursing home. Do I do home visits? There are a total of five sections to fix.
The medicare person explains that our application has actually been wrong for five years, but now medicare, that is, Noridian, is getting audited so they have to get everything cleaned up.
So THEY have KNOWN it was wrong for five years, but held my payments since July, while they try to get their act together and tell me what the hell is wrong with it?
I want to be paid INTEREST for all the time they have held my payments and for the time I have spent on the phone and redoing the cryptic application.
And many thanks to my congresswoman, for keeping my clinic open.