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Exclusive: Glitch puts squeeze on doctors

October 1, 2008 12:00:00 AM PDT
Some California doctors aren't getting reimbursed by Medicare, and it's beginning to affect a number of medical practices and the ability to pay their bills.This has been building for months. Doctors say they expected these glitches to have been cleared up, but they haven't been and so now they are speaking out. At a practice visited by ABC7 Eyewitness News near Huntington Hospital, 70 percent of its income comes from Medicare.

Watch the exclusive video: Will doctors be forced to close their doors?

Gertrude Mach is a Medicare patient whose very life depends on regular visits to her cardiologist. Medicare is supposed to be reimbursing her physician. But lately, when her doctor's office calls Medicare's newly contracted billing service, they get hours of waiting, no information and no payment.

It is so bad doctors at Southern California Heart Specialists in Pasadena just axed their own salaries.

"The doctors are going without any compensation," said Dr. Joel Heger from Southern California Heart Specialists. "We're not taking any distribution this month."

Doctors statewide are suffering, according to the California Medical Association.

"Some have had to borrow money from banks, and you know how hard that is these days. And some are afraid they are going to be closing their doors soon," said Dr. Richard Frankenstein from the California Medical Association.

They say the bottleneck is at Palmetto Billing of South Carolina. It was recently contracted by Medicare to handle claims for all of California, which is made up of 70,000 doctors. It's all part of a federal plan to downsize billing contractors from 44 to 15.

"But I think it's pretty irresponsible for Medicare to order a transition like this that they simply were not prepared to do," said Dr. Frankenstein.

A spokesman for the Center for Medicare Services says many of the problems were "inherited from the previous contractor," and that they are "aggressively working on improving line service."

Meantime at the doctor's office, they are looking for a line of credit in the midst of a national credit crunch.

"We have to pay our employees, we have to pay our rent, we have to pay equipment," said Dr. Heger. "We're here to help the patients, and we need help. We need help to just make that process run."

Medicare has set up a type of strike taskforce to expedite payments, but at this point, doctors say they still have no estimated time of when they will get paid in full.

 

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