Late Medicare repayment laid to computers

November 16, 1991|By Jonathan Bor

Many doctors who treat large clienteles of elderly patients say they are owed thousands of dollars and are struggling to pay their employees because of a new computer system that has slowed the processing of Medicare claims.

Dr. J. Leonard Lichtenfeld, a Pikesville internist, said Thursday that he and many colleagues have received virtually no Medicare reimbursements since Blue Cross and Blue Shield of Maryland, which processes Medicare claims in the state, started using new computer software on Oct. 1.

"One week, two weeks, now we're in the middle of November and there is virtually no money coming through," said Dr. Lichtenfeld, who is also president of the Maryland Society of Internal Medicine.

Rose Matricciani, assistant director of the state medical society, said the level of anger has intensified as the weeks have dragged on. One physician, she said, told her that he was owed $30,000 by the Health Care Financing Administration, which runs Medicare and contracts with Blue Cross and Blue Shield.

"I think it's more than anger," she said. "It's probably desperation at this point. Doctors are six weeks to seven weeks into their reserve funds because of non-payment of claims."

The problem, a Blue Cross official said, stems from an HCFA requirement last spring that many Medicare contractors switch computer software by Oct. 1 to provide greater uniformity from state to state.

Blue Cross of Maryland selected and then modified a program designed by the General American Life Insurance Co. of St. Louis, which processes Medicare claims for Missouri. Now, the two states are using a common system.

Despite advanced training, employees have had trouble adjusting to the new system, said Glenn Shimmel, vice president of Medicare operations for Blue Cross.

Claims are usually paid in two to three weeks, but some have taken as many as six weeks to process since the new system was implemented.

"For the people here, using a new system has been like learning a new job," Mr. Shimmel said. He said the claims should be flowing at their old rate by Dec. 1.

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