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Local Doctors Aren't Getting Paid Save Email Print
Posted: 7:00 PM Jul 17, 2008
Last Updated: 8:30 PM Jul 17, 2008
Reporter: Josh Gauntt
Email Address: joshua.gauntt@wjhg.com


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Medicaid, a major health care insurance provider has been under the gun recently for reportedly not paying physicians.

In turn, those physicians can't provide adequate service and are having to turn you away.

Dr. Fernando Malamud, a Panama City oncologist deals with a lot of patients on a regular basis, but for a while now, he's been having some problems with Medicaid.

"I have not seen a check for Medicaid or we have direct deposited in four weeks," Malamud said.

And, he's had to turn patients away who can't afford chemotherapy.

"As a doctor, how does that make you feel? Devastated, I know, despite the fact that he does not have a curative disease; the chemotherapy in his situation would improve the quality of care. I don't have the funds to provide that care," Malamud said.

After doing some investigative work, we found that it's not Medicaid who's really to blame, it's a new billing system called Electronic Data Systems or EDS.

When you finish visiting the doctor, he or she fills out the claim either online or by phone.

With the high volume of traffic, EDS can't respond fast enough to the claims.

"So down from providers submitting claims all at once, the time things got a bit tied up," Fernando Senra, press secretary for the Florida Agency for Health Care Administration said.

"As of today, not a penny has been sent to me yet," Malamud said.

And it's those payments, doctors rely on to pay for your treatments.

"We had the old system for 18 years. So you know, you get used to the current system and changes. There are all types of things to get used to and of course we anticipated glitches and issues that we know are going to surface," Senra said.

Senra stresses, the problems within the system should be fixed within a month. "We're really finding as soon as we become aware of an issue, things are being turned around very quickly," he added.

"We have to purchase our chemotherapy as well as other biological therapy drugs out of our own pocket, then expecting a reasonably prompt payment. Otherwise, we will run out of money and be broke," Malamud said.

We spoke with other doctors Thursday and they tell us they haven't been paid by Medicaid either.

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Posted by: lisenby home care, inc Location: 412 n. cove blvd on Jul 18, 2008 at 09:41 AM
The physicians are not the only ones having problems. We were all told that this system would be the " best thing since sliced bread". Maybe if it worked correctly, it will be. We were told that we could load any number of line items on the claim, but the truth is right now, it is one line item per claim. After two weeks of trying to enter claims nonstop, I figured out that maybe I could do the 1 item claims, and that is how I finally got claims into the system. The problem is not with Medicaid, just the system they were sold. The company representative that services our area has been great. She listens to our complaints and concerns, and will report them. We are still having major issues with the system, but at least we have been able to get claims in and paid. The idea that the whole state went on line the same day is crazy. I have billed Medicaid since the late seventies, been through a number of changes, and never have had a problem like this. Ann Parmer

Posted by: CATHY Location: Panama City on Jul 18, 2008 at 08:30 AM
I am a biiler at a medical office and have been for 12years. I have been through many new billing agency's taking over medicaid pymts and this the WORSE mess I have ever seen. We were informed when this new company took over, that they were prepared for the switch and we would not have an interuption in receiving payments for services rendered. My question is where in the world is Gov. Crist? The economy is struggling as it is with a crisis of health care.

Posted by: Janet Location: Lynn Haven on Jul 18, 2008 at 12:47 AM
Our office had the same problem as well. Until you get the hang of it it's impossible to figure out or it's impossible to get through cause the lines are always busy. Things have calmed down a little bit since you can go online and find the information out now. In order to use the system, you have to know it and be able to navigate before you even start..so your pressing 2 is for this 3 is for that and press it before it goes through the whole recording or your stuck there listening to recording for ever..it really is a huge hassle.

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