This blog is for you. while there is no difficulty in others reading it, this one concerns you all directly. Well at least those of you who accept Medicare, Medicaid and TriCare. (If there is a federally funded carrier that I missed, I apologize, and advise you to check on them as well). Look and see if any of your Medicare claims submitted after December 19, have been received, paid or rejected. And then look at your Medicaid claims and see it they have been paid. (In Oklahoma, look after December 28). If the answer is yes, well then never mind. If not well, it is your attention that I am seeking.
I understand this does not affect physicians that work at the VA, many of the Indian Clinics, and possibly those that are federally funded, but for the rest of you, this absolutely affects you, whether in practice for yourself, a small group, or those employed by a hospital. CMS has installed firewalls blocking claims from getting through. This is not just for providers who are not 5010 compliant. I went through all the steps required to be compliant, and my payments have been blocked. This is not just the 2 week delay we were told to anticipate for the 5010 conversion. This is a complete block that appears to not be vendor specific nor clearing house specific.
After checking those of you who have found this to be true that you have not been paid by those under the umbrella of CMS, I am asking for your help. I have attempted to contact CMS and cannot get through. Their email addresses are only for those who wish to report fraud either on themselves or someone else. I am asking you to take the time to write your Senators and Congressmen/women, in order to get this situation fixed. If not, many of us in smaller clinics have only a small amount of time left.
This is not about greed, this is about getting paid for services you provided. Last week, I had to pay my staff’s payroll partially out of my own bank account. If you want to write it off as bad business decisions that is fine. I have made some, but realize that if you are not getting reimbursed, at some point you will find that you also are unable to practice medicine. I am not asking for money that is not mine, only what I have earned. I cannot continue practicing without income coming in. My practice is 45% Medicaid and 25% Medicare. How long could any of you go without receiving payment from 70% of your patients?
And for those of you who accept neither, ask yourself what will happen if Medicare and Medicaid are allowed to get away without paying? What will happen to the rates to your private insurance payments? And those in the Emergency Rooms- where do you think that those patients that can no longer see their physician will end up? I am just asking that you write your Senators and Congress for help to end this block so that we as physicians can get paid for what we have done. I have not committed fraud, and I have followed the rules. And following the rules has led to me being within two weeks of being forced to close my office, because that is the reality. I cannot afford to bankroll my staff any longer than that. They say you should find a career you would do for free, I have been doing that since the end of December, I cannot see myself paying to do this for long.
Thank you for your time and any effort you put towards my cause, and for many of you, your own cause.