Some New York City doctors say they are facing their own financial meltdown, squeezed by a months-long delay in Medicare reimbursements.
One Manhattan psychiatrist said he hadn’t been paid for 20 patients since April, and another said he was still waiting for about $3,500 in reimbursements.
Dr. Leslie Bennett, a Queens internist, said lack of payments between July and the end of September have put him in an enormous bind.
About 40 percent of the patients at his Kew Gardens Hills practice have Medicare, the government’s health-insurance program for the elderly.
“I couldn’t pay my bills. I couldn’t pay my mortgage. I couldn’t pay my malpractice,” Bennett said. “It was incredible.”
The delays are so bad that they are prompting fears that doctors may drop out of the Medicare program or decide to retire early.
“If you’re running a business and you don’t have that cash flow coming in, it’s a disaster,” said Dr. Malcolm Roth, a plastic surgeon and president of the New York County Medical Society.
He said that he’d experienced payment delays and that some doctors had had to take out loans to stay open. Ninety-three percent of doctors in New York accept Medicare.
The payment problems are tied to a switch in March to a new contractor, National Government Services (NGS), which is now processing all Medicare claims in New York.
The change was part of a nationwide effort to standardize claims payments. Delays have also been reported in other states, including New Jersey.
Doctors say claims are being rejected for seemingly petty omissions, such as the lack of a patient’s middle initial.
“Sometimes you’d speak to the people on the other end, and they’d have no explanation for why this happened,” one doctor said.
Medicare said it was not aware of any widespread processing issues that were delaying payments.
“Are some physicians having difficulty? Of course, but our data does not suggest that their payment issues are pervasive,” said Jeffrey Hall, Medicare spokesman for New York.
But NGS spokesman Todd Siesky acknowledged a backlog in paper claims, which he said the firm was working to rectify.
He said NGS processes 5 million claims per month in New York and Connecticut, of which 5 percent are filed in written, rather than electronic, form.