Q&A with Dr. Tom
Patients that have passed away are still on my Medicare Advantage panel list months later and I am still getting their capitation payments attributed to me. What should I do?
Years ago, when I reconciled my patient list every month, patients who were deceased persisted on the list months—-sometimes for over a year.
I took to calling my insurer every month to correct the error, but the patient names persisted on the list despite my efforts.
I was told that revenues were reconciled and inappropriately credited monies were corrected in the final yearly calculations before any checks were cut.
I looked for it. I and my OCD followed the dollars just to see. I never found a single dollar clawed back. Not a one.
I brought this up to our insurer liaison at the time of one of our final yearly reconciliations. He pulled out an attestation of compliance signed by the corporate compliance officer and said “don’t worry about it.”
So I cashed the check, but I still followed the dollars.
And waited for the clawback.
The clawback never came.
Later, we were told that CMS was able to interface with state death databases, which would “fix the problem.”
I saw no difference.
After a while, I stopped looking at the deceased patients on my list. No action I could conceivably take had any result, so I stopped wasting my time and worked on issues where my attention had some effect.
You should to.