Medicaid Mix-up Frustrates Patients

By: Robert Borrelli
By: Robert Borrelli

Along with the New Year, some 1000 Medicaid patients at an Elkhart doctor's office found they'd been switched to another doctor. However, they were NOT supposed to be.

The Hoosier Healthwise program makes sure Medicaid patients get the care they need.

Just before Christmas, patients at Elkhart's Bristol Street Pediatrics received letters reassigning them to different doctors.

While the medical practice did switch the agency that carries their plan, patients were supposed to follow, but instead, were reassigned to other doctors.

"They're very upset and confused,” says Senior Partner, Doctor Lynnette Valentijn of Bristol Street Pediatrics. "It seems that nobody really wants to admit who's fault it is."

Valentijn is frustrated for her Medicaid patients.

Most of Elkhart's pediatricians practice at her office.

Fully, 15-percent of the patients there are on Medicaid and were told about a week ago they'd need to go to another doctor.

A state Medicaid manager says a clerical error is to blame for the mix-up.

Mark Fritz told us in a phone interview from Indianapolis, “It was brought to our attention of our staff this morning, I think, by your phone call to MHS. Bristol Street Pediatrics was put into the system as specialists instead of primary care physicians. That was a mistake of checking a wrong box."

Fritz went on to say, "It's a small mistake with a small impact. Across the whole state there were 250,000 members across the state who've been moved from one doctor to another and this is the only group we've heard of in the last two weeks."

However, it’s a momentary mistake that'll take up to three months to fix.

Fritz told us that, “All the members will be contacted over the next 90-days by Americhoice, the enrollment broker, and will be reassigned back to the Bristol Street Pediatric Group. In the meantime, patients are covered, whether they go to their new physician or the Bristol Street Physicians," where affected patients are being treated for free until the mistake can be repaired.

Doctor Valentijn says, “We try to serve the community and to serve the children that need us and this is just unacceptable. This response that they can't fix it for 90-days, that's just ridiculous.”

Doctor Valentijn has practiced medicine for 17-years and says she has never seen a "mess-up" this bad.

What made it worse: patients were getting the letters right at Christmas-time.

Even the doctor's office couldn't get answers because many Medicaid managers were off during the week between Christmas and New Year's.

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