Archive for fraud

And I thought that stuff like this only happned in movies…

Posted in Uncategorized with tags , , , , , on 4, July 2008 by chockblock

Source: CNN.com: Woman who died on hospital floor called ‘beautiful person’

To people around the world who have seen the video, Esmin Green is a symbol of a health-care system that seems to have failed horribly.
Surveillance video shows Esmin Green on the hospital floor for more than an hour before anyone helps her.

Fellow churchmembers say they served as a family for Esmin Green, shown in 2007, after she left Jamaica.

Green, 49, is shown rolling off a waiting room chair at King County Hospital in Brooklyn, New York, on June 19. She lands face-down on the floor, convulsing.

I was a clerk at my local mental health clinic. When I was not handeling patient records I was fighting the Medicaid SALUID! for patient benefits. Each claim form hace a 4″ by 4″ square. In the square I had to write about the problems patients had, theraputic goals set by our therapists and problems that would block those goals. In a 4″ by 4″ square.
Srsly. There was the client who was court-ordered into therapy and case management. A therapist treats problems, case managers follow up and make sure clients are ok. That costs lots of money. We were not paid by the state for three monts, to the tune of over $20,000. That was for therapy, calls to his parole officer, employers, family and medications. Turns out that they believed that he was in another city, 100 miles away. I said that if that were turn, the judge would have had the client arrested, becasue there was a VERY good reason he was in therapy. Another time the Medicaid office was off for lunch. I need to resolve four claims, confirm two more and process three new clients. The Medicaid office chose that day two take a 3 hour lunch. Needless to said I was one the phone first thing the next day.

Canada is NOT the model or solution to any of our health care problems. I am ashamed to call myself a health care professional after hearing about Esmin Green death. Yes I was not a provider, but part of the health care machine. The problems start that the private insurance companies and work their way into government. I only hope that horro stories prompt calls for real reform