Earlier this year, Grace Elizabeth Elliott received a mysterious hospital bill for medical care she never received.
She soon discovered that clerical errors could span continents and how frustrating to fix.
During the 2013 college holidays, Elliott, then 22, fell unconscious and began to develop a fever while visiting his parents in Venice, Florida, about an hour south of Tampa. rice field. Her mother, her nurse, took her to a facility that locals simply know as Venice Hospital.
In the emergency department, Elliott was diagnosed with a kidney infection and was held overnight before being discharged on a prescription for antibiotics, a common treatment for the disease.
“My hospital bill was about $100.
She recovered and eventually moved to California to teach kindergarten. Venice Regional Her medical center was acquired by Franklin, Tennessee-based Community Health Systems in 2014, eventually renaming her to ShorePoint Health Venice.
A kidney infection and an overnight stay in the ER would have been nothing more than a memory for Elliott.
Then came another bill.
patient: Grace E. Elliott, 31, is a preschool teacher who lives with her husband in San Francisco, and Grace A. Elliott, 81, is a retiree and lives in Venice, Florida.
Medical services: For Grace E., in 2013, an emergency room visit and overnight stay, plus antibiotics to treat a kidney infection. For Grace A., shoulder replacement and rehab services in 2021.
Service provider: The Venice Regional Medical Center was later renamed Shorepoint Health Venice.
Total bill: $1,170, the patient’s liability for shoulder replacement services, after adjustments by health insurance independent of Elliott and payment of $13,210.21. The initial charge was $123,854.14.
Gives: This is a case of mistaken identity that started at the hospital registration desk and didn’t end until months after the files were handed over to the collection agency.
Earlier this year, Grace E. Elliott’s mother opened her daughter’s bills from Shorepoint Health Venice, claiming more than $1,000 for recent hospital services, Elliott said. She “quickly realized something was wrong.”
After months of research, it was finally revealed that the bill was aimed at Grace Ann Elliott. Grace Ann Elliott is a much older woman who underwent shoulder replacement surgery and rehabilitation services at a Venice hospital last year.
Accessing the wrong patient’s file due to name confusion is a common error, experts say, but safeguards usually exist, such as checking the patient’s photo ID.
The hospital has treated at least two Grace Elliotts. When Grace A. Elliott came in for her shoulder replacement surgery, a hospital employee accidentally called up her Grace E. Elliott account.
“This could definitely happen,” said Shannon Hartsfield, a Florida attorney who specializes in health care privacy breaches. (Hartsfield does not represent anyone involved in this case.) “There are all kinds of human errors. Workers can pull names, click the wrong button, and not check. [the current patient’s] Confirm your date of birth. “
Young Elliott received bills from a hospital she had not visited in years for procedures she had not received. But it took her nearly a year of hours of phone calls to undo her damage.
Initially worried that she had been a victim of identity theft, Grace E. Elliott contacted ShorePoint Health Venice and was transferred from one department to another. At one point, a billing employee of hers revealed to Elliott that the hospital had recorded the date of birth of patients undergoing shoulder replacement surgery. It wasn’t hers. Elliott then sent a copy of her ID to her hospital.
It took weeks before administrators at ShorePoint’s headquarters in Florida acknowledged the hospital’s mistake and promised to rectify it.
But in August, Grace E. Elliott received notice that corporate headquarters had sold the debt to a debt collection company called Medical Data Systems. The agency was chasing Grace E. Elliott for the remainder of her shoulder surgery, even though the hospital had admitted its mistake.
Grace E. Elliott said, “I thought, ‘Well, I’m just going to work directly with them.’
Her appeal was dismissed. In its refusal letter, Medical Data Systems said it contacted the hospital and verified the name and address on file. The agency also included a copy of Grace A. Elliott’s expired driver’s license with Grace E., along with several pages of the elderly woman’s medical information, to support that conclusion.
“As hospital business associates, collection agencies have an obligation to ensure that incorrect patient information is not shared,” Hartsfield said.
In an email to KHN, collection agency vice president Cheryl Spanier wrote, “MDS complies with all state and federal rules and regulations.” Spania declined to comment on Elliott’s case, she said, requiring written consent from both the medical system and the patient to do so.
Elliott’s second appeal was also denied. She was told to contact the hospital to fix her problem. But the health care system had sold her debt long ago, so she didn’t have the momentum to seek help from her ShorePoint Health Venice, Elliott said. The hospital closed in September.
Resolution: In mid-November, shortly after the reporter contacted ShorePoint Health, which operates other hospitals and facilities in Florida, Grace E. Elliott received a phone call from Stanley Padfield, the Venice hospital’s privacy officer and head of health information management. I received “He said, ‘It worked,'” Elliott said, adding that she was relieved but skeptical, “I’ve heard that many times.”
According to Elliott, Padfield said he told her she was on the list as a guarantor for Grace A. Elliott.
Elliott soon received a letter from Padfield confirming that ShorePoint Health had removed her information from Grace A. Elliott’s account and that she had not been reported to any credit agency. The letter said her information had been removed from the collection agency’s database, and acknowledged that the hospital’s corrections were “failed to be properly communicated” to the collection in the first place.
Padfield said the error started with a “registrar” who “received additional privacy training as a result of this incident.”
Devyn Brazelton, marketing coordinator for ShorePoint Health, told KHN the hospital considers the error to be an “isolated incident.”
Using the date of birth provided by hospital staff, Elliott was able to contact Grace A. Elliott and explain the mix-up.
“I’m a little upset right now,” Grace A. Elliott told KHN on the day she learned about the billing error and disclosure of medical information.
Take-out: When Grace E. Elliott asked Padfield, a retired privacy officer at Venice Hospital, if anything could be done to combat such blatant identity mistakes, he replied, “Probably not.” said.
According to experts, this is the dark secret of identity issues. Mistakes entered into the database can be very difficult to correct. And such misinformation can live on for generations.
For patients, this means it is important to review information on the patient portal. This is an online medical profile that many providers use to manage things like scheduling appointments, organizing medical records, answering patient questions, and more.
One of the drawbacks of electronic medical records is that errors are easily propagated and frequently repeated. It is important to use all available documentation to dispute medical record errors and to correct them early and forcefully. Whether the problem is the wrong name, a drug you’re no longer taking (or not taking at all), or an incorrect diagnosis, it’s true.
The process of amending records can be “very complicated,” Hartsfield said. “But as patients have more and more access to their medical records, they want them fixed, and health care systems and their affiliates need to prepare for that.”
Grace A. Elliott told KHN that she received a call from ShorePoint Health a few months ago indicating that she was unpaid for her shoulder replacement surgery.
She asked for a copy of the bill, she told KHN. It’s been months since she asked and it still hasn’t arrived.
Bill of the Month is a crowdsourced study by KHN and NPR that analyzes and explains healthcare costs. Have an interesting medical bill you’d like to share with us? Tell us about it!
This article was produced by KHN, which publishes California Healthline, an independent editorial service of the California Health Care Foundation.
|
|
.
