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Rumblestiltskin@lemmy.ca

She helped thousands get COVID-19 shots. Now she's on the hook for $600K (www.cbc.ca)

submitted 1 week ago by smokebuddy@lemmy.today to c/ontario@lemmy.ca

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A Kingston, Ont., doctor celebrated for organizing drive-thru vaccination clinics that helped thousands get shots at the height of the COVID-19 pandemic is now being ordered to pay back more than $600,000 in fees for those same services.

Dr. Elaine Ma said she organized 45 mass vaccination clinics that administered roughly 35,000 doses between April 2021 and the following February.

Her work was recognized by the Ontario College of Family Physicians, which granted her its Award of Excellence in 2021, in part pointing to Ma's role in boosting local vaccination rates.

About a year later, the doctor said she received notice from the Ontario Health Insurance Plan (OHIP) seeking to recoup the money she had billed for the shots — approximately $600,000, plus around $35,000 in interest.

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[–] streetfestival@lemmy.ca 13 points 1 week ago (5 children)

"This doctor billed the Ministry for over 23,000 vaccines over 5 days, incorrectly billing the Ministry for $630,000, 21 times their eligible payments."

Those vaccines were not administered by her or her staff, but by local medical students, and not in her office, both of which apparently go against billing codes.

I'm not sure I agree with seizure of all funds here, and the vaccine clinics did good, but I think the doctor intended to misuse billing codes and I understand why the Ministry wants some money back. There should have been more communication and compromise earlier on. Like, if a doctor bills the province for $100,000 for a day's services that should raise a flag

[–] halcyoncmdr@lemmy.world 5 points 1 week ago (3 children)

Billing codes are purposely complicated to deny legitimate claims a lot of the time. Two nearly identical codes will have one covered and another not for whatever reason they come up with. It's why there are entire teams to handle billing at large institutions.

The real question honestly, is if those individuals were authorized to give shots, are there different billing codes that should have been used instead? And if not, why?

[–] streetfestival@lemmy.ca 3 points 1 week ago (2 children)

This happened in Canada, not the US, but I agree with the US healthcare issues you mentioned

[–] healthetank@lemmy.ca 3 points 1 week ago

Canada is the same, just single payer (ie instead of hospitals billing the insurance company, they bill OHIP). There's still complicated codes, though for what it's worth they don't change much, if at all. If you're billing thousands of shots you'd probably want to double check you're using the right codes.

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