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

submitted 21 hours ago by [email protected] to c/[email protected]

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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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[–] [email protected] 5 points 18 hours ago (1 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?

[–] [email protected] 3 points 18 hours ago (2 children)

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

[–] [email protected] 2 points 10 hours 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.

[–] [email protected] 7 points 17 hours ago

The Canadian Healthcare system isn't that different from the US as much as you all might want to think it is. You just have fewer groups paying, the bullshit complexity built into the system is a near copy of the US.