51˶

Sinking Pediatric Practice Afloat After 51˶ Profile

— Sometimes an article is worth $97,000 (in back pay).

Last Updated March 9, 2015
MedpageToday
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To her patients, , is a celebrity, but outside of her eastern-North Carolina pediatric practice, Edwards passed her days in relative obscurity. Last October, a 51˶ profile nudged her into the spotlight, and now that spotlight has paid off.

Edwards' practice was suffering financially. The pediatrician even cashed in all of her retirement savings to keep it afloat.

With 80% of her patients on Medicaid, she and her staff faced a series of devastating blows when the state of North Carolina failed to pay for services rendered. "I told my staff that I wasn't sure I'd be able to keep paying them," Edwards said at the time.

But after the 51˶ article ran, things began to look up.

Just a week after the article was published, Edwards found a small, pastel envelope, mixed in with her mail. A family practice in Detroit had taken up a collection and sent a check for $599 to help with Ahoskie Pediatrics' bills.

"I was trying to send it back but the secretary said, 'They really mean for you to have it,'" Edwards says. "They just wanted me to keep doing my work. So I kept it. I'm sure it paid my salary that week."

Three days later, Edwards received two carloads of visitors from Raleigh. The state Department of Health and Human Services had instructed two different departments to make the 2-hour drive to go sort out Ahoskie Pediatrics' financial woes.

"That article gave us exposure," Edwards says. "I think the state read it and they were like, 'We are going to help you, we aren't going to let this happen to you.'"

The first DHHS group was tasked with guaranteeing that Edwards' EHR system interfaced correctly with the state's new Medicaid management software. The other visitor's job was to make sure the practice was billing the state correctly.

"They should have car-pooled," Edwards laughed. "Neither knew the other one was coming, but both were sent by the state powers that be. I was in awe."

The DHHS employees confirmed the practice's billing and software were working correctly, but no one was able to give her the money owed for patients she had seen up to 2 years prior. They told her she'd have to wait for another "sweep," a departmental reconciliation that sends bulk payments to Medicaid providers.

In order to keep paying her staff, Edwards began to cut corners -- she stopped paying for her EHR system, a $3,000 expense for software that didn't meet her needs. She switched to paper charts. At home she began to cut corners as well, eyeing a growing pile of past-due notices from the IRS and state Department of Revenue. When she had liquidated her retirement to keep Ahoskie Pediatrics' lights on, she had failed to withhold the correct amount of taxes.

But then on an otherwise normal day in early January, Edwards received an electronic notice that $97,000 had been deposited into her business accounts. For the first time in more than 3 years the state was up-to-date on all it owed the practice.

"Three months' response time may seem long to someone else," Edwards says. "But I have no doubt that was a direct result of them reading that article in October. I have no idea how long we would have been waiting otherwise."

Disclosures

This story is part of a partnership between 51˶ and , a not-for-profit news organization covering health care in the state. The collaboration will make it possible for us to publish regular profiles of healthcare professionals from North Carolina.