Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: WEDNESDAY, January 27, 1993 TAG: 9301270070
SECTION: BUSINESS PAGE: A9 EDITION: METRO
SOURCE: CAROLYN CLICK STAFF WRITER
DATELINE: LENGTH: Medium
MEDICAL CLAIMS OFF TRACK
A computer software problem apparently has derailed medical benefits for thousands of railroad retirees, but officials said Tuesday they hope to have the system back on track soon.Until November, Joseph Pakush Sr. of Roanoke had little complaint about the speed with which his railroad Medicare claims were processed.
His doctor bills and other medical expenses usually were paid within four to six weeks by The Travelers Companies, which handles health claims for railroad Medicare beneficiaries.
But in November, he received a letter telling him he had met only $18.47 of his annual $100 deductible. Pakush knew that was impossible, because earlier in the year he had received payment for a doctor's bill that exceeded $100.
It turned out the problem was linked to software supplied to The Travelers by a vendor hired by the federal Health Insurance Financing Administration, said Dennis Milewski, a spokesman for the Travelers. HIFA oversees Medicare.
"There was a large backlog of claims that we couldn't, frankly, do anything about," he said.
The problem was corrected last weekend, he said, and The Travelers is working now to catch up on benefits payments.
"In about two weeks, we expect the backlog to be cleared up," said Milewski. "We feel for them and we have been doing everything we can."
Other insurance carriers also were affected, and some Medicare recipients not linked with the railroad found their benefits temporarily halted, he said. The sums involved generally were not large.
The Travelers' Augusta, Ga., office, which processes the railroad claims, now has a taped message explaining the difficulties.
"This is a nationwide Medicare problem," the tape says. "All claims affected will be automatically reprocessed when the problem is corrected."