Shelby Knowles for KHN
Earlier this 12 months, Grace Elizabeth Elliott received a mysterious hospital invoice for medical care she had by no means acquired.
She quickly found how far a clerical error can attain — even throughout a continent — and the way irritating it may be to repair.
Throughout a school break in 2013, Elliott, then 22, started to really feel faint and feverish whereas visiting her mother and father in Venice, Fla., which is about an hour south of Tampa. Her mom, a nurse, drove her to a facility that locals knew merely as Venice Hospital.
Within the emergency division, Elliott was recognized with a kidney an infection and held in a single day earlier than being discharged with a prescription for antibiotics, a standard remedy for the sickness.
“My hospital invoice was about $100, which I bear in mind as a result of that was some huge cash for me as an undergrad,” mentioned Elliott, now 31.
She recovered and finally moved to California to show preschool. Venice Regional Medical Middle was purchased by Group Well being Techniques, based mostly in Franklin, Tenn., in 2014 and finally renamed ShorePoint Well being Venice.
The kidney an infection and in a single day keep within the E.R. would have been little greater than a reminiscence for Elliott.
Then one other invoice got here.
The Sufferers: Grace E. Elliott, 31, a preschool instructor residing along with her husband in San Francisco, and Grace A. Elliott, 81, a retiree in Venice, Fla.
Medical Providers: For Grace E., an emergency division go to and in a single day keep, plus antibiotics to deal with a kidney an infection in 2013. For Grace A., a shoulder substitute and rehabilitation providers in 2021.
Service Supplier: Venice Regional Medical Middle, later renamed ShorePoint Well being Venice.
Whole Invoice: $1,170, the affected person’s duty for shoulder substitute providers, after changes and funds of $13,210.21 by a well being plan with no connection to Grace E. Elliott. The preliminary expenses had been $123,854.14.
What Provides: It is a case of mistaken identification, a billing thriller that began at a hospital registration desk and did not finish till months after the file had been handed over to a collections company.
Early this 12 months, Grace E. Elliott’s mom opened a invoice from ShorePoint Well being Venice that was addressed to her daughter and sought greater than $1,000 for latest hospital providers, Elliott mentioned. She “instantly knew one thing was fallacious.”
Months of sleuthing finally revealed that the invoice was meant for Grace Ann Elliott, a a lot older lady who underwent a shoulder substitute process and rehabilitation providers on the Venice hospital final 12 months.
Specialists mentioned that accessing the fallacious affected person’s file due to a reputation mix-up is a standard error — however one for which safeguards, like checking a affected person’s photograph identification, normally exist.
The hospital had handled at the least two Grace Elliotts. When Grace A. Elliott confirmed up for her shoulder substitute, a hospital worker had pulled up Grace E. Elliott’s account by mistake.
“That is the form of factor that may undoubtedly occur,” mentioned Shannon Hartsfield, a Florida legal professional who makes a speciality of well being care privateness violations. (Hartsfield doesn’t symbolize anybody concerned on this case.) “Every kind of human errors occur. A employee can pull up the names, click on the fallacious button, after which not test [the current patient’s] date of beginning to verify.”
It was a seemingly apparent error: The youthful Elliott was billed for a process she did not have by a hospital she had not visited in years. However it took her almost a 12 months of hours-long telephone calls to undo the harm.
At first, nervous that she had been the sufferer of identification theft, Grace E. Elliott contacted ShorePoint Well being Venice and was bounced from one division to a different. At one level, a billing worker disclosed to Elliott the birthdate the hospital had on file for the affected person who had the shoulder substitute — it was not hers. Elliott then despatched the hospital a replica of her ID.
It took weeks for an administrator at ShorePoint’s company workplace in Florida to confess the hospital’s error and promise to right it.
In August, although, Grace E. Elliott acquired a discover that the company workplace had offered the debt to a collections company known as Medical Knowledge Techniques. Though the hospital had acknowledged its error, the company was coming after Grace E. Elliott for the stability due for Grace A. Elliott’s shoulder surgical procedure.
“I believed, ‘Properly, I am going to simply work with them instantly,'” Grace E. Elliott mentioned.
Her attraction was denied. Medical Knowledge Techniques mentioned in its denial letter that it had contacted the hospital and confirmed the title and deal with on file. The company additionally included a replica of Grace A. Elliott’s expired driver license to Grace E. — together with a number of pages of the older lady’s medical data — in assist of its conclusion.
“A set company, as a enterprise affiliate of a hospital, has an obligation to make sure that the fallacious affected person’s data isn’t shared,” Hartsfield mentioned.
In an electronic mail to KHN, Cheryl Spanier, a vice chairman of the collections company wrote that “MDS follows all state and federal guidelines and laws.” Spanier declined to touch upon Elliott’s case, saying she wanted the written consent of each the well being system and the affected person to take action.
Elliott’s second attraction was additionally denied. She was instructed to contact the hospital to clear up the difficulty. However as a result of the well being system had lengthy since offered the debt, Elliott mentioned, she received no traction in making an attempt to get ShorePoint Well being Venice to assist her. The hospital closed in September.
Decision: In mid-November, shortly after a reporter contacted ShorePoint Well being, which operates different hospitals and services in Florida, Grace E. Elliott acquired a name from Stanley Padfield, the Venice hospital’s outgoing privateness officer and director of well being data administration. “He mentioned, ‘It is taken care of,’ ” Elliott mentioned, including that she was relieved however skeptical. “I’ve heard that again and again.”
Elliott mentioned Padfield instructed her that she had change into listed as Grace A. Elliott’s guarantor, that means she was legally chargeable for the debt of a girl she had by no means met.
Elliott quickly acquired a letter from Padfield stating that ShorePoint Well being had eliminated her data from Grace A. Elliott’s account and confirmed that she had not been reported to any credit score companies. The letter mentioned her data had been faraway from the gathering company’s database and acknowledged that the hospital’s repair initially “was not appropriately communicated” to collections.
Padfield mentioned the error began with a “registration clerk,” who he mentioned had “acquired further privateness training on account of this incident.”
Devyn Brazelton, advertising coordinator for ShorePoint Well being, instructed KHN the hospital believes the error was “an remoted incident.”
Utilizing the date of beginning offered by a hospital employee, Elliott was capable of contact Grace A. Elliott and clarify the mix-up.
“I am a bit of upset proper now,” Grace A. Elliott instructed KHN on the day she discovered concerning the billing error and disclosure of her medical data.
The Takeaway: Grace E. Elliott mentioned that when she requested Padfield, the Venice hospital’s outgoing privateness officer, whether or not she might have executed one thing to struggle such an apparent case of mistaken identification, he replied, “Most likely not.”
This, specialists mentioned, is the darkish secret of identification points: As soon as a mistake has been entered right into a database, it may be remarkably tough to repair. And such incorrect data can stay for generations.
For sufferers, which means it is essential to periodically evaluation the data in your affected person portal — the web medical profile many suppliers use to handle issues like scheduling appointments, organizing medical information, and answering affected person questions.
One draw back of digital medical information is that errors unfold simply and repeat steadily. It is very important problem and proper errors in medical information early and forcefully, with each little bit of documentation obtainable. That’s true whether or not the issue is an incorrect title, a drugs not (or by no means) taken, or an inaccurate analysis.
The method of amending a document may be “very concerned,” Hartsfield mentioned. “However with sufferers ready now to see increasingly more of their medical information, they will need these amendments, and well being methods and their associated entities must get ready for that.”
Grace A. Elliott instructed KHN that she had acquired a name from ShorePoint Well being in the last few months indicating that she owed cash for her shoulder substitute.
She requested for a replica of the invoice, she instructed KHN. Months after she requested, it nonetheless hadn’t arrived.
KHN (Kaiser Well being Information) is a nationwide, editorially unbiased program of KFF (Kaiser Household Basis).