Doctor refuses to rehire sister at family practice after $40k billing mistake, parents insist she stays: 'We had to write off the balances for all the patients we saw'

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  • "AITA for not wanting to rehire my sister after she cost my practice $40,000?"

    This is kind of long so bear with me; also, throwaway account. I am a medical professional and joined my dad's practice 20 years ago.
  • Currently, the practice has been opened 51 years (not really important but kind of cool.) My sister, T, joined the practice the same time I did and started doing all of our insurance and patient billing.
  • She has MS and her symptoms like memory loss and anxiety have gotten worse over the last few years.
  • My dad went part time about 8 years ago so I've been running the practice; meeting with the consultants, monitoring the P&L, keeping our cost down, etc.
  • In August of last year, I noticed that we weren't having as much money coming in.
  • I couldn't figure it out because I was seeing plenty of patients. I went searching through everything and found out that we weren't getting paid by Medicare.
  • I told T to figure out what was going on. She came back to me and said that we were kicked off of Medicare because we didn't respond to emails for some info.
  • She swears up and down that she didn't get any emails. So we had to re-credential with Medicare.
  • That took about 45 days. When we got the info back Medicare said that we weren't getting paid for May through November.
  • We had to write off the balances for all the patients we saw then to the tune of $40,000!
  • We appealed to Medicare and they sent us a statement of what had happened on their end.
  • T ignored three emails with requests for updated information. Fast forward to today (sorry it's so long).
  • T was very sick with shingles meningitis in July. She was hospitalized for 9 days. It was really serious, we thought she was going to di_.
  • She had to have 21 days of acyclovir by IV around the clock. She had issues walking and one side of her face is permanently paralyzed causing speech issues.
  • I honestly didn't think she would come back to work. She has long term and short term dis lity and I really thought with this illness and her MS she would stay at home.
  • While she was gone I uncovered a whole lot of info about our insurance and patient billing.
  • INSURANCE POLICY TERMS AND CONDITIONS T NOE UNITED OFAME wing will er they ghout this any Policy caused 2. Flood Exc hereunder, includ number and the item individually amendment to Q WB 51621676B Your and AS side 100 either by way o Your circumsta You will have laim. For three main Ex standard Excess this Policy unless noted next to the co
  • If the insurance didn't pay, she would write off the balances instead of following up to get the info she needed to refile the claim.
  • She never sent statements to the patients, just wrote off anything over 90 days so it looked like we were getting paid when we weren't.
  • When she said she was coming back I told my parents that I didn't want her back because she lied about everything and cost us a lot of money.
  • They said she's family and she couldn't get a job anywhere else, so she gets to come back to work and I have to over see all the insurance billing to make sure there aren't any mistakes; like I have the time for that with the 30- 35 patients I see in a day.
  • I have another staff member doing it now but she doesn't want to continue because she knows T will make the front desk a toxic area.
  • Also, my parents are hemming and hawing on selling me the practice because they know if I own it I'll fire her.
  • I'm fed up and frustrated the whole situation and I just want to quit but I've got 20 years here and I love my patients.
  • AITA for not wanting to rehire my sister? Edit: wow guys, thanks for the responses. I had to step away to see patients, but let's see if I can clear up some things.
  • 1. My sister cannot own the practice; in my state medical professionals cannot work for non-medical professionals.
  • The big corporations get around this by hiring a medical professional in a similar field and put them on the board.
  • 2. I can't start my own practice. Trust me, I would if I could. I'm a single parent.
  • Opening up a new practice right now is horribly expensive and I won't see profits from it for about two years.
  • If I had a spouse we'd have a salary to fall back on while I work part time at another practice until mine takes off.
  • I just can't risk it with my child. 3. I think part of the problem is that my dad isn't ready to sell something that he's worked on for 50 years.
  • I may be naive, but I think he's having a hard time letting go. The plan was always for me to buy the practice.
  • When it was theoretical he didn't have to face it, now he does. That doesn't excuse his attitude right now though.
  • 4. We have a meeting in a few days to address these problems. I think if my parents don't listen I'm just going to wash my hands of the whole thing.
  • I won't abandon my patients, but neither will I continue to run the practice. My dad can come back in and run things.
  • One of two things will happen; it will either get run into the ground and I can buy it cheap or he'll find an unsuspecting new grad who doesn't know how to read a P&L and sell it to them.
  • At that point I'll leave for another office and take my patients with me.

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