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The
Jon Yates column in the
Chicago Tribune:
Before the state's budget woes stole a piece of her freedom, Felice Dworkin (pictured)indulged herself with a daily trip to the park.
The 83-year-old would board her motorized wheelchair and proudly steer it through the front door of her North Side nursing home. "It was getting out," Dworkin said.
Not anymore.
Since the wheelchair broke in June, Dworkin has relied on nursing home employees to push her around in a manual chair.
"It stifles me," said Dworkin, who has cerebral palsy. "I can't go anywhere, I can't do anything."
A former state employee, Dworkin said she has asked the repair company repeatedly to fix her chair, but the company, Mobility Systems in Hickory Hills, has refused. The reason? Her insurer, the state of Illinois, still owes Mobility Systems $2,291.12 for her previous two repairs -- in November 2008 and in March.
Dworkin said she understands the repair company's dilemma and does not feel that Mobility Systems is being unfair. Her anger is with the state.
"They have the funds somewhere," Dworkin said. "I'm sure of it."
This is not the first time the Problem Solver has written about the state's problems paying its health insurance claims. In September, What's Your Problem? featured a woman who received a collection notice because the state hadn't paid its share of a physical therapy session in January.
Before the budget crisis, the state was paying claims in about 15 days. By September, Illinois' Quality Care Health Plan took 185 days to pay in-network providers. Out-of-network claims took 212 days.
Annie Thompson, a spokeswoman for the Illinois Department of Healthcare and Family Services, said the payment times have gotten only worse since then.
The wait for in-network payments is now more than 200 days; out-of-network claims take 230 days, Thompson said.
"If the state's going to be able to pay these providers in a timely manner, we're in desperate need of new revenue streams," Thompson said.
The impact is visible in Dworkin's room, where her sleek, custom-fitted electronic wheelchair sits dormant against a wall. When the Problem Solver visited her last week, she said it had been two weeks since she left the facility for fun, as part of a larger group of residents who were going out to dinner.
She said she doesn't like to ask employees to wheel her around too often because it's unfair to other residents who share employees' time.
Dworkin said she called Cigna, which administers the state's plan, and was told it's working on getting payment for the previous repairs.
"I'm very upset, but I'm holding it in," she said. "I'm trying."
The Problem Solver called Mike Scheg, owner of Mobility Systems, who said he is just as frustrated as Dworkin. He said he tries to cut customers some slack, but when an insurance company fails to pay in a timely manner on more than one claim, it's difficult to continue providing service.
"I feel bad for these situations, I really do," Scheg said. "There is a fine line between business and compassion."
Scheg said the state's payment delays put businesses like him in a difficult position.
"Everyone I deal with is disabled," he said. "In the end, it winds up being a service business with receivables and billables."
If Scheg continued to provide service without getting paid, he would get "buried," he said.
He said he always offers customers the option of paying upfront and then getting reimbursed when the insurance payment comes through. Dworkin said she is unable to do that because she doesn't have enough money to cover the initial cost.
After the Problem Solver spoke to the state about Dworkin's case, the state said there was a billing error on her November 2008 claim. Thompson, speaking on behalf of the state's Department of Central Management Services, said that claim should be paid within a week.
The second claim, from March, falls roughly within the 230-day time frame for out-of-network providers. That claim, too, will be paid by the end of the week, Thompson said.
Scheg said Monday that the state has informed Mobility System the claims are being processed. He plans to send a repairman to Dworkin's nursing home this week. Because there are special-order parts needed, the repairs could take about 10 days to complete, Scheg said.
"We're moving forward on it," he said. "Everything's good."
Dworkin said someone from the state called her Friday afternoon to discuss her case and help her get the wheelchair fixed.
"I can't believe this," she said. "It makes me laugh so much."
The Jon Yates column in the Chicago Tribune:
