Critics of the switch say the federal Medicare agency is also to blame for undertaking two major transitions within months of each other. In an effort to cut costs, the agency picked a contractor that was not equipped or prepared to handle California's Medicare providers, they contend.
But federal officials defend the choice. Torris Smith, an associate regional administrator for the agency, said Palmetto has more than 40 years of experience as a Medicare contractor and was selected after a "full and open competition."
"There are always going to be general transition issues," Smith said.
Officials of both Palmetto and the federal agency said they expect the backlog of applications like Wong's will be eased by Dec. 31.
Claims, meanwhile, are being paid, they said.
"I think we're seeing change now," Smith said. "We're making some progress."
Medicare's regional office is also trying to assist doctors with serious problems, he said, and Palmetto will advance emergency payments.
But change isn't coming soon enough for doctors and their staffs, who have wasted hours on hold with no relief.
The California Medical Assn. has fielded calls from more than 1,000 doctors seeking help with delayed reimbursements. Palmetto officials said they receive about 4,500 calls per day -- that's down from the 45,000 calls on the first day when they had been expecting only 2,500. Through September, callers were met with a busy signal 90% of the time, Barlow said.
With added phone lines, only 10% of the callers should be getting busy signals now, Barlow said.
Dr. Sally Davis of Walnut Creek-based Cardiology Associates, who is doing the office laundry along with her two partners, said, "It's unbelievably embarrassing that we've reached that point."
Dirty linens, though, is the least of her problems.
Roughly 80% to 85% of her patients are on Medicare, and the practice is owed more than $700,000.
"We said we would ride this out through December, then we'd have to decide what to do next," Davis said. "We're likely to have to break the practice apart. . . . You can't grow a practice in the community when you're not getting paid."