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

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

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, 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 die. 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 disability 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.

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?

Note: 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.

Here's what people had to say to OP:

09Klr650 said:

NTA. I will be blunt. She is going to destroy the business. But put this back on your parents. Every dollar she costs will be deducted from the value of the business for what you have to pay for the business.

Separate-Parfait6426 said:

Tell your parents that the amount of money that you sister loses you each year is significantly more that the amount of money that you pay her. Tell dad that if he wants to keep her around that he can oversee all of the insurance billing.

If your parents are refusing to sell the clinic to your because of your sister, would you be able to afford to leave and start your own practice, or would equipment cost too much? I am sure that all of your patients would follow you, and your parents would lose their practice and their future financial security. Maybe that would be enough to let you fire your sister.

GroovyYaYa said:

Your patients will follow you. At this point, it sounds as if your sister would qualify for disability. To give your parents some grace - they are probably in deep denial that their daughter is on such a decline. MS is a horrible disease. But you have a responsibility to your patients. If you lose Medicare again - you cannot treat them.

You may need one last sit down and let them know that unless your sister does not work at the clinic, you will be opening your own practice and leaving this one. If she works there and continues to mess up in this way - it won't be worth buying OR inheriting, and next time the mistakes may not be solvable by just dipping into the savings.

Elegant_Anywhere_150 said:

NTA it sounds like she isn't capable of performing the duties needed of that type of position and she needs to stay on disability. But for the sake of getting the business, lie to your parents and tell them you will rehire her with another person to help her keep track of important documents...

This person will be the same job position but SENIOR or SUPERVISOR and their job is literally to take whatever she does and fix it or keep up on tasks/documents she fails at...However, tell your parents "This is sister's PERSONAL ASSISTANT"). Do not talk about it in text form or email, only verbally.

Have it in writing for the job description that she does not have authority to write off anything or cancel or make any contracts without signoff from you or a higher manager.

Make it a writeup-able offense for her to do that or to fail to file medicare/insurance claims appropriately. Then make it a fireable offense to fail 3 writeups. Then when they give you the practice, fire her and keep her supervisor.

mountain_life86 said:

Nta. Gross negligence. She would get sacked in any job. I'd start deducting mistakes from her salary. Or tell her she can come back to a different role as she has fraudulently written off claims etc.

ihsotas said:

Either you're running the practice or you're not. If you are, don't hire her. If you aren't, then you're trapped in a boat with holes in the bottom. Abandon ship as early as you can.