Insurance mistake labeling man 'female' causes big problems

Created: 04/30/2014 6:16 PM
By: Kai Porter, KOB Eyewitness News 4

It was a little paperwork mistake that caused big problems for an Albuquerque man.

Starting in January, Erik Montana said he suddenly had to prove that he was not a woman each time he visited the doctor or picked up a prescription.

He discovered there was a problem when he tried to pick up a prescription at the pharmacy.

"I'm asked for my I.D. and they're constantly, 'It shows on our paperwork that you're a female. It doesn't match up,'" said Montana.

Apparently someone accidentally changed his gender label from "male" to "female" in his insurance medical records. He showed KOB Eyewitness News 4 an insurance eligibility form that clearly lists him as a female in the gender section.

Montana has Medicaid, which helps pay for his insurance through Presbyterian Centennial Care. He takes daily medication to treat PTSD and anxiety attacks. He said the paperwork error has resulted in difficulty picking up his prescriptions at the pharmacy and some of his insurance claims have been returned to his doctor's office unpaid. He said the stress of the situation made his anxiety worse and he worried he'd be left to cover medical expenses out of pocket, since his insurance claims were being denied.

"I just keep trying to bring proof to them, every kind of paperwork to prove that I'm a male not a female," said Montana. "It just seems to be the constant run around."

Montana's wife, Melinda, also said they got nowhere trying to fix the mistake. She called the insurance company and dozens of government agencies, with no luck.

"A click of a button changed it," she said. "You would think it would change it back."

But after KOB made just a few phone calls to Presbyterian and the New Mexico Human Services Department, we finally got results.

In a statement, a spokesperson for Presbyterian Healthcare Services wrote: "With prompt help from the Medical Assistance Division of the New Mexico Human Services Department, which oversees Centennial Care, the Income Support Division was able to amend their records and the issue as reported should no longer be a problem."

The NM Human Services Department confirmed the mistake had been corrected. The department said it believes the error was made when a federal agency transferred over records about Montana

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