This post is about our experience with Intermountain HealthCare and how we encountered the issue of them overpaying my wife.
My wife, Wendy, is a physician for Intermountain HealthCare (IHC) here in Utah. IHC is the largest healthcare provider here in Utah. They are a nonprofit healthcare system. They own more than twenty hospitals, multiple clinics, and employ over 800 physicians across the state of Utah [source]. Simply put, they are a large organization.
In December of 2011, right before Christmas, Wendy got a phone call from her boss wanting to know why Wendy had been getting overpaid and not said anything about it yet. Wendy, needless to say, was surprised to hear that she was getting overpaid. So she started investigating and found that just as her boss had said, she had been getting overpaid. Here is the kicker though. This overpayment had been going on for two years, and no one in payroll had caught it. I would have imagined that any company would do at least yearly (if not more often) audits to make sure that their money is going where it’s supposed to.
Ordinarily, it can be fairly easy to see that a paycheck is wrong. Most of the jobs I’ve had were salary or hourly, and I can easily see that something is wrong. Being married to physician has opened up a whole new world to me of how someone gets paid for their work. Now just in case you aren’t aware, I have a BS in Engineering. This means I’m no stranger to math. Wendy and I sat down with one of the payroll dept people for IHC and after a lot of time and me working with a spreadsheet, I was finally able to understand how Wendy’s compensation is supposed to work. I will try to explain it below.
Wendy works at different clinics around town known as Kidscare. It’s after hours urgent care for kids. Her work value is calculated with a unit known as a relative value unit (RVU). This means that if she sees a kid with strep throat, IHC has determined that that visit is worth so many RVUs, which would be less than say a kid that needs stitches. Her contract with IHC says that they will pay her a certain amount for each RVU that she performs. There are monthly reports generated that tell her how many RVU’s she made each month. We just have to trust that the number crunchers some where are totaling these numbers correctly as she doesn’t really have the means to keep up with how many RVUs she collected each night at work. We can look up these reports, and find out how much money Wendy is owed by multiplying the number of RUVs for that month by her rate that she is paid. These reports are of course a month or so behind so it takes some effort to match it up with her bi-weekly paychecks. But in addition to her RVU rate, she gets a minimum hourly rate if she doesn’t reach a certain threshold of RVU’s for a night’s work. We don’t know which nights those are that she is getting her minimum plus whatever RVU’s she collected that night. There are also two methods for getting paid that physicians can choose between which are monthly compensation and what is known as the six month average.
The six month average method works like this. There are 26 pay periods in the year. IHC will take the number of RVU’s you made for your previous six months, multiply it by your RVU pay rate, and divide it by thirteen (the number of pay periods for the next half of the year). This gives you what you will see for each paycheck for that half of the year. The downside to this is that it compensates you for your RVU’s six months after you earn them. So when Wendy picks up extra shifts, she doesn’t see an increase in pay until the next six months. The plus side is that it makes budgeting for us easier because we know how much Wendy will be making for half of the year.
Now for the monthly compensation method. In UT, the law states that employers must pay their employees at least bi-weekly. Since her RVU reports only come out once a month, IHC has a system set up to help with that. Each month they get two paychecks except for June and December where they get three. The first paycheck of each month is given as an advance, and it is the same amount each time. When the last paycheck of the month comes in, the RVU total is paid for the previous month. For example in February, you get January’s RVUs. Also on that last paycheck, they are supposed to deduct the advance they gave you on the previous paycheck for that month. This makes for a monthly fluctuation in her income, and makes budgeting much more difficult. So much so that I chose not to budget the first two years we were married.
So here is where we encountered the problem. Her paycheck was too difficult for me to track at the time, so Wendy and I just trusted that IHC was doing it right. They are after all a big organization that is supposed to know what they are doing.
Well, while Wendy was getting the monthly compensation method for her pay, for two years they were not taking the advance back each month like they were supposed to. As I said, its a complicated paycheck and we just trusted them, so we didn’t bother to check. I personally didn’t know how her pay was set up so I just didn’t bother to ask.
We got married in the last half of 2009. When this mistake in pay started was in January of 2010. We were still learning how to live off her salary at the time so, it was still during an adjustment period. Wendy noticed that her anual totals were higher, but she explained it from a few ways. One, 2010 was when the H1N1 outbreak happened. She saw a lot more patients which means that naturally her pay would go up. She got more training from her company on charting, so she was able to chart in a way that got her more money. She also changed her deductions because she went from being single to married. She was also picking up extra shifts.
Well, we were grateful for what she was getting paid. We were also being smart about it by not spending money that we didn’t have. The house we bought when we got married was well within what she was getting paid before the mistakes in her pay began. The bank told us we were qualified for 3 times the loan that we took out. We bought things to improve our home, but only when we had the money to pay for it. We bought new energy efficient windows for our home to replace the old single pane windows that were leaking terribly.We also put money into our IRA’s each year and bought some other investments. We paid off my car loan, and were putting extra on the principle to our home loan each month. We gave money to our church as well. We also went on vacations because we could afford it. We were keeping an eye on our finances to make sure we were in the black. Wendy and I had never lived in the same town before we got married, so we were just enjoying being a married couple, but we were being responsible about it. In November of 2011, we bought Wendy a new car because her old car was getting to be unsafe to drive. Then just a couple of weeks after we took out a loan on Wendy’s car, we find out that the income level we had planned for was getting cut.
Initially, we were both very angry about this as IHC wanted us to pay them back. After a couple of days of thinking and praying about it, we both decided that paying IHC back was the right thing to do. It wasn’t our money. Wendy had agreed to be paid so much money for so much work, and the right thing to do was to honor the agreement.
We met with a couple of lawyers and accountants about our situation. Mostly, we wanted to find out what our rights were, and if there was any precedent for this. Everyone we talked to couldn’t believe what had happened. Needless to say, there is no precedent for overpaying an employee for two years. Most of the time this is a month or two that goes by before a mistake is found. One of the lawyers told us that she had taken on a case for a firefighter here in Utah that had been overpaid for a long period of time. He refused to pay it back and won the case in court. He lost his job though. It was argued that the correct compensation was set by his employer because it had become a regular amount over such a long length of time. It was also argued that his pay was difficult to calculate, so he couldn’t be expected to check it himself. Wendy loves her job, so we didn’t want to her to lose it by going to court. Besides, like I said, we felt it was the right thing to do by paying it back.
We met with a member of middle management at IHC a few different times to try and solve this problem. IHC was being ruthless about this whole ordeal. First they wanted to blame Wendy on it because she didn’t notice it. Never mind that they weren’t able to answer all my questions about how her paycheck works during that meeting. If they couldn’t understand her paycheck, I don’t know how they could expect us to be keeping track of it. IHC did not want to take, nor did they take, any of the responsibility for making the mistake of paying her incorrectly. It seemed to me that they have double standards for their employees. Let me give you an example. Say one of the employees from payroll comes to Wendy’s clinic with a sick child. Wendy prescribes a medication and sends them home. What if Wendy were to make a mistake and give the wrong dose for the prescription for the medication? I doubt the parent would go home and check the Internet to see what the correct dosing is for that medication. Similarly, it shouldn’t be expected that Wendy goes home and recheck’s IHC’s payroll people to make sure they are doing their job correctly. I want to know how it is that IHC is able to bare no responsibility for this mistake. So now, because of their incompetence (and I can think of no other word but incompetence seeing as how a huge organization managed to go two years without noticing that they were paying someone way too much) we are the ones who have to bare the burden of their mistake by taking on hardships in our life.
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