Shaddyr's Eclectic Collection > Pretender Fanfiction > Exchange Part 3

 

Exchange: Part 3
by Liz Shelbourne



Next they went shopping.  Jarod patiently sat in a plastic chair near the dressing room while Amanda sifted through a small pile of clothes, trying to find something to fit her tiny frame.  They then they added a couple of paperbacks, a few snacks, sundries and soft drinks to their purchases and drove back to the hotel.  The plan was that Amanda would stay sequestered in the room, leaving the "Do Not Disturb" sign on the door and generally making herself invisible until Jarod was able to return. Back at the hotel, she immediately changed into new jeans and a sweat shirt, then climbed onto one of the double beds and stretched out on top of the floral bedspread.

"Oh," she sighed.  "This feels good.  Real clothes, a real bed, things you don’t appreciate until you can’t have them." Jarod smiled at her, a touch of sadness in his expression.  She caught the look out of the corner of her eye and turned toward him as he stood near the door.  "What, what is it?"

He shook his head.  "I’m glad that you’re happy.  You’ll be even happier when we get you home, and that will be soon, I promise.  It’s just good to know that you’re safe for now." She stood up and walked over to him, grasping his hands in her own.

"Thank you Jarod, for everything.  I don’t know what I would have done without you.  I’ll pay you back, you know, all the money, but I don’t know how I can repay you for the help."

"Don’t worry about it, any of it.  Here," he reached into his pocket and pulled out several large denomination bills, which she unwillingly took.  "Use whatever you need, get room service, but remember to order for two, just in case.  If there’s anything left, you can give it to me when I come back for you."

"Does this mean you’re not staying here tonight?"  Her expression was coy, but her eyes were teasing.

"Flirting again, Misty?  Actually, I’m going to go to work.  I heard that an insurance company needs someone in their Information Support group." She sighed dramatically.

"Well, I guess the honeymoon is over, Mr. Alstadt.  She leaned up and kissed him on the cheek.  "Have a good day at work, honey."

"Thank you, Mrs. Alstadt, I will."  He turned and walked toward the door. "Jarod," she called suddenly.  "Please, be careful." He smiled reassuringly and closed the door behind him.

  PremiaMed was one of the new breed of health care insurance companies that had sprouted up during the early 1980’s, offering an assortment of managed care and traditional coverage, including HMO’s, PPO’s and almost any other combination of options.  As the field had changed over the last two decades, PremiaMed had been in the unique position of having a relatively affluent and healthy group of enrollees in its formative years, so that by merely following the fee trends in the rest of the market, they had been able to put together an impressive profit for their shareholders.  After swallowing up a few smaller competitors over the years, it had grown to the point where its now more numerous customers could be well accommodated and profit still remain high.  The members of the Board of Directors were congratulated each year with a sizeable bonus.

While the company itself was a regional leader, from the beginning it had been decided that fewer people and more technology were the key to keeping the system streamlined and functional, and so the corporate headquarters used only two-thirds the staff that their same sized competitors might.  This also meant, however, that if one of the employees were not available for their shift, that work may well not be done at all until they returned, as there was little redundancy in positions.  Occasionally, the company called upon the services of a temporary agency, to fill in for things such as maternity leaves and extended vacations.  It was with these credentials that Jarod walked into the front lobby that evening.

"Hello," he remarked softly to the woman at the reception desk busily getting ready to leave for the day.  She looked up and saw a nicely dressed man with gold rimmed glasses and a pleasant, if somewhat vacuous expression on his face.

"Yes, may I help you?"

"I’m here from the temporary agency.  I’m supposed to do some computer work for you?"  He finished the second statement as a question, his eyes overly wide through the lenses. The receptionist mentally rolled her eyes.  Computer geeks, she thought to herself, they never have any idea what’s going on outside of their monitor.  She smiled her secretarial smile.

 "I think Mr. Toliver can help you with that."  She handed him a badge with a number on it and pointed down a hallway behind her.  "You can find him in room 164, just down this hall and to the right."

Jarod thanked her profusely, gathered up his briefcase and, somewhat apprehensive looking, followed her directions.  Once out of sight, his nervous demeanor faded and he scanned the doors and the names and titles upon them.  This hallway looked to be filled with middle management, people responsible for all the other people, but not for making critical decisions.  Gerald Toliver, Information Support Department Director, was near the end of the hallway.   Knocking softly on the door, then entering when invited, Jarod once again put forth his rather meek and confused persona.

 "Mr. Toliver?  The temp agency sent me, they said that you needed some help right away?" Toliver was a man looking forward to retirement in a few years who had never become completely comfortable working in a suit.  He sat in his shirtsleeves behind a desk that was neatly organized but very, very full on top  It seemed, at least from the first glance, that he had almost every kind of Information right there on his desk, files, disks, reports, printouts – the only support needed might be an additional leg brace.
Looking up at Jarod, his face lit up as if he were being delivered from a death sentence.

He rose from behind the desk and reached out a strong hand.  "Yes, yes I do!  My goodness, I just sent the request in this morning, I’m surprised Personnel managed to get you here so soon."  He grabbed a set of keys from inside a desk drawer and motioned Jarod to follow him out the door. "Normally we have a wonderful woman that does this work, but she left work early the other day and no one has been able to track her down.  Frankly, I’m a little worried about her, I called her house but her kids don’t know where she is either."  He unlocked a doorway which led to a stairwell.  "This is the way to the Records Room, it’s in the basement for some reason, when you come in next time, you can take the elevator in the lobby down."  He led Jarod down the stairs to another door way, this one open, and down the hallway to the right.  Coming upon a door marked "Records", he slid a key card into a slot on the nearby wall and waited while the light on the lock turned silently from red to green.  "I’ll have to get you a keycard after Personnel does their check on you, for the time being, however, I’m going to have to let you in."

 He opened the door into a very large room, divided roughly down the middle.  Half of the room was taken up with shelves and shelves of paper records, the other half was filled with a variety of electronic equipment, from a simple copy machine to a fax to what Jarod could guess was the server for the computer system.  Four desks ran across the room, on three he could see monitors and keyboards and a tangle of cables and wires that ran between them.  Looking at the shape of the oversize desks, he grinned inwardly.  To Amanda, the underneath of one of them would be almost large as her tent.  It was not inconceivable that she could hide there unseen, especially with the chair in front.

 Jarod listened with half an ear to Toliver’s explanation of his new duties and responsibilities, looking over the equipment instead.  He did not plan on being there long enough to actually accomplish much in the way of "work."  However, he thought briefly, if he were able to get a little bit done, it would be that much less for Misty to do when she returned, and he would undoubtedly be checked up on in the near future.  He paid more attention to his supervisor.

 As he had expected, once Toliver had turned on the monitor and entered a passcode for him (which Jarod noted and immediately memorized), he was left to his own devices with a stack of reports eight inches thick on the desk beside him.  Forty-five minutes later, Toliver returned. "Do you have any questions, Jarod?"  he asked around a mouth full of cookie.

"Um, just one," Jarod replied, his wide eyes staring up owlishly at the other man.  "If I have to leave the room, how do I get back in?  You know, if I have to use the, um, facilities or something."

Toliver frowned.  "Today, you’ll just have to rely on me, I guess.  I’ll try to get you a security card tomorrow.  Why don’t I plan on coming back in two hours, if that will work, and give you a break.  You can get something to eat then, or what ever you need to do."

Jarod nodded and mumbled a thanks, then turned back to the monitor.  "This is quite a system you have here.  Your database must be extensive."

"We’ve got all of the records for almost 30,000 people in there, and we’re adding more every day.  Yeah, it’s a helluva system, had it specially designed for the company a couple years ago.  It’s got a few trouble spots in some of the more remedial tasks.  Amanda, the woman you’re subbing for, managed to streamline her area a little bit, there are a few other places that that should be done, but all in all, it’s a good system.  Well, " he announced, popping the last of the cookie into his mouth.  "I’ll see you in a couple hours, but don’t hesitate to call me in my office if you need help with anything."

Jarod watched as the other man walked out the self-locking doorway.  Hopefully, tomorrow he would receive one of the security cards and be able to do a little physical recon around the building, today, however, would be for investigating the computer. Flicking on the monitor on the desk beside him, Jarod took off his glasses and pulled out the list of patients downloaded by Amanda.  He had taken the opportunity back at the hotel to scan the disk for security features, then printed out the seventeen pages of names and billings for the last three years.  Now he needed to cross-reference those names with the general customer base of the company, but, just in case, he wanted his own monitor ready to show just how hard he was working. Misty had warned him about the security that she had found while she was looking for the file, but as the visit from the man with the gun had already proven, she had missed at least one warning flag, possibly more.  With his more extensive knowledge, Jarod was fairly certain that the watchers would never know that anyone was in the files. It took almost an hour for him to carefully wend his way through the security maze.  Obviously, whoever was concerned had come back a second time and added even more features since Amanda had last made her attempt.  Finally, he was able to access the data he was looking for, and compare it to his list. Ten minutes early, Toliver cracked open the locked door and walked in.  Jarod noticed once again how the electronic lock on the outside gave no audible warning when someone was about to enter, no wonder Amanda had been surprised.

"How’s everything going," Toliver asked as he surveyed the growing pile of papers in the "finished" pile.  "Thought you could use a break."
Jarod had actually expected to be looked in upon earlier than this, and had shut off the other monitor and stowed the copy of the list in the breast pocket of his suit jacket twenty minutes before.  He looked up from the form he had been working on and smiled.

 "I guess I could stand to get away from here for a little while, stretch my legs a little.  Do you have a cafeteria?" Toliver graciously informed him of the employee lounge on the second floor and warned against the coffee.

 "If you’re a coffee drinker, bring your own.  I don’t know what they do to the stuff in there, but it could take paint off a car.  Why don’t you take a half hour, and I’ll meet you back here?"

****

Having had little time to eat before, Jarod scanned through the variety of vending machines in the lounge and settled on a prepackaged sandwich that looked less suspicious that the others.  Eating this and a bag of chips took all of seven minutes (he did not try the coffee) and he was faced with twenty-two minutes of time and nothing to do.  He had considered taking a walk around the interior of the building, checking out the locations of some of the key players, but decided against it.  Tonight he could ill afford to raise any kind of suspicions; there was still work to be done tomorrow evening and he needed to be invited back. He strolled casually back to the basement, using the lobby elevator, and was still five minutes early.  The door to the records room was propped open and he could hear voices inside.

"I don’t see why you have to look through the guys briefcase, Morrell, I mean, isn’t that against the law?"

 "It’s my job, Toliver," retorted a lower voice.  "Consider it a security check.  Since your Ms. Teague disappeared, I’ve been a little concerned about the way things are run around here."

"But you’re not Security, and you’re not Personnel.  Remind me, what is it that you do here?" There was conspicuous silence, then Jarod heard the zip of the pocket of his briefcase.  When Morrell spoke again, his voice was menacing.

"I watch your ass, Toliver, every day.  Maybe you should consider doing the same thing." Jarod chose this moment to walk back into the room, the vacuous expression again filling his face.

"Oh, hello." The man standing close to Toliver was of medium height, with thinning hair brushed over his pate.  He looked over at the newcomer and smiled, but not quickly enough to disguise the glare that had been in his eyes just a moment before.  Jarod did not register it in his expression.

"Hello," Morrell answered pleasantly.  "You must be from the temp agency.  Toliver and I were just talking about you.  Things are going well for you so far?"

"Well, yes, very well," Jarod answered truthfully.  "I haven’t really had much of a problem with anything yet."

"Good, very good.  Nice to meet you then."  He glanced back quickly at Toliver, smiled once more at Jarod and walked toward the open door.

 Jarod was able to get a quick glimpse of the shoes he wore beneath his designer suit:  black wingtips "with all the little holes in them," just as Amanda had described.  It was nice to know so early just which side Mr. Morrell was on. "Who was that?"

Toliver sighed.  "That was Geoff Morrell.  He’s one of the lawyers here, but honestly, I’m not really sure what he does.  He usually doesn’t bother us down here, but since Amanda went missing, he’s been all over me.  I think he’s worried that the company will somehow be held liable."  He rubbed his hand over his face and shook his head.  "I’ll try to keep him out of your way."

Jarod mumbled another "thanks" and sat down in front of the keyboard again.  "And thanks for keeping the door open for me, I appreciate it."

"No problem.  Tomorrow we’ll get you a card of your own.  Have a good rest of the night, and make sure the door locks on your way out.  I think I might head home, I’ve suddenly come up with a splitting headache."  He grinned without humor, waved and walked out, shutting the door behind him. Jarod leaned back in the chair and once again removed the clear lens glasses, then patted the list in the interior pocket of his jacket.  There had been nothing to implicate him in his briefcase, of that he was certain, and now he knew at least one of the people that would come under his scrutiny in the next few days, along with Drs. Carmichael and Borkowski.  For now, however, he had six hours of Amanda’s work to do in four hours time.  He wanted to make a good impression on his first day at work. After four rings, a tentative voice answered the phone.

"Hello?"

"Misty, its Jarod.  How are you doing?"

"Oh,"  Amanda sighed in relief.  "I couldn’t figure out who would be calling.  I’m fine, a good night’s sleep will do that for you.  How did it go at work?"

Jarod twisted his neck around to stretch it; he had just woken from a well deserved few hours of sleep after leaving the insurance company early in the morning.  "So far, so good.  I’ve managed to cross-reference a number of the names on your list against the general population.  Every one of them had been diagnosed with Alzheimer’s, that can be proven, but either the Carmichael/Borkowski clinic is running twenty four hours a day or there are an awful lot of bogus claims here, and I tend to think that it is not the former.  I’ve noticed that not every Alzheimer patient is ‘referred’ there, but I’m not sure why.  I’m going to be looking at that and a couple other things tonight."

"Wow.  You certainly have been busy.  I managed to read half of a book and eat almost an entire pizza for myself, but I guess it doesn’t really compare." Jarod grinned.

 "Right now, that’s your end of the deal.  Just keep yourself out of sight until I can figure out who exactly is behind all this."

"Isn’t it obvious?  I mean, the money is going to Carmichael and Co., I would assume that they would be the ones behind it."

"That may be true, but it may not be the whole truth.  It doesn’t factor in your little gun-toting visitor, who, by the way, I have tentatively identified, nor does it explain how that amount of billing has never been caught by the auditors, and I would assume that your company is audited on a regular basis.  Right now I figure that the good doctors are billing somewhere around $650,000 to $700,000.00 a year, and at least half of that may be fraudulent.  That’s enough money to make people do some pretty crazy things if they feel threatened.  No, I want to find out exactly who is behind this thing, before I let you back into general circulation."

"Well, that brings up a good point."  Her voice was hesitant.  "I was wondering if I could call the boys, I’m worried about them."

"I’m sorry, Misty, I don’t think that would be a good idea.  Given the technical expertise and paranoia I’ve seen here, they may have gone as far as to tap your phone.  I told Jason and Brian  that I would call if I hadn’t found you in two days; by now they know that you’re with me and safe.  I understand, it’s difficult, but we need to keep you under wraps for a little bit longer." Amanda agreed grudgingly, offered him her thanks once again and wished him luck.  Jarod returned to PremiaMed the next evening, and true to his word, Toliver was waiting at the door with a security card.

 "I asked them to put a rush on your background check.  That’s one of the nice things about working the night shift, everything gets done during the day and you get to reap the rewards when you come in.  I guess you checked out okay ‘cause this was waiting in my mailbox."  He handed the card over.  "I’ve got a little mess I have to figure out, so I’m going to let you get going, but if you run into any problems, just give me a call."

Thanking him for the card, Jarod mused silently that any problems he might encounter could probably not be fixed by anything less than a Sweeper team.  He was determined not get himself into that kind of a situation. Once he was set up and had a few dozen of the waiting reports entered into the system, Jarod got up from the desk and walked over to the rows and rows of paper files.  He had formulated a theory since last night, and instead of risking exposure by accessing the computer files again, he had opted for the old-fashioned method. Pulling a list of names from his pocket, he followed the long lines of shelves to the "P’s" and extracted the file for Paula Petersen.  He scanned the details of her life: age, weight, marital status, primary physician, residence, next of kin, responsible parties.  Mrs. Petersen was an elderly widow living in a managed care facility, where her physician, Dr. Bigelow, saw her twice a year during his rounds of his numerous patients there.  She had been a member of PremiaMed since it had started, when her husband’s former company had been convinced to change plans for their retirees and their dependants, and, until the Alzheimer’s, had been in excellent health.  Her husband’s estate was paying for her group home, and her daughter was listed as the party to call in case of emergency. Jarod moved on to the next.  Martin Johansen was a sixty-seven year old confirmed bachelor who’s company had signed on with PremiaMed three years before his forced retirement.  Martin had been experiencing decreasing mental capacities for almost two years and his G.P., unable to do anything to help, had referred him on to the Plan’s choice for Alzheimer’s patients, Drs. Carmichael and Borkowski.  His son, living out of state, was listed as the responsible party when Mr. Johansen moved into a nursing home six months ago. Chloe Burroughs was a sad case.  Only fifty-eight, she had had a rapid onset of symptoms and had been forced into a nursing home by her now ex-husband.  Jarod could visualize her, sitting in a room surrounded by people twenty years older than she was, her past fading away rapidly as the disease ravaged her mind.  The law firm of Dannon & Comfry was listed as a responsible party, somehow, Jarod doubted that they visited her very often and she had no children.

He continued to search through the files.  Martha McDougal.  Harold Planes.  Marion Jones.  Terrence Whitfield.  Each had a different plan doctor, each of them were different in age, but all referred to the Carmichael/Borkowski clinic.  That made some sense, they were the neurologists of choice for PremiaMed, but what made them different from the other patients that Jarod had been able to prove as legitimate?

He picked out another file.  Kelly O’Malley.  Mrs. O’Malley was seventy-three, also a patient of Dr. Bigelow’s.  She had been diagnosed four years ago, and last year moved in with her daughter and her family, as her husband had passed away.  Jarod scanned the file, memorizing the details, then placed it back on the shelf and returned to the computer monitors.  An idea was forming. Once again turning on the second monitor, he bypassed a few of the simpler security measures and retrieved Mrs. O’Malley’s records.  Yesterday, he had found a way to call up one record at a time, using Amanda’s passcode, but checking 30,000 records one at a time would have been ridiculous, so he had chipped away at the system until he had been able to access all of the records he had needed to run his comparison.  Now, however, the single file request would do. Mrs. O’Malley had been seen by Dr. Carmichael soon after her original diagnosis, but only once until last year, or so the record said.  At that time, she was run through the same battery of test which Amanda’s mother had been through, to the tune of $1950.00, billed directly to PremiaMed, of course.  Jarod checked the date of the second round of exams – July 7 through July 24.  He went back to her paper file and looked again, something about that date had been familiar.  Her husband had died in March, that was not it, but it looked like she had had a change of address posted in the beginning of June – she had moved in with her son and his family and the responsible party had changed from her (now deceased) husband to her son. Less than a month, and Mrs. O’Malley was being given the royal treatment by the Alzheimer specialists.  It could be that her son had wanted her to explore a more aggressive protocol, but Jarod doubted it.  If she was living with her son now, he had probably been aware of the original diagnosis, it was doubtful that he would suddenly want her to be re-evaluated now. Jarod looked at the file in his hand.  That was it, that was the connection.  The son, or rather the "responsible party."  For every one of these patients, their care was being supervised not by a spouse, but by a third party, whether it be son, daughter, or a group of lawyers, every one of them was being cared for by someone else, most likely someone who had taken on the responsibility on top of an already overloaded schedule.  It was obvious with Misty; she had two boys and a mother to take care of, a full time job and no spouse to share the workload.  It was unlikely that she had the time to go over all of her mother’s medical records, if she had ever seen them.  It was likely that these bills had come directly from the clinic to the insurance company, never actually showing up in the Teague mailbox. Or had they?

Another thought crept into Jarod’s mind – what exactly was the relationship between the clinic and PremiaMed?  Was it actually necessary for the clinic to ever create those bills, or could they simply appear digitally, generated deep within the bowels of the PremiaMed computer?  Either way, the clinic was receiving sizable payments for services never rendered; the question was whether Carmichael and Borkowski were committing the actual fraud, or just reaping the rewards.  Tomorrow it was time for Jarod to visit the clinic.

****

The Alzheimer’s Treatment Center was a surprisingly small building on a very wide street that had once been the main thoroughfare for the community, supplanted years ago by freeways and strip malls.  Nowadays, the stone and brick buildings on the street had become a collecting place for a variety of professionals plying their trades and up-and-coming singles excited to live in a converted warehouse.  Behind old store fronts and reconditioned apartments, plastic surgeons consulted down the hall from lawyers, and dentists shared parking lots and elevators with investment counselors. While smaller than almost all of the other buildings on the street, the Alzheimer’s Treatment Center, or the ATC, as the employees referred to it, had something that few of the other inhabitants could brag about – Drs. Carmichael and Borkowski had the building all to themselves.  There was no sharing of parking spaces here, no central lobby sending patients to the wrong floor, no neighbors conducting late night meetings.

At 5:30 p.m. every evening, the receptionist closed the doors and switched off the lights, not to be turned on again until the next morning. It was a nice location in the middle of a gradually rejuvenating town now considered a suburb of the growing city.  Although a longer than usual drive for some of the patients who insisted on living in the central city, it still was close enough to the population center to make it the clinic of choice for the PremiaMed plan. Jarod walked up to the two story stone building and opened the glass and metal door, allowing an older woman and her daughter to walk past him out into the bright sunshine.  Once they had passed, he proceeded into the shade inside the building, removing his sunglasses and putting them into the pocket of the casual shirt he wore.  He walked up to the receptionist.

"Hello," he said pleasantly when she looked up from her computer screen.  "I’m wondering if I’m in the right place, I’m looking for Doctor Carmichael?"

"Doctor Carmichael is a member of our staff here, yes.  Did you have an appointment?"  Her expression, like her voice, was professional but not unfriendly.

"Oh, no, I didn’t.  I was hoping I could talk briefly with one of the doctors.  You see, I’m looking for some help, for my friend and her father." She smiled in understanding.

"I’m very sorry, Dr. Carmichael is booked up for today, but if you’re just looking for some information, perhaps Dr. Borkowski can help you.  Let me check the schedule."  She gazed back at the computer screen, manipulating the mouse dexterously. "I think you may be in luck, one of Dr. Borkowski’s patients forgot to come in, but the next one is already here.  Maybe we can move Mr. Anderson up and get you in to see the doctor right afterward."  She motioned to the waiting area, partially filled with men and women of every age, some evidently patients, some obviously their relatives and loved ones.

Jarod sat in one of the luxuriously padded chairs and picked a brochure off of a nearby table.  This one told of the warning signs of  Alzheimer’s, a little too late for most of the people here, he thought, but worthwhile reading for him to brush up on his information.  Reading another, and then a pamphlet detailing the causes and effects of osteoporosis, twenty minutes passed quickly.  He was pleasantly surprised when the receptionist asked him to follow her down one of the hallways. Dr. Borkowski’s office was spotless.  The mahogany desk held four stacks of files, each neatly laid out in perfect precision.  The shelves of books which covered one entire wall were filled with manuals and compendiums, journals and reports, all in alphabetical or numerical order.  A large abstract watercolor hung on the far wall, while the wall across from the windows was filled with frame after frame of certificates and diplomas.  There were only a few pictures and objet d’art on the shelves of an expensive wood etagere. He sat on the far side of the desk and waited once again.

The door opened and a woman walked in, dressed smartly in a long skirt and jacket.  She looked to be in her late forties, tall and thin, almost overly so, the body of a marathon runner.  She held out a strong hand.  "Thank you for waiting, I’m Chris Borkowski."

Jarod was a little taken aback.  He had expected "Christian Borkowski" to be the name of a man, however, he stood and shook her hand warmly.  "Thank you for meeting with me, Doctor.  I understand that I didn’t have an appointment, it's kind of you to work me in." The woman sat in the high backed chair behind the desk.

 "My pleasure, Mr….?"

"Please, just call me Jarod."

"Alright, Jarod.  As I was saying, I’m glad to help.  My receptionist said that you have a friend who might be needing our help."

"Well, actually," Jarod began, "he’s the father of a acquaintance of mine.  He’s begun acting very different lately, acting a bit immature, you might say, doing things that you wouldn’t expect at his age.  At times it seems as if he’s completely forgotten about his daughter, and he’s getting more and more paranoid."

"Yes, I see."  Dr. Borkowski looked up from the notes she had been taking on a white legal pad.  "You said that this is a friend’s father, not your father, correct?"

"Well, yes, I guess.  However, Mr. Parker and I have a long relationship."

"So you could see this change in Mr. Parker yourself, I take it?"

Jarod nodded.  "He certainly isn’t the man that he used to be."

"Hmmm."  The doctor leaned back in her chair.  "While what you’ve described, the paranoia, the inability to remember family members, the re-occurrence of juvenile behaviors, are all symptoms of Alzheimer’s disease, they tend to be secondary or even tertiary.  Usually the disease manifests itself in less obvious ways at first, the classic forgetfulness, losing things easily, losing track of time or the days of the week.  To get to the point where Mr. Parker would be demonstrating the behaviors you have described, he would also be exhibiting these other behaviors to a great degree, and you have not mentioned them."

"I hadn’t really noticed him acting that way," Jarod confided, "but I can ask my ‘friend’ if she’s noticed anything."

"I think that would be helpful, however, I think your friend would have noticed these things, as would yourself, had they been present.  In fact, they would be hard to miss, if Mr. Parker had indeed progressed to the point where his actions have become as erratic as you describe.  I’m going to make a suggestion.  I think that it would be more beneficial for Mr. Parker to see a psychologist or psychiatrist before you bring him here for evaluation.  We do have an excellent psychologist on staff here, but her area of expertise is the Alzheimer patient and their family, and I’m afraid that Mr. Parker may be afflicted with something else.  However," she smiled understandingly, "if I am wrong, we will be happy to schedule an appointment for him."

Jarod had one last lure to throw out.  "His insurance is PremiaMed, do they cover things like that?"

"Oh, yes," she reassured.  "Many of our patients have PremiaMed for their coverage, in fact quite a few of them are referrals from psychiatrists.  They have a number of excellent practitioners in the Provider Book, have your friend look through that.  If you would like, she may call me, I’d be happy to discuss some of the different specialists I have worked with."

Jarod stood up.  "Well, Doctor, you’ve been very helpful.  I think that I’ve at least weeded out some of the possibilities here.  Thank you for your time."

"I’m glad I could be of help, even if it is to send you in a different direction.  Good luck with Mr. Parker to you and your friend."

"Thank you, Doctor," Jarod said as he walked toward the office door.  "We’ll take all that we can get."

Jarod sat in his rental car outside the Alzheimer Treatment Center, thinking, looking through the brochure he had found on the way out the door.  He had "accidentally" gotten lost in the building and taken the time to find some of the facilities.  Four exam rooms, offices for the two neurologists and the psychologist, and an array of expensive lab and diagnostic equipment, including one room dedicated to a CT imager and a visiting radiologist three times a week.  It seemed that the clinic was very concerned about testing for everything but Alzheimer’s, as the brochure pointed out, to rule out possible misdiagnosis.  Jarod knew that the only iron-clad diagnosis of Alzheimer’s could be made during an autopsy. So now he knew why the patients were subjected to the battery of tests, and it made some sense – the diagnosis of Alzheimer’s disease was a crippling blow to the patient and to their family, it could not be done casually.  Dr. Borkowski, to Jarod’s surprise, had not jumped at the opportunity to see, evaluate, test and bill "Mr. Parker," even after he had dangled the name of PremiaMed before her.  She had seemed a meticulous and conscientious physician, not the type to be fraudulently billing an insurance company for patients who were not seen.  Although he knew that appearances could be deceiving, Jarod had a strong feeling that Chris Borkowski was not completely aware of the billing practices of the clinic.
 
 

part 4