OPA: $ 19.8 million in overdue patient bills still not collected

(PNC file photo)

Between January 2017 and June 2018, Guam Memorial Hospital billed a total of $ 22.1 million for patient treatments, but 90% of that amount was not collected due to the continued failure of the hospital to put in place a rigorous billing and collection system, according to the Office of Public Accountability. .

In an audit released on Monday, the OPA said the outstanding accounts are worth $ 19.8 million.

Fundraising has been a long unresolved challenge at the hospital, which constantly faces a lack of funding.

In a dazzling report by public auditor Benjamin Cruz, GMH was attacked for invoicing and collections.

“The Guam Memorial Hospital Authority (the hospital) billing and collection practices for true self-paid accounts did not comply with the law, applicable rules and regulations, and policies and procedures, giving thus the possibility for patients and / or guarantors to avoid paying their hospital bills, ”says the report.

“Management has authorized non-collection or untimely collection of overdue accounts by failing to institute rigorous billing and collection systems. “

The auditors also found that GMH did not refer the overdue accounts to a contracted collection agency.

“I am appalled by the decision of the new administrator not to forge a new direction for the hospital. Instead, GMH’s official response portrays the old thinking of management to rationalize the hospital’s unfortunate situation by not accepting that the GAR and the policies are there for a reason, ”Cruz said in a commentary. communicated.

As for the collections, this is an issue where GMH recently announced that it would get help from the Attorney General’s office.

“Filing a collection case is a last resort, but the attorney general’s office also has an obligation to ensure that the government receives payment for the services it has provided,” the attorney said. General Leevin Camacho last week.

But is it really a last resort? According to the OPA, GMH’s collection staff “are not focused on collecting overdue accounts. About 99% of the time, collection staff perform tasks unrelated to collection, such as receiving various calls and concerns from patients or visitors. “

The OPA made the following recommendations:

(1) Create a policy on:
• Implementation and review of tariff changes;
• Account referral process to the collection agency, including how the analysis
should be done and when to report;
(2) Execute the execution of a credit agreement before the patient is discharged and define who is responsible for carrying it out; Legal requirements to provide partial and interim bills to patients;
(3) Evaluate whether a review and / or corrections should be made on overdue patient invoices;
(4) Provide formal training and set target collection results for the credit and collections supervisor and collection staff; and
(5) Assess, based on current hospital conditions, whether the reinstatement of a financial advisor will help improve the recovery process.

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