[04/18/02]Billing problems at River Region Medical Center could be eliminated with new procedures in place to maintain patient accounts.

New accounting software will no longer turn patients over to a collection agency prematurely, said River Region Chief Financial Officer Wade Walters. In addition, patients will begin receiving itemized bills summary statements showing the details of charges within days of when the services were provided, he said.

“We certainly acknowledge there were problems, but we are working as hard as we can to make corrections,” said Diane Gawronski, director of marketing and public relations for River Region, which moved its base of operations into a new hospital on U.S. 61 North in February.

A common complaint in recent years has been from patients saying they received notices from collection agencies before ever receiving a bill. The notices didn’t specify details of the charges, just a lump sum, and no one seemed to be able to answer questions.

“In the past, the hospital had to do transactions back and forth to collection agencies on a manual basis, and had to pull the reports and send them to agencies electronically,” said Walters, who has been with River Region Health Systems for six months. “Now everything just flows back and forth with the click of a button.”

Walters said the new system, Star Patient Accounting Interface, can communicate with collection agencies to update information and share payment history on accounts daily. When people call with questions, details will be easier to find.

Another enhancement is “tickler files” on accounts where insurance is pending. “We can follow up with accounts and hold our collectors accountable to that and make sure they are working through their accounts,” Walters said.

Other problems included bills that had become dormant that were inadvertently “kicked out” to collection agencies when transferred to the new system. Apology letters should have already reached those customers by now, along with a 50 percent discount offer in exchange for paying their full balance. Walters said most older accounts have been cleared.

He said many of the problems arose because summary statements were not being used by previous management. “That’s been a big complaint in the community that we have addressed with this new system,” Walters said “We’re now able to send out a summary statement seven days after the date of service.”

The statement tells a patient what the patient is expected to pay and what their insurance provider will cover. That way, when patients get explanation of benefit (EOB) forms from their coverage-providers, they can compare them with the summary statement.

Chief Executive Officer Phillip Clendenin said River Region, a subsidiary of Dallas-based Triad Inc., that bought out Quorum Inc., hopes the new approaches will provide consistency and clarity.

“When we get a call from a patient, and pull up an account that another collector has been working on, we can see immediately what has been told to this patient and they can see the amounts they have to pay and adjust their account accordingly,” Clendenin said.

“I think part of what happens and where people are getting different stories (is that) they talk to the hospital, then talk to the collector and things didn’t match up. Now things are going to match up.”

The new system is now churning. “If we’re still getting problems in the next 30 days, I’m going to really be upset because we’ve got a new system, we’ve got our things in place, and we shouldn’t have anymore setbacks,” Walters said.

Using the summary statements, patients will see if they need “to get involved with their insurance company to expedite things from a payment standpoint,” Clendenin said.

Collection action will still be taken for unpaid bills. “Once insurance is paid, we’ll send (patients) a bill showing them the balance and that will go out in two billing cycles where people will have the opportunity to pay us,” said Clendenin. “After that point, we’ll turn them over to a third party; again, that may be several months after the date of service (but) we’re only allowed to carry people’s balances so long.”

The hospital does not charge interest on past-due accounts and, the officials said, will work with patients to set up a reasonable payment plan.

“We wish we could turn back the clock and correct all the issues that were there,” Clendenin said. “But what we have done is make sure we have good people in place who are knowledgeable and have a vested interest in having a good billing procedure and system.”