CHCC: OPA report didn’t use updated info

The Commonwealth Healthcare Corp. has pointed out that the Audit Recommendations Tracking System the Office of Public Auditor recently released for CHCC didn’t cite up-to-date information.

Had it done so, it would show the collaborative work of OPA and CHCC in the current revenue cycle, according to the corporation’s chief financial officer, Derek Sasamoto, in a statement.

“Though we always appreciate OPA’s efforts and the work that they do, we simply desire an update that shows in good faith the collaborative work of OPA and CHCC,” he said.

OPA, an independent agency of the government, audits three aspects of public funds given to government agencies: receipt, possession, and disbursement of public funds.

In a report at the end of December, OPA outlined several recommendations for CHCC, but admitted that “OPA was unable to thoroughly review most of the documents provided and make proper determinations for the corresponding recommendations.”

CHCC said that no status changes could be made to the 11 recommendations because the current information was never reviewed by OPA.

The next report will be released in June 2018.

The 11 recommendations that OPA gave to CHCC were the following:

To develop and implement policies and procedures for prompt verification of patient’s insurance coverage and eligibility; discuss payment requirements, payment reminders and options with patients at the time of registration;

Collect upfront payments from all patients regardless of coverage unless it is certain that the insurance or guarantor will pay the bill in full. If patients are unable to make payment, CHCC should discuss payment options and ensure follow-up procedures are performed. OPA finds this resolved.

Require doctors and nurses to prepare the information necessary to estimate bill at the time the patient is discharged;

Develop a plan of action that addresses the backlog in coding, billing, collection, and posting payments;

Seek technical assistance that would result in the assessment of the current IT structure and the acquisition of a comprehensive accounting and billing system;

Develop and implement policies and procedures effectively to address claim denials and rejections. OPA finds this resolved.

Provide staff with relevant documentation and training and develop and implement policies and procedures effectively to review third-party reimbursements;

Adopt and publish a listing of all procedures and related fees in one complete schedule;

Update contracts with insurance companies;

Reconcile billings created and payments received from contractor. Any discrepancy should be resolved and the overall effect should be analyzed and documented; and

Comply with CHCC’s procurement regulations when seeking the services of an outside billing and collection agency.