$5M hospital billing backlog uncovered

 Lt. Gov. Eloy S. Inos and CNMI Healthcare Corp. CEO Juan N. Babauta uncovered up to $5 million in unpaid billings at the Commonwealth Health Center yesterday morning.

Babauta said the pile of records were documents that have not been decoded yet for issuance of billings to patients. He said these documents were all stored in a big table that sat neglected for many years.

Babauta said that CHC has an estimated $52 million in collectibles from patients and only “a very small portion” of it is considered collectible.

He said the bulk of the $52 million are past the statute of limitations and must be written off the corporation’s books.

Saipan Tribune learned that majority of the backlog covers unpaid accounts dating back from May 2005. Inos said the accounts represent all the services that have been provided to patients but were not collected and paid to the hospital.

“From the $52 million estimated uncollectibles, only a very small percentage is collectible,” Babauta said, because majority are covered by the six-year statute of limitation.

Inos, who expressed himself not surprised at seeing the billing backlogs yesterday, said that Babauta has hired an assistant who will look into the pile of records exclusively to determine if these are recoverable. To make the hospital billing section efficient, Inos said a serious revamping is needed.

Inos also talked to personnel of the billing department yesterday to get more information on how the processing can be sped up.

“As I observed this morning, the billing has started to come around. It’s just that it’s based on an antiquated system that need serious revamping. The CEO has hired an assistant who will exclusively look into those documents, at least until the things here are all operational and going,” Inos said.

Saipan Tribune learned that CHC has only one coder assigned each for in-patient and outpatient sections.

Inos emphasized that the healthcare corporation will scrutinize all the backlogged documents to come up with accurate billings that will result in less disputes, less appeals, and will expedite payments from patients.

Besides the billings and record department, Inos and Babauta also inspected the hospital laboratory and checked on the inventory of supplies and equipment, among others.

Inos assured the administration’s continued collaboration with the corporation until everything is settled.

He said the administration wants to prevent what happened when the Commonwealth Utilities Corp. transitioned from the Department of Public Works and inherited a huge deficit, resulting in CUC being placed under an emergency declaration for many years.

Prior to the corporation’s takeover on Oct. 1, the Department of Public Health had a contract with Guam Marianas Collection Agency to issue billing statements to CHC patients. Collection, meantime, remains the function of CHC.

Babauta said the contract with the billing agency is up for the board’s review. “We have to review that contract to make sure that we will benefit from it and if not, we will do some changes. Our challenge now is really our backlogs,” he said.

With the numerous challenges at the hospital, Babauta said any expectations that it will all be resolved overnight is “totally unrealistic.”