Authorization letters no longer honored for non-emergencies

Private sector employees who used to avail of hospital services for non-emergency cases using just authorization letters from their employers can no longer do so unless they are insured or pay upfront following the Commonwealth Healthcare Corp.’s decision to strictly enforce its payment policy.

Interim corporation CEO Esther Muña confirmed with Saipan Tribune that since the enactment of the local law that freed employers from providing mandatory insurance coverage for their employees, the hospital has been implementing upfront payment for non-acute treatment—unless the patient’s company enters into a prior arrangement with the hospital.

Muña made this clarification following information that an employee of a private company was refused service at the Commonwealth Health Center last week for failing to pay upfront. The patient, it was learned, just had an authorization letter from the company expressing willingness to be billed for the patient’s charges.

“This has been the hospital policy: all companies should be treated the same way we treat our self-pay patients who come in, see their physicians, and pay for the services rendered,” said Muña.

She said CHC no longer accepts or honors authorization slips and recommendation letters for non-emergency cases.

She, however, emphasized that the hospital will waive this rule of requiring upfront payments in emergency and acute cases.

“If it’s not an emergency case, they [companies] can first arrange a payment arrangement with the hospital and we’re doing that,” she told Saipan Tribune.

According to Muna, the hospital has been suffering for many years as a result of uncollected charge accounts, resulting in inadequate funding to meet the hospital’s operational needs such as supplies and equipment.

“When you go to a hotel, you check out and you pay. Why is it not the same for the hospital? Why is CHC forced to wait to be reimbursed for services we provide?” she asked.

Muña said the public hospital is not trying to chase away patients, because it attends to every immediate case that comes its way. However, she said that for non-emergency treatment, there has to be some responsibility to fulfill. Non-emergency treatment, she said, can be planned.

“For non-emergency, everybody needs to pay affront but if it’s an emergency and acute cases, patients can be billed and that’s always been the practice. So for uninsured patients, they should be treated the same way we treat the self-pay,” she said.

According to Muña, there are some companies that take advantage of the billing system of the hospital. “What’s stopping the companies from insuring their employees? Because they don’t want to pay the premium,” she said, adding that CHCC will not provide “special treatment” for non-emergency patients.

“Some companies think that they can just authorize a payment [for their employees’ medical bills] by issuing an authorization or recommendation. My question is: Why issue an authorization instead of a check?” asked Muña.

CHCC is an autonomous agency that heavily relies on its revenue to continue operating. Its income is sourced from reimbursements from federally-funded Medicare and Medicaid clients and self-paying patients.