OPA: $19.8 million overdue patient bills remain uncollected

(PNC file photo)

Between January 2017 and June 2018, the Guam Memorial Hospital billed a total of $22.1 million for patient treatments, but 90 percent of this amount remained uncollected because of the hospital’s continuing failure to institute rigorous billing and collection system, according to the Office of Public Accountability.

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

Collection has been a long unresolved challenge at the hospital, which is perennially facing a funding shortfall.

In a blistering report from Public Auditor Benjamin Cruz, GMH was taken to task over billing and collections.

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

“Management allowed non-collection or untimely collection of past due accounts by not instituting rigorous billing and collection systems.”

Auditors also found that GMH failed to refer delinquent accounts to a contracted collection agency.

“I am dismayed by the decision of the new administrator for not forging a new direction for the hospital. Instead, GMH’s official response portrayed old-management-thinking to rationalize the unfortunate situation of the Hospital by not accepting that the GAR and policies are there for a reason,”  Cruz said in a statement.

In regards to collections, this is an issue which GMH recently announced they would be getting some assistance from the Office of the Attorney General.

“Filing a collection case is done as a last resort, but the Office of the Attorney General also has an obligation to make sure that the government receives payment for services that it has provided,” Attorney General Leevin Camacho said last week.

But is it really a last resort? According to OPA, the GMH collection staff, “is not focused on collecting delinquent accounts. About 99 percent of the time, the collections staff perform non-collection tasks, such as entertaining various calls and concerns from patients or visitors.”

The OPA made the following recommendations:

(1) Create a policy on the:
• Implementation and review of rate changes;
• Account referral process to the Collection Agency, including how the analysis
should be done and when to refer accounts;
(2) Enforce the execution of A credit arrangement before the patient’s discharge and define who is in charge of performing them; The law requirements of providing partial and interim bills to patients;
(3) Evaluate whether review and/or corrections should be performed on outstanding patient bills;
(4) Provide formal training and setting target collection outputs for the Credit & Collection supervisor and collections staff; and
(5) Assess, based on the current conditions of the hospital, whether reinstating a financial counselor will help improve the collection process.