A federal team of medical experts that exited the Commonwealth Healthcare Corp. this week recommends getting rid of the hospital's contract with a collection firm, which it described as “costly.”
As part of the hospital's sustainability plan, the team said that getting rid of the contract can be done by September 2014, in anticipation of the completion of revenue cycle automation.
“Return self-pay debt collections to the [corporation's] business office. The contractor currently performing this function is very costly and is not fully integrated with the CHCC business office,” states the team's report.
Guam Marianas Collection Agency currently does the billing and collection work for the hospital.
Once the complete revenue cycle is automated, hospital staff should be cross-trained to function as collection agents for these self-pay recipients, and a gradual transition from the current contractor to CHCC staff should ensue, the report states.
The team bared that CHCC has three financial reporting systems in place that are not interfaced: JP Edwards, RPMS (resource and patient management system), and GMCA.
The goal should be to integrate all existing financial reporting systems in order to capture, input, extrapolate, and report financial and revenue data more accurately and comprehensively, the team report states.
The GMCA collection agency contract uses its own financial system and the team said it would be more cost-effective to train the GMCA staff to input self-pay data into RPMS.
“Long term, CHCC should assume the GMCA contract duties once revenue cycle processes are automated,” the report adds.
GMCA only gets paid when it actually collects money for the hospital. GMCA's contract provides a 25-percent fee for what it collects and a 10-percent fee for billing works.
The corporation's board instructed the hospital's management during its last meeting to submit a report assessing the performance of GMCA.
Outpatient pharmacy
The hospital sustainability plan also recommends analyzing a possible conversion of the contracted outpatient pharmacy at the hospital to a corporation-owned and operated one. PHI Pharmacy currently runs the pharmacy at the hospital.
“This has the potential to increase revenue and can assist with providing remote fill prescription services to the outlying CHCC clinics to further maximize revenue,” states the team report.
Rehire MIAP position
The plan also recommends rehiring staff for the Medically Indigent Assistance Plan “because it is a great return on investment.” With many patients on hemodialysis and other chronic conditions, this will open the door for expansion to other services, the team said.
They also recommended hiring a patient benefits coordinator to advise patients who might qualify for Medicaid, Social Security Disability, SSI, and other assistance programs.
MIAP is a program that assists non-insured indigents by providing discounted rates on their prescription drugs.
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