In the first four months of this fiscal year, the hospital’s reimbursement from Medicare went down while private insurance companies are incurring payment balances in their accounts, according to Commonwealth Healthcare Corp. interim CEO Esther Muña yesterday.
Muña did not disclose the amount collected from Medicare from October to January but said the reduction is a result of some “transition” at the federal agency.
“In the last four months, revenues from Medicare are reduced. They’re saying that they’re in a transition and this is something we encounter every time the contractor [for Medicare] changes. Every provider was told that revenues will be slow,” explained Muña.
Since the corporation is seeking an extension on its loan with the Marianas Public Land Trust, Muña said the reduced collection from Medicare is a concern because MPLT always seek assurance of repayment.
Medicare is the biggest funding source for the hospital.
Vice chair Pete Dela Cruz pointed out, though, that there remains other areas that could boost the corporation’s collections and revenue, alluding to the collections from private insurance companies.
Dela Cruz expressed dismay at the disappointing collection totals generated from private insurance companies.
“We understand that Medicate is the bulk portion of our collection income but how about the private insurance companies? Where are we? What are the outstanding and how much have we collected versus the billing?” asked Dela Cruz.
Based on the financial documents handed out yesterday, many private insurance firms have incurred significant balances in their payment to the hospital.
Of the 32 bills the corporation sent to Aetna Global totaling $163,630, the company has only paid $10,020, leaving a balance of $153,610.
Calvo’s Insurance did not provide any payment for its billings amounting to $18,174. This data is from Oct. 1, 2013, to Dec. 31, 2013. There were a total of 14 billings for this account.
Moylan’s Insurance also has a payment balance of $5,302 for the six billings in the same period.
Staywell, meantime, has a payment balance of $13,878 during the first three months of the fiscal year. Takecare Insurance owes $35,504 while Tricare has a $1,114 balance.
According to the records, only Aetna Global has a payment in the first three months of the fiscal year, while the rest did not pay any amount.
Collectibles from insurance companies totaled $227,880 as of Jan. 2.
For Medicare payments, records show that the hospital sent 87 bills, of which nothing has been paid as of yesterday. These bills amount to $749,379.
“We have to accelerate collections from private insurance companies,” Dela Cruz told management officials yesterday.
It will be recalled that when the corporation implemented a new fee schedule for hospital fees and services, insurance companies asked for discounted rates but that has yet to be finalized by both parties.
Board chair Joaquin Torres asked if this is what is holding up the payments of insurance companies, to which Muña said that the corporation and insurance companies have yet to sign any such “agreement.” However, she could not immediately say if this is the reason for their non-payment.