The Commonwealth Healthcare Corp. will continue to use the services of the Guam Marianas Collection Agency for their billing and collections, particularly with their backlogs.
According to CHCC chief operating officer Esther Muña, the hospital currently has backlogs with their billing.
“The only way to do it on the date of service is likely by using our own personnel. But in the meantime, we do have backlogs. So those backlogs will continue to go to the [Guam Marianas Collection Agency], for example,” Muña said.
Last month, CHCC signed an agreement called Net Metering and Intergovernmental Cooperative Agreement with the Commonwealth Utilities Corp. to address the millions of dollars the hospital owes the utilities company.
Aside from required payments as well as the construction of a solar power system at the hospital, the agreement requires CHCC to improve their financial management.
NMICA states that for clinic and ancillary services billing, “the policies, practices, and hiring of direct personnel, and initiation of place of service billing shall commence…within six months” while for inpatient billing, “CHCC may generate a preliminary bill for inpatient charges upon discharge within nine months of the execution of the NMICA…”
Muña said they would eventually establish their own system and personnel to handle billing but there would be “outliers” where they may need the help of a provider in order to process.
“To completely phase them out, it’s probably impossible,” Muña said. “Billing and coding is complicated.”
Muña said billing services for hospital and healthcare keep changing, the recent one being the use of ICD 10 from ICD 9 last October.
ICD, or the International Classification of Diseases, is used to standardize codes for medical conditions and procedures. It is implemented by the Centers for Medicare & Medicaid Services and the American Medical Association and a mandate that applies to all parties covered by the Health Insurance Portability and Accountability Act, not just providers who bill Medicare or Medicaid.
Muña said the new ICD increases the number of diagnosis codes to specify what procedures or healthcare was provided for a patient.
“That in itself is a transition that created a gap in our billing system,” she said.
Muña said they were able to improve and close the gap in their billing and collection.
From last year when they were billing within two years’ time, Muña said most of our bills are now within one year’s time.
“We’re trying to improve our financial management system. We’ve improved so much already over the years. We see that with how we…are able to pay our vendors, we are able to pay our payroll,” Muña said.
“What we want to continue to do, what we basically plan to do with this, what we’re trying to show with this agreement is, for example the clinic and ancillary services, we are looking at identifying the weaknesses and gaps, looking at more gaps,” she added.