After accommodating insured patients to meet their needs, the Commonwealth Healthcare Corp. is now pushing health insurance companies to do their part and pay the hospital for services rendered. <\/p>\n
\u201cWe want to maintain our services and be available but we also want to get paid. We weren\u2019t able to do that in the past because we were behind in our billings and in our payment postings,\u201d said CHCC CEO Esther Mu\u00f1a.<\/p>\n
CHCC has now updated its billing records and that means their records are now current; this time, they want insurance companies to be current with their payments as well.<\/p>\n
\u201cNow that we are updated, we are basically saying that our records are valid and legitimate. These are not just numbers but actual claims. We are saying that these were provided for your members and health insurance companies must pay,\u201d said Mu\u00f1a. <\/p>\n
To date, three health insurance providers owe CHCC at least $2 million each, Mu\u00f1a said. These are TakeCare Health Plans, StayWell Saipan, Inc., and Calvo\u2019s Insurance.<\/p>\n
\u201cWhat we have been doing recently is we\u2019ve been closely monitoring the insurance companies and how they are performing. The system is showing a $2-million claim from each insurance company and we need it. Our vendors go after us so we need to go after insurance companies, too, to do their part,\u201d Mu\u00f1a said.<\/p>\n
CHCC has hired Tiffany Sablan as Revenue Cycle director and her hiring and other improvements in CHCC\u2019s revenue cycle has resulted in updated financial processes in the hospital\u2019s billing and collection system.<\/p>\n
\u201cThe majority of the insurance claims are from the last two years. Some of them even goes back to 2012 but the reality is that majority of those claims are from the last two years. These should be collectible,\u201d Mu\u00f1a said.<\/p>\n
She said that CHCC needs to identify funding sources to be able to implement its plans to increase salaries, improve services, and hire more doctors for Saipan, Tinian, and Rota.<\/p>\n
\u201cAs for the salary increase, we implemented some and the idea is, by October 1st, we are going to implement the salary scale that we submitted in our budget plan. We plan to improve our services, especially in the improvement of care and renovations of facilities. That is why we are more aggressive in collecting our claims,\u201d Mu\u00f1a added.<\/p>\n
Non-payment could push CHCC to get out of the insurances\u2019 network. <\/p>\n
\u201cWe don\u2019t have contracts with them but we plan to have provider agreements with them. That has not been completed because some questions need answers and at the end of the day, there needs to be mutual agreement between CHCC and the health insurance providers,\u201d she said.<\/p>\n
According to the CHCC CEO, the Legislature plans to introduce a bill that is similar to Guam\u2019s prompt payment law and this is welcome.<\/p>\n
\u201cGuam has a prompt payment law where the claims are billed by the Guam Memorial Hospital, that insurance companies have a certain time to \u2018scrub it\u2019 and basically say these are the bills that are clean so we have to pay the hospital or in our case, the CHCC.\u201d <\/p>\n
Pushing for payment from these health insurance companies is a way of providing service to patients who were attended to by CHCC and who are paying insurance premiums to get service.<\/p>\n
\u201cAt CHCC, our utmost obligation is to serve our patients who are members of these health insurance providers and, that being so, it is their obligation to pay us,\u201d Mu\u00f1a said.<\/p>\n
MD: CHCC pushes for health insurance companies to pay<\/p>\n","protected":false},"excerpt":{"rendered":"
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