NRMC changes collection and financial assistance policies

Saturday, May 3, 2014

By Gloria Tucker

Nevada Daily Mail

Potential patients at Nevada Regional Medical Center may hear an unexpected phrase when scheduling appointments and procedures -- Can you make a payment?

Before services of a non-emergency nature are scheduled, patients will be asked to provide their status as self-pay or insured, discuss financial concerns with a financial counselor and make an initial payment.

The hospital's revised collection policy states: self-pay patients must pay the first monthly installment and insured patients may choose to pay a deposit upfront before service.

Uninsured patients will catch a break, though, with an automatic 35 percent discount and an additional 5 percent discount, if payment is made in full within 30 days.

The NRMC Board of Directors approved the collection policy changes, as well as changes to the financial assistance policy, at its meeting Tuesday.

The revised financial assistance policy qualifies patients for charity care based on residency in Vernon County, Rich Hill or El Dorado Springs, income falling within 200 percent of federal poverty guidelines and Medicaid ineligibility.

In addition, the CFO may waive the income requirements, should the total balance be at least 50 percent of the income of the family for the immediate past 12 months. This will constitute a catastrophic illness, resulting in a discount of 90 percent.

In the CEO report, Interim CEO Dave Hample said the hospital is on target to implement the policies May 12.

"We will start with diagnostic imaging, respiratory therapy and physical therapy and then expand to include all hospital procedures," Hample said.

Hample also told the board progress had been made on unassigned call coverage in the ER, patients who do not have a primary care doctor.

"While the document compensating physicians for providing coverage is not yet signed, it does appear that we have reached an accord with physicians willing to provide ER unassigned call," he said.

Hample said he met with CEOs from Bates County Memorial Hospital and Cedar County Memorial Hospital to discuss continuing the affiliation with area hospitals.

"We are planning to hold routine joint meetings with the hope of identifying areas where we can work together for common goals," he said. "This might include physician recruiting, sharing of department directors or contracting for services between hospitals."

In his report, QHR representative David Yackell told the board the firm had narrowed CEO candidates to four.

"After in-person interviewing, I anticipate we would bring some or all of the four candidates on site to interview with the board, medical staff and administration," Yackell said. "Right now, we're kind of targeting the end of May, beginning of June for making a final determination and making an offer. Hopefully, we'll have that person on site to start at the end of June, beginning of July."

In other business, the board approved a $225,000, three-year Toshiba Service contract for a CT scanner including parts, labor, system upgrades and technical support which represents $28,425 in savings over the life of contract, as well as replacing laundry and linen contracts which would save approximately $105,000.

Greg Shaw, CFO, also requested a Cerner Patient Financial Services contract for 12 weeks of PFS consulting services, including workflow and process analysis and improvement recommendations for $30,000.

Shaw stressed the PFS department's need for training using the Cerner billing system.

Board member Bill Turner said he hoped the goal of the training would be to have a system that works and staff will be able to keep up with.

Turner jokingly warned against trusting Cerner, and said, "If Cerner comes in and uses the words 'increasing functionality,' you have my permission to shoot them right between the eyes."

On a more serious note, board member Catherine Hissink asked if the hospital could afford the contract.

"We're supposed to cut expenses $300,000 to $400,000 a month," she said. "It seems, we've done more increasing expenses than decreasing expenses."

Shaw replied the training should bring in net receivables around $3 million.

"If I can spend $30,000 to bring a couple million in the next 6 months, that's money well spent," he said.

Hissink said she was not necessarily against this particular contract, but had concerns overall.

"I've heard we need to do this (reduction)," she said. "Every month, that's not happening, and we get deeper and deeper into the hole. At some point, I don't know how we get out."