Letter to the Editor
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Mr. Sharp, thank you for letting us know about our billing mistake, and for speaking with me on the phone about it. We appreciate patients that bring this kind of situation to our attention. I want you to know that in no way was this intentional. We attribute the oldest text of ethics in Western medical practice to Hippocrates, a Greek physician, paraphrased, “first, do no harm.”
As I explained on our phone call, we have done an overhaul of our Financial Services Department to move us up to industry standards. For instance in automating processes wherever feasible to get bills to insurers and out of patient’s accounts ASAP and in most areas, we are now operating according to those. Additional areas that have been rectified include the ever-challenging and ever-changing obligations of compliance with federal and commercial insurance payers. However, our consultants doing the overhaul gave us mixed messages on this certain Medicare billing standard, and our interpretation and their oversight of our interpretation caused this billing mistake. Simply stated, we needed to track and billed services like yours and a few others, in a different way so as to get reimbursed by Medicare, and not send you or Medicare a bill. We have fixed that, and addressed yours and other patients’ accounts similarly affected. Best of all, the whole process is automated. It’s another “fix”, thanks to your persistent notification.
The Financial Services Department overhaul has been much like a home remodel. We have taken three steps forward and one step back on many of the very complicated billing standards in an attempt to make them both efficiently automated while making them fit our Electronic Health Record (EHR) platform (Meditiech). When you measure (re-measure!) and order what you think is the perfect set of cabinets for your kitchen remodel and go to install them, you’re shocked to find an unexpected extra two inches of gap. How could this happen when you’ve measured and remeasured? This analogy is much like the little gaps we have experienced over the course of the last 18 month Financial Services Department overhaul. The gap can be fixed with some ‘work arounds.’ The gap you got caught in was similar to finding out after 6 months of the kitchen remodel, you have been smelling something pungent, only to snoop around under the sink to find that the new garbage disposal has been slowly leaking. You discover the gasket the plumber used to install the garbage disposal was one of many brands approved for this model of disposal on the installation instructions, but it did not work for this install with this sink. Admittedly, we have all had these kinds of things happen whether during a kitchen remodel or in this case, a Financial Services Department overhaul.
My request to our patients is that anyone that calls or comes in for customer service from any department in our organization and you don’t get a clear answer, please kindly bring that to my attention and make an appointment to call me or come in and let’s visit. We have worked on revamping our service recovery for patient inquiries and we want you to have answers. During the COVID-19 crisis, we need your feedback, understanding, grace, and more than ever your support. We remain committed to providing you the best in patient care and respect for your pocketbook. We are humbled and honored to care for you and your families. Please call me at the hospital at 660-465-8511 and let’s talk.
Warm regards,
Randy Tobler, MD, FACOG, CEO
Scotland County Hospital