Salem Memorial District Hospital is getting help collecting its growing backlog of unpaid patient accounts.
Outsourcing some of the billing to TruBridge, a medical services company that helps collect money owed, began Jan. 2, administrator Kasey Lucas told the SMDH board at its January meeting last week.
TruBridge is handling the hospital’s Medicare, Medicaid, managed Medicaid, Blue Cross, commercial insurance, workmen’s compensation and VA billing. Private-pay billing will still be done in house.
Lucas said it will take about 45 days to get through the transition to TruBridge, which will receive a portion of what it collects under its contract.
“We have to make sure everything is transferred over and make sure they’re getting exactly what they need on certain types of bills,” he said. It’s been a struggle at first. “Each hospital is set up little different, so there’s a little bit of transition for us.”
SMDH also has to make certain TruBridge gets all the information it needs on a timely basis to keep everything in the proper billing queue, he said. Claims must also be coded properly to keep them from being rejected, slowing down the process.
“And if they collect more for us, they make a little more. That’s really what we want to see: them collecting more than what we were collecting. That’s what we hope to see as the outcome,” Lucas told the board.
Since the move to TruBridge, the hospital has lost its commercial biller and Medicaid biller, replacing one of them. Self-pay billing will be split between the two billers still on staff.
In her report, chief financial officer Monica Stogsdill said accounts receivable now stand at just over $16 million, an increase of $1.2 million over last month. The largest portion of that, $7.4 million, is private pay accounts. The second largest is $3.6 million in unpaid Medicare reimbursement. A year ago, accounts receivable was just under $10 million.
The majority of the $1.2 million increase from last month, $846,390, is in private pay, Stogsdill said. Over the last few weeks, 2,116 accounts totaling $3.28 million were sent to collections, with another 664 accounts totaling $417,454 going to collections in the next few days, she said.
In her summary of operations, Stogsdill also reported a slower month in December, with 10 acute care patients per day, down from 14 in November, and an acute care occupancy rate of 36.9 percent.
In the emergency department, of the 158 patients seen, 50 were transferred, 82 were admitted and 25 declined treatment. EMS transported 178 patients and had 48 dry runs.
Patient revenue totaled $5.3 million for the month, with $1.99 million in net operating revenue after deductions. After $2.33 million in net operating expenses, the hospital recorded a net loss of $289,169 for the month, the summary shows. Despite the loss, SMDH still operated in the black in 2019, Stogsdill said.
Board member Ray Bruno noted that contracted services are now the hospital’s third-highest expense. Stogsdill said TruBridge is being paid for coding expenses and confirmed that SMDH paid $90,230 for contracted nurses last month.
In her report, chief nursing officer Debbie Hines said the home health department underwent a compliance survey in January, its first since new updated regulations went into effect.
“So it was very thorough,” she said. “They looked at everything very closely. The surveyors that were here were very positive about our agency, had many compliments and good things to say.”
A notice of any deficiencies requiring a plan of correction was expected later in the week, she said.
The ambulance service was also surveyed for recertification and to become a training entity. Hines said the survey went well. “We are awaiting final approval,” she said. Long-term care was also surveyed with only one deficiency and dialysis will be surveyed soon, Hines said.
Under old business, Lucas reported that incumbent Judy Thompson, District 1, and new appointee Willie Strader, District 4, were the only candidates to file for the hospital board in the upcoming April election. With no opposition in either district, no election will be held.
Lucas also reported that bid requests for the in-house MRI and Phase 1 renovation project have been extended until Jan. 28 to elicit more response. The deadline for proposals for financing the expansion is set for Jan. 31. After the finance committee meets, a special meeting is needed for making decisions on bids, he said.
In other business, the board heard a report Carolyn Adams, director of the SMDH Family Medicine clinic, on its growth since being established in 2009.
When it opened in Jan. 2009 as Salem Family Health Care, the clinic had nine exam rooms, a procedure room, break room, four offices and six employees, including two providers, two nurses, a biller and an office manager. It became certified as rural health clinic in May of that year.
In its first year the clinic served 1,800 patients through 3,456 visits and made 310 referrals to outside specialists. In 2019, it served 5,380 patients through 16,032 visits. Fifty-five percent of patients are female over the age of 40, Adams said. The majority of visits are funded through Medicare and Medicaid.
In Sept. 2010, Salem Family Health Care became SMDH Family Care and continued to operate where Dr. Yvonne Prince had practiced since 1994. In 2015, it merged with SMDH Family Medicine and construction of a new building was completed.
In 2017, the hospital opened an outpatient lab draw office in the clinic. In 2019, it added an interactive playroom, revamped phone system and another checkout window, Adams said.
The clinic currently has 21 exam rooms, a procedure room, 10 offices, a break room, and 30 employees, including seven providers and 11 nurses, six front desk employees, a referral coordinator, two patient accounts billing employees and two administrators.
Adams said she is looking forward to clinic expansion in the future, with one new provider coming in 2021 and another in 2023.
In other action, the board:
• Reappointed active and courtesy staff physicians for 2020
• Approved a conflict-of-interest policy
• Appointed Willie Strader to the finance committee
The board also approved several equipment purchases totaling $41,217, or $28,762 under budget, including:
• An AccuView vein viewer for the lab for $5,645
• A Hoyer Calibre lift and sling from McKesson for acute care patients up to 850 pounds for $7,314
• A Stryker big-wheel stretcher with scale for the ER that holds up to 700 pounds for $7,695
• Three IV pumps from B. Braun for the ER for $8,013
• A Viper Fang floor scrubber with 26-inch traction drive for housekeeping for $6,495
• Two high-flow nasal oxygen supply systems from Fisher & Paykel Health Care for $6,055
