Dayton Chronicle - Your Hometown News Source

DAYTON–Columbia County Health System (CCHS) presented a major concern about some bad debt that was written off from patients from Texas during last week’s meeting on December 3. During October 2019, Columbia County Health System approved $28,118 in bad debt write offs from a number of patients. Of this amount, approximately $5,000 was from two patients from Texas.

Although many Texas license plates have been observed on autos at PacifiCorp’s Marengo I and II repowering projects, currently contracted out to Vestas, a company headquartered in Denmark that designs, manufactures, installs, and services wind turbines, it is unknown at this time if the two Texas patients are employees of that project. It was suggested to investigate this because it would be presumed that they would have health insurance through their employer.

Shane McGuire, CCHS Chief Executive Officer (CEO), reported that if calls were made to the employer to ask about the employees receiving health care, it would violate those individual’s Health Insurance Portability and Accountability Act (HIPPAA) rights if the purpose of the health care visits were not work related. McGuire stated that collection of those debts will be pursued in the same manner as all debt collection is pursued, using debt collection companies. He added that the debt collectors are really good at tracking people down. Rules that protect privacy do not benefit the collection process.

As for the rest of the bad debts, it was reported that staff graciousness is being abused regarding financial obligations of patients. If a patient cannot pay, there are resources that can be accessed to help. However, in order to connect patients with resources to help pay their financial obligations to the hospital, the staff must request information that patients are unwilling to provide. Therefore, sometimes it is difficult to provide that resource to the patients. Some of the patients with bad debts are repeat offenders. It was suggested to take a firmer stance on those patients. For example, they can be prohibited from using clinic services, but they cannot be prevented from using emergency services.

One of the major contributors to the bad debts is that patients have reasons for not paying their co-pays at the time of service. Being a public hospital supported by taxpayer funds, the policy is to be gentle with patients, to include the financial obligation. It was mentioned that sometimes staff do not ask the patient for the co-pay. One board member stated that she has never been asked to pay the co-pay. If the co-pay is requested, and a patient insists they cannot pay, the instructions given to the staff are to not engage or argue at the desk. Instead, their accounts are noted for follow-up. McGuire stated that “you didn’t ask me at the time of service” is not an appropriate reason to not pay the co-pay because the account is not referred to collection without some type of follow-up, such as letters and phone calls. However, patients are ignoring the phone calls and the letters.

There is a system in place to email the billing staff with the reasons for patients’ refusal to pay co-pays; and this has helped get some of the co-pays collected. McGuire stated that the hospital wants to maintain an environment of healing, and not of financial confrontation. It is felt that people who are sick will not come if they fear confrontation over payment of the co-pay. The policy is to try to engage those patients at a later time in a non-threatening manner.