NATCHEZ — Collections for the Natchez Regional Medical Center bankruptcy estate are running approximately $1.6 million behind where they were projected to be at this time.

“They had projected about $4.1 million (in accounts receivable), and we have collected about $2.5 million,” said Kenneth Lefoldt, the certified public accountant who was appointed by the federal bankruptcy court to serve as the former county hospital’s liquidating trustee.

“I don’t know where they got that number from — I think they made some assumptions I was not privy to — but some of that has to do with the fact that for the August and September billings, some of the professionals (at the hospital) had not been certified (for that period).”

In medical billing, doctors and other providers have to be certified with Medicaid, Medicare and private insurance companies to bill them. Sources close to the hospital said in September several of the doctors’ billing certifications had been allowed to lapse.

Since the hospital’s change of ownership from Adams County to the privately held Community Health Systems in October, all of the doctors associated with the hospital — which is now technically a new entity with the same name — have been re-certified.

Bankruptcy attorney Jack Lazarus, who represents Adams County’s interests in the trust, said he will meet next week with accountants and other attorneys to plan strategies to recoup more money.

The trust has been able to recoup approximately $100,000 in funds taken during Recovery Audit Program (RAC) audits, through which a third party — on behalf of the federal government — demands the hospital repay Medicaid and Medicare funds for supposed overbilling. RAC audits can be appealed, and often are successfully so.

“That (amount recovered) is not a small amount, and they are hoping for more,” Lazarus said. “They are questioning a number of those audits, and our position is some of those monies that were paid over by NRMC in RAC audits never should have been paid because there was no problem.”

At this point, the liquidating trust has paid approximately $3 million in obligations, including payroll and benefits, payments to post-bankruptcy vendors and cures for contracts and leases, Lefoldt said.

The trust will soon start the process of reviewing claims against it and filing objections with the court against any it does not find reasonable, he said.

The trust also applied for meaningful use incentive payments with the Center for Medicaid and Medicare Services in December. Meaningful use requirements for hospitals include upgrading to electronic records — among other things — which NRMC had done prior to its bankruptcy.

The projections included approximately $1 million from meaningful use funds, Lefoldt said.

“Now we are just in a situation of waiting to collect additional receivables, and meaningful use money will be a big piece of that for us,” he said.

The trust also has $4 million in an escrow account that will have to wait for two years before it can be released for payments. Two years is the clawback period for Medicare and Medicaid claims.

The final Medicare cost report for the former hospital’s operations is due March 2.