Sources: NRMC care went unbilled

Published 12:05 am Thursday, September 18, 2014

NATCHEZ — Natchez Regional Medical Center’s financial woes were worsened by the administration’s inattention to detail, hospital workers said this week.

Hospital sources, who spoke on a condition of anonymity to protect their jobs, said lapses in paperwork caused the work of several physicians to go unbilled at a time when the now bankrupt hospital already was burning through cash.

The problem was particularly an issue at the Natchez Medical Foundation, sources said.

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The Natchez Medical Foundation — a multi-specialty group practice of doctors primarily affiliated with NRMC — lost $3.86 million in 2013, a loss the hospital had to absorb in addition to its own $4.65 million loss.

But sources close to the situation said the NMF’s losses might not have been as severe if the hospital’s administration had made sure the hospital had been able to bill for the services of doctors and nurse practitioners on time.

In medical billing, physicians have to annually renew their credentials with Medicaid, Medicare and private pay sources such as insurance companies in order to send a bill to that provider.

The credentialing process involves filling out applications, checking the provider’s education and past experience, a review of their practice history and personal references.

In some instances, some doctors would have credentials for the hospital side of operations but not for the foundation’s clinic, sources said.

Another source said physicians aren’t responsible for the credentialing and might not know theirs have lapsed.

“We had one physician who found out his credentials had lapsed from a patient,” the source said. “A patient called and asked, ‘Why isn’t Medicare paying my bill, am I going to be liable for this?’”

When a credentialing issue was raised, those who asked about it were told not to ask questions, a source said.

“It is a very daunting process because it is a lot of paperwork, but it’s not rocket science,” a source said. “As a stand-alone hospital, you are going to have to have somebody where that is his or her only position.”

Those employees who knew about the credentialing situation have been upset.

“They are hearing that their PERS isn’t paid, but then there is money that isn’t coming in,” a source said.

Employees were informed last week the hospital has not paid the employer contribution portion to the public employees retirement system since November even though the employee portion had been deducted from paychecks.

Community Health Systems — which was awarded the sale of the hospital last week — has already taken the necessary steps to ensure all of the health care providers at the hospital have credentials in order, sources said.

NRMC filed for bankruptcy in March, the second time in five years.

While the sale has been awarded to CHS, it still needs approval from the federal bankruptcy court overseeing the case. The court will have a confirmation hearing for the matter Sept. 29 in Natchez.