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Archive for Thursday, February 18, 1999

HOSPITAL OFFICIALS GET TO HEART OF BILLING GLITCH

February 18, 1999

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Lawrence Memorial Hospital officials aren't sure how much in lost revenues a computer error cost the hospital, but they are resending bills to former cardiac care patients.

A computer error at Lawrence Memorial Hospital under-billed patients for certain cardiac tests, and LMH officials say they don't know how long the problem went undetected or how much it cost the hospital.

In January alone, the glitch resulted in $184,933 in unbilled "cardiac marker" tests, which are four sets of three tests to determine whether someone had a heart attack and how severe it was.

Bonnie Peterson, LMH chief operating officer, said the annual increase in billed tests is expected to be $2.67 million, now that the error has been found.

Peterson released the information during the hospital board's monthly meeting Wednesday morning.

LMH officials were quick to point out that the amount of money the hospital bills and what it actually receives in revenues are substantially different, depending on insurance reimbursements.

"The actual number is subject to all the contractual allowances that are typical to our revenue," Gene Meyer, hospital CEO and president, said. " ... That's why it's so difficult to say this is going to mean we can expect `X' thousands of dollars in the future."

Meyer and Peterson did say the increase in revenue will be "substantial," but hospital officials wouldn't offer an estimate of lost revenues. Tom Pagano, chief information officer in the management information systems department at the hospital, said it's unknown when the billing error began.

The SAINT software system used to bill patients has been at the hospital for 10 years, Pagano said, but it's possible the glitch happened during an upgrade.

Patients who had the cardiac tests can expect to find updated bills in their mailboxes, and tests taken after November already have been rebilled, LMH community relations director Janice Early-Weas said.

"We are continuing to go back beyond that, where it's feasible," she said. "It's a very labor-intensive process, and sometimes third party payers (insurance companies) have limits on how far you can go back and correct a billing.

"You can go back and try to recapture lost charges, but it varies," Early-Weas said.

Accounting and laboratory personnel uncovered the error in early January during tests in preparation for a new software system, Pagano said. Before the new system, Star, can go online in April, Pagano said a detailed analysis of the current system had to be completed.

Tom King, director of the LMH laboratory, said the series of cardiac tests are done over an 18-hour period, but they were entered into the computer system at one time. The SAINT system is programmed to eliminate duplicate billing, and interpreted the four series of tests as one test being billed four times. It would automatically eliminate three series of the tests, King said.

Peterson said the tests cost between $300 and $1,200.

"Obviously, you don't want an error where someone puts in an order, and 10 minutes later, a duplicate order is billed to the patient," King said.

-- Chris Koger's phone message number is 832-7126. His e-mail address is ckoger@ljworld.com.

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