JOINT BASE SAN ANTONIO-FORT SAM HOUSTON, Texas (August 31, 2021) – The Brooke Army Medical Center is launching a number of initiatives to help patients navigate the complex maze of medical billing.
From financial advice to a revamped collection process, BAMC officials hope to alleviate billing issues, especially for civilian trauma patients.
“We want our patients to focus on their recovery, not to be stressed out by billing issues,” said Air Force Col. Patrick Osborn, deputy commander of surgical services at BAMC.
As a military hospital, BAMC is known for its mission to care for the country’s combatants, retirees and their families. However, BAMC also has a unique, and perhaps lesser-known, commitment to its community. As the only Department of Defense Level I trauma center, the hospital provides complex emergency care to civilian patients in an area that encompasses 22 counties in southwest Texas.
“We are able to take care of civilians without military benefits through a special program authorized by the Secretary of Defense,” Osborn explained. Through the Secretary-Appointed Program, with approval, BAMC is authorized to provide trauma and injury-related follow-up care to non-military beneficiaries for up to six months.
Caring for trauma patients has a dual benefit, Osborn noted. “It helps the community in which we work and live, while providing our military medical professionals with vital hands-on training that translates directly into battlefield care,” he said.
Military treatment centers are required by federal law to charge for all care provided to civilians without military benefits. As in other medical facilities, civilian trauma patients with medical insurance rely on their private insurer for coverage.
“If the patient has insurance and we have this information on file, we file a claim with their carrier as a courtesy to our patients,” said Army Maj. Matt Slykhuis, deputy chief financial officer of BAMC. “Once an invoice is generated, we have 120 days to work with the insurance company to facilitate a payment, whether it’s a full payment or a payment less a deductible or a quote. go.
Patients are billed if an insurance company denies a claim and all appeals, if there is a balance left after payment for insurance, or if a patient’s insurance information is not on file. In the absence of payment, as a federal health care facility, BAMC is required by law to transfer the remaining balance to the US Department of the Treasury for collections.
“Military processing centers are not allowed to waive, reduce, suspend or terminate debt,” Slykhuis said.
New improved process
Until recently, once transferred to the Treasury, the debt immediately began to generate significant interest and charges, causing additional stress for patients, he noted.
Recognizing the difficulties patients face in the face of growing indebtedness, BAMC worked closely with the Defense Health Agency and the Department of the Treasury to implement a new, more flexible process. As of November 2020, rather than billing patients directly, BAMC now automatically transfers any remaining balances to the Treasury Department’s centralized receivables department after 120 days of insurance processing.
Unlike BAMC, CRS has the option of setting up longer term payment plans or suspending collections depending on demonstrated difficulties. As an additional relief effort, CRS is not required to add to the fees and penalties generated by the central Treasury Department.
“This gives patients flexibility in collections that BAMC is not permitted by law to provide,” said Slykhuis.
In addition, BAMC strives to better educate patients and their families throughout treatment about the financial process in order to combat misinformation and confusion.
“We are in the process of bringing in experienced financial advisors who can help patients navigate the insurance and payment process,” said Army Maj. Rebecca Morrell, chief innovation and development officer. strategic transformation of health care. The counselors will be assigned to the emergency department and inpatient departments to help patients and their families, she explained.
Additionally, the advisors will serve as a liaison with insurance companies, facilitating claims and determining additional eligibility for optional enrollment in programs that offer payment assistance for specific patient populations. This includes insurance programs for patients who do not have coverage and federal, state, and local grant programs.
Inside or outside?
One of the most common areas of confusion is BAMC’s status as a federal health care facility, Morrell noted. Since BAMC is not authorized to contract with insurance companies, many carriers treat BAMC as an “off-grid” facility. However, the law requires all insurance companies to view federal healthcare facilities as “networked” for billing purposes.
“Unfortunately, insurance companies often view BAMC as ‘off-grid’ and deny claims or reimburse at a reduced ‘off-grid’ rate,” she said. BAMC is working behind the scenes to provide clarification and information to help patients, but the delay can cause undue stress and additional financial liability for patients facing the collection process.
The advisers will also help navigate the process of insuring patients in the event of an accident, from the vehicle to the workplace.
BAMC is working to integrate these advisers in the near future. In the meantime, the hospital will continue to help patients through initial counseling sessions and financial information forms and brochures.
The billing team also looks forward to the implementation of a new electronic health record called Genesis at BAMC in January 2022 and an updated billing system in January 2023. The new EHR and billing system have the potential to provide itemized inpatient billing for military treatment facilities, which is not a feature available with existing systems currently in place.
“This will allow us to be more transparent about our healthcare costs and help insurance companies research detailed information,” Morrell noted.
Aware of the issues, community leaders are also working to change laws to benefit patients. Recent state legislation outlined in Texas House Bill 2365 allows military treatment facilities to be considered participating providers with Medicaid effective September 1, 2021. This will allow BAMC to take Medicaid reimbursements as full payment. . In addition, BAMC will be able to bill Medicaid for outpatient services, which was not the case previously.
“This is great news for our Medicaid patients and for our providers who will be better able to ensure continuity of care,” said Osborn.
Ask for help
As BAMC strives to implement these improvements, billing experts recommend several steps patients can take to better navigate the billing process:
1. Make sure BAMC has all the up-to-date information, including the name of the insurance company, mailing address and contact details, before you leave the hospital.
2. Immediately review all BAMC invoices / documents received by mail. Insured patients who receive an invoice for the full amount should contact the BAMC Uniform Business Office as soon as possible to ensure that a claim has been properly filed with their insurer.
3. For billing questions / concerns, contact the BAMC Uniform Business Office (UBO), email [email protected] or call 916-8563 / 5772.
4. Contact insurance companies directly to confirm their level of coverage and personal liability.
BAMC will continue to explore ways to improve the billing process for patients, noted Osborn.
“We are incredibly proud and honored to serve our community as a Level I trauma center, and an important part of that commitment is to ensure that our patients are treated with empathy and compassion in all aspects of their care,” said he declared. “This extends to making sure they receive the best financial advice and education possible.”
|Date posted:||09.01.2021 14:27|
|Site:||FORT SAM HOUSTON, Texas, United States|
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