Weiser hospital administrators discuss indigent claims with commissioners

By: 
Steve Lyon

Weiser Memorial Hospital administrators expressed some concern in a meeting last week with county commissioners that the hospital has not seen any revenue from the indigent fund so far in 2019 and a dozen claims have been denied.
 The revenue collected through the county indigent fund has never amounted to a lot for the hospital, but CFO Mark Christensen said the hospital has received nothing so far in 2019. If the county denies the indigent claim, the hospital doesn’t get paid and doesn’t have any remedy.
 He said the hospital would like to be engaged in the review of applications the hospital submits to the county to get a better understanding of why claims have been denied. The governing statute that covers indigent claims hasn’t changed.
 Christensen provided the commissioners with the number of claims the hospital has submitted and the amount paid out of the indigent fund to the hospital dating back to 2013. In fiscal year 2017, the hospital submitted 16 claims and eight were allowed for $15,325. In 2018, there were 15 claims and 11 were allowed for $1,910. So far in 2019, 12 claims have been made by the hospital and all have been denied by the county.
 Any amount helps the hospital’s bottom line as bad debt write-offs and charity care costs continue to rise, hospital officials said. The total amount of bad debt and charity care has risen from $1.38 million in fiscal year 2015 to $2.16 million in FY 2019.
 Hospital board member Mike Hopkins said hospital officials wanted to engage in a “friendly conversation” with commissioners to let them know the hospital’s situation and try to figure out what the hospital can do to get indigent claims approved.
 County officials said if an indigent resident doesn’t cooperate and provide the necessary information required to complete an application, they can’t do anything else but deny the claim based on state law.
 “It’s a big issue with people not cooperating,” commissioner Nate Marvin said.
 The county clerk’s office makes a diligent effort to get information from residents unable to pay to process indigent claims when they apply for assistance. The county is governed by state law on what can be approved and what can’t be approved, he said.
 As a critical access hospital, WMH is mandated to treat every person who walks through the doors, whether they have health insurance or not. When they can’t pay, the hospital submits an indigent claim to the county. The charges are already discounted to the Medicare rate.
 Idaho law governs payment for medical and non-medical expenses for indigent county residents. Assistance from the county is provided by taxpayer funds and is to be “a last resort.” Under Idaho law, an automatic lien is created on all real and personal property of those who file an application for county medical assistance.
 The applicant must provide personal and financial information and any other documentation relating to residency and resources. The county conducts an investigation of the application to present to the county commissioners to make a decision. Any assistance approved by the county is required to be reimbursed.  
 The county will cover indigent bills that qualify up to $11,000 and anything above that goes to the state’s indigent fund. The county allocates nearly $200,000 annually in the budget for claims from indigent county residents.
 Commissioner Kirk Chandler also said there has been a problem over the past year with getting information from county residents. In addition, some claims for payment the county has received from the hospital are not complete.
 “We’re doing some investigating that the hospital should be doing,” he said.
 WMH CEO Steve Hale said if the hospital is sending in incomplete claims an effort will be made by staff to do more.
 The hospital’s bad debt write-offs could be reduced when Medicaid expansion begins in early 2020. More low-income residents of the state will be enrolled in the health insurance program approved by state voters last November.

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18 E. Idaho St.
Weiser, ID 83672
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