HSA to clean up $90M bad debt trouble
(CNS): The local hospital will be focusing on resolving its more than $90 million old and bad debt problems over the coming year by trying to collect around $10 million of its oldest debt, writing off what can’t ever be recovered, focusing on reducing the recent debt and stopping it from mounting in future. Speaking at the Public Accounts Committee Wednesday, Health Services Authority CEO Lizzette Yearwood and HSA Board Chair Jonathan Tibbetts spoke about the plans for dealing with the hospital’s mounting debt problems.
Over the years, when the public hospital has treated patients who are either uninsured or under-insured it has struggled to collect payment for both medical services and drugs. And with so much debt, which has not been properly reviewed for write-off, the hospital is carrying it over year to year in its financial reports, preventing it from balancing its books.
But as some of the debt is more than ten years old and will never be recovered, Tibbetts told PAC that the HSA is now in a position to begin writing debt off, having been given the green light to do so by the government.
Yearwood told the committee that the hospital accountants have estimated that they can probably recover around $10 million of the whopping $90 million owed to the hospital. She said the HSA would be conducting a procurement process to find a local company that could help with that collection. While it is still unlikely that the public facility would seek to sue the local man in the street for outstanding fees, it will go after insurance companies that have not paid, among other overseas debtors.
Now that the board has the power to write off the oldest debt, Tibbetts said, the balance sheets can also be cleaned up and the hospital can then focus on the collection of debt that is less than a year old and put in policies and procedures to prevent further future debt and improve payment collection.
The problem the hospital faces, however, is that despite the mandatory requirement for everyone in Cayman to have health insurance, in practice it is simply not the case. There are many people in Cayman who are working on casual contracts or for rogue employers who did not pay their health insurance.
There are small micro traders who simply cannot afford to cover their own health insurance policies and a significant number of people on the basic SHIC plan, which is still woefully inadequate for any serious medical problem.
As a public service, the HSA is obligated to treat everyone in need of medical attention, including visitors and local indigent patients. In addition, when the insurance companies refuse to pay and patients don’t have the means to pay, the hospital is left indebted.
Category: Government Finance, Government oversight, Health Insurance, Politics
Memo to the HSA accounting dept.:
Immediately after a patient has received treatment, prepare an invoice, place it in an envelope, address the envelope to the insurance company concerned or the patient if there is no insurance, place a stamp on the envelope, take the envelope to any post office, drop it in the slot marked ‘local’ or ‘overseas’ as appropriate.
That is how you recover costs.
If we had single-payer, universal health insurance, there would be no debt.
Investigation needed into all allegations on here. If HSA really did fail to do what they should and are now trying to cover it up, heads should roll and criminal charges be filed. The first head to roll should be the CEO’s.
Bad Debt will be cleared up at the HSA when politicians stop turning the country into a “Welfare State” – solely for political votes.
It’s more likely for me to build a space craft in West Bay and get into orbit, than it is for HSA to clear their bad debts.
I agree with the commenters who have written about the HSA Finance Dept. being so lax. Twice I have had bills sent to me so long after that I couldn’t even remember what they were for! The last one I can tell was sent to my insurance company past the deadline, then was billed to me. They were small amounts so I paid, but I resent the fact that I was showing on their books as a debtor. If they don’t get their act together this ‘bad debt’ situation will go on.
Could not agree more… And it is just not HSA. Chrissie has just as much of a problem when it comes to invoicing. I just received a phone call for a “bad debt” from February 1014. There was never and invoice sent after going to the insurance company. There needs to be a big mirror placed in both hospitals when it come to who’s fault it is.
It would be a mistake to reset/forgive past debts and not address the regime and thoughtless hierarchy that created it. We don’t want to be doing this again in 5 years.
Maybe if they stopped sending invoices for amounts that have already been settled by insurance companies their books would look a little better off. By the way, who was held accountable for CarePay? Another glorious day in the Civil Service.
another glorious day for the civil service……more awards franz!
If Government ever enters the real world occupied by the private sector, and requires all civil servants(and dependents), numbering in the many thousands, to pay their insurance premiums, co-insurance and deductibles, they would recover this HSA deficit within a year or two.
How come the buttons are no LOL and Troll only?
CNS: Technical issues. We’re working on it.
It’s not bad debt, it’s a free health service for Caymanians pretending to be user pays. Services (and drugs from the pharmacy) are supplied to uninsured locals with a nod and a wink about the bill being sent to them with both parties knowing full well it’ll go straight in the bin.
What needs to be discussed are the claims that the hospital have not submitted to insurance at all and are now calling people about. The hospital accounts department has been very lax about submitting claims even when pre-approvals were granted. Now they are calling people saying they owe money they never once tried to collect and that the insurance is willing to pay and just never heard about. Speaking from a personal experience.
Ditto, I have the same experience. Services provided, co-pay paid and non-submission (by HSA) to the insurance company. Now time barred for submission they are chasing me for their errors.
I agree with you wholeheartedly, I was just given a bill from June 2012 that was never submitted to the insurance company for payment, yet I presented the insurance card for my son and he was operated on. I’m sure if I did not present that insurance card he wouldn’t had gotten his operation. A lot of slackness in the HSA accounts department and what they need to do is get their act cleaned up. I for sure won”t be paying this bill as I had valid insurance and it wasn’t my responsibility to send the HSA bill to the insurance company for payment. I contacted the insurance company and was told that it will have to be a write off because it was not submitted to them for payment and nothing is showing on their system saying payment was refused either or deferred and I can”t be forced to pay it.
I agree and have experienced this on 2 separate occasions. If I did not take the initiative to contact my health insurer to verify the claims were submitted (of which 1 was not submitted and the other past the 6 month timeframe at the time), the HSA would have continued harassing me for payment. The HSA should hold their finance/accounts departments liable for claims not submitted on time or at all.
I am always surprised that this common problem has been overlooked. Some years ago my insurance company preapproved an outpatient procedure. Two years after the surgery I received a bill from HSA, the first I’d heard about it not having been paid at the time and well past the submission date for insurance coverage. For two years after that, HSA occasionally wrote or called me to complain about my non-payment – each time, I had to explain yet again that it was their error in failing to submit it to the insurance company and I wasn’t going to pay it. I was accused by incredibly unprofessional HSA staff members of various things including lying about not receiving a bill immediately after the surgery, failing to submit my insurance details when I checked in to the hospital, even moving and changing my address and then forgetting I had done so! The last straw was a shocking and blatantly untruthful letter telling me that my insurance company had paid the surgeon and then my benefits had “run out” before the hospital bill could be paid. So my “debt” is no doubt included amongst those written off when it would not have, but for HSA incompetence, existed in the first place. I suppose it is easier to simply assume that it is indigent locals and obnoxious expats running up these bills, but the light really needs to shine back on the HSA and its procedures. In the end, my bill was paid by all of our tax dollars (the real result of “writing off”) instead of my insurance company. Whose fault is that?
Yes, that’s true, at least in my situation. Plus, the HSA waits far too long before billing insurance companies; in some cases, they wait so long that the insurance company will no longer pay it, and guess who the HSA expects to pay when that happens? That’s right. The patient who — in good faith — got preapproval for the procedure, and did everything they were supposed to do.
Why is the health insurance Law not being enforced? Why are there thousands of non Caymanians living here with no health insurance? Why is immigration not requiring evidence of health insurance of every non Caymanian resident (including the hundreds of children in our schools).
Not thousands…some perhaps..everyone I know as an expat has it.
You are sadly mistaken. Many expats do not have health insurance that lasts past the date of application for their work permit.
Helpers and the foreign spouses of Caymanians and their children are expats too!
And how do you know they don’t?
Because I know children who are in schools here but have been totally under the radar. Some have been born in Cayman but never added to their parent’s health insurance, or their parents work permits for that matter. As long as they never travel, it seems there is no issue.
Read the article. It is not lawful for any person resident here to not have health insurance, and yet many do not.
That is the very reason we have them in schools here, because they are provided with everything. Free transportation, uniforms, food/breakfast or lunch, education and insurance. It is time to close the gate, in order to reduce the debt. Too much freeness.
HSA management and board could not confirm who signed off on the AIS fiasco where nobody in management and the ministry of health could be bothered to read the contract or could determine who paid 1.8 million to AIS but now they can fix 90 million of bad debt. ROFLMAO
C’Mon Maaaaaaaan
They will fix it by writing it off.
If they can find a pen.
… and if they know how to use it.