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Massena Memorial Hospital CEO acknowledges shortcomings in billing


MASSENA — The CEO of Massena Memorial Hospital acknowledged this week that the financially struggling hospital could stand to improve the speed and accuracy of its billing.

“We’re not the first hospital that has billing issues,” Chief Executive Officer Charles F. Fahd said Monday at a hospital board of managers meeting.

He said that like other hospitals, Massena Memorial suffers from the loss of longtime employees who were knowledgeable in areas such as Medicaid, Medicare and commercial insurance.

“We have issues with staff more often than we’d like to,” Mr. Fahd said. “We don’t have a very deep financial staff and billing staff. If somebody leaves or is on vacation, it takes us quite a while to backfill that. We’d like to get our bills out quicker so that they’re more accurate. Sometimes that doesn’t always happen.”

The board of managers of the municipally owned hospital, which lost $3.3 million last year and has cited state pension costs as part of its financial problem, has recommended turning the facility into a nonprofit organization. Some employees and residents have questioned whether internal reforms could be made short of privatization to improve the hospital’s finances.

Councilman John F. Macaulay said the town board has been fielding questions from residents about the hospital, and he turned to hospital officials Monday night to try to answer some of them.

Among them was whether the hospital has had auditors review its billing practices. The board of managers agreed Monday night to write off $227,690.04 in bad debt for March.

“I just thought I’d ask tonight, is there any formal audit that we do, whether it be internal, external or not, on our billing practices?” Mr. Macaulay asked.

Mr. Fahd said the hospital doesn’t have audits done specifically to look at its billing procedures.

He said the hospital routinely receives questions from patients about their bills, such as why they were being billed now for something that happened six months ago.

“We did hire some outside collection agencies to help with that process,” Mr. Fahd said.

That didn’t work out well, he said, and the work was brought back in house.

“We continue to have some issues in the billing department. ... Can we do better? Sure. Are we going to do better? Absolutely,” he said.

He said the hospital has identified areas where it can improve, including hiring the appropriate people in the department who ensure the billing is being done properly and sent out in a timely fashion.

Board of managers member David M. MacLennan wondered whether the hospital should consider doing an audit of its billing procedures. Chief Financial Officer James L. Smith said he didn’t recommend it.

“I don’t think there’s a need for it. I’m not aware of a lot of hospitals that get into that level of details,” he said, noting it was receiving assistance from reimbursement analysts in Syracuse and various public accounting firms.

Mr. Macaulay wondered if sample files were examined each year to see if the billing was done correctly.

“We have a corporate compliance program,” Mr. Fahd said. “Records are reviewed for accuracy. If mistakes are made, we’ll certainly correct them. But we rely upon our auditing firm that comes in and spends quite a bit of time here looking at our financial statements and making sure they’re correct.”

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