Wyoming health system loses up to $200k to surgery center billing delays: 9 things to know

Campbell County Health in Gillette, Wyo., missed out on $150,000 to $200,000 in Medicaid payments as a result of billing delays at its Powder River Surgery Center, according to a Gillette News Record report.  

Here are nine things to know.

1. PRSC, a multispecialty surgical facility also in Gillette, joined Campbell Health in 2016. It was previously independent.

2. PRSC has since experienced billing delays, according to Dalton Huber, CFO of Campbell County Health. He told the Gillette News Record some bills to Medicaid were denied because they were delayed more than a year.

3. He told the publication some bills to Medicaid and Medicare beneficiaries also took six or seven months to get to patients after their care.

4. Mr. Huber said of the billing issues: "I don't want to point fingers at who was to blame. It was just kind of a difficult process. Powder River was independent, and now, it's part of CCH. It took a little bit to work through that."

5. He attributed the delays to various factors, including unexpected computer issues, as well as how long it took to complete paperwork regarding PRSC's change from an independent facility billing as an ambulatory surgery center to one billing as a hospital-based surgery center.

6. Additionally, Campbell County Health upgraded billing software to accommodate PRSC billing, but that process wasn't completed until last June, according to the report. The billing process has been slowed as a result.

7. Not having enough CCH staff who are trained on the upgraded software also has contributed. Mr. Huber told the Gillette News Record training for additional staff is planned in the coming weeks.

8. Overall, Mr. Huber told the publication he doesn't expect CCH to fully resolve PRSC's billing delays until June or July.

9. PRSC still reported a profit of $4.59 million in fiscal year 2017, even with billing delays, and Mr. Huber attributed that growth to an increase in patients, according to the report.

Read the full report here.



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