If Your Brand Is the Same, Your Billing Systems Need to Be the Same

Sound familiar? Two organizations operating under one roof with the same name but separate back-office systems, so that billing mistakes made by one get blamed on them all?

The Star-Ledger newspaper in New Jersey publishes an ongoing series of consumer complaints called “Bamboozled,” and the most recent subject was a patient of the Robert Wood University Hospital in New Brunswick. The patient, Lamar White, was treated in the emergency and released in the same day. He provided his current insurance information and paid his deductible, but later had his account sent to a collection agency, which reported his failure to pay to a credit agency.

White eventually paid the collection agency, even though he was certain he owed nothing. He was unable to get an explanation from the hospital why his account had been turned over to collections. So he took his case to the newspaper.

Once the Star-Ledger began investigating, White received his answers. The debt was owed to the Robert Wood Johnson Medical Group, not the hospital. Even though White had presented his current health insurance information to the hospital, that data had not been used by the medical group, which instead relied on old information it had on White from an appendectomy. Between the two procedures White had changed insurance and moved.

To add insult to injury, the medical group eventually received the updated the insurance information from White, billed the payor and received payment, and then sent White a refund for his payment to the collection agency, but sent it to his old address. “Even the collections agency sent the collections notice to me at my new address, so I am not sure why they would send the check to the old address,” White told the Star-Ledger.

The Robert Wood Johnson University Hospital, the Robert Wood Johnson Medical Group, and Financial Recoveries, the collection agency, did not provide the newspaper details about how this snafu occurred, but within the context of the story there are a few valuable lessons to be extrapolated:

• Confusing branding creates confusion. Apparently the hospital and physicians group operate separately at Robert Wood Johnson University Hospital, but the patient only knew he was using the services of the hospital. Furthermore, the late bill came from an organization using the same Robert Wood Johnson name. Had it come from “New Brunswick Associates,” the patient may have been able to correct the issue far sooner.
• Single points of contact should mean single back-office systems. The patient in this case had only one point of contact for Patient Access services, that being the hospital. His updated insurance information was never relayed properly to the medical group, which outside of clinical staff apparently had no interaction with the patient. ”The rep said the medical group billed White’s old insurance because that’s what information it had on file from a 2010 appendectomy White had at the facility,” according to the story.
• Separate back-office systems are costly and prone to mistakes. White’s updated information was never transferred to the medical group. According to the Star-Ledger story, the reason behind this is never clear, but as the hospital billed the correct payor and the medical group did not, one can assume that they operate using separate systems. The medical group “did not offer any explanation for the breakdown in communication between the hospital and the medical group about why the latter was not given updated information from my visit,” White told the newspaper. “After they didn’t receive payment — I am not sure how long they wait — they sent it to the collections agency because as she noted, they are not in the business of debt collection.” When the correct insurance information was entered into the system “someone either entered the incorrect information or entered it in the wrong field in the system,” White said he had been told.