Wrangell Sentinel -

By Dan Rudy 

Hospital to adopt new billing services contract


In a pair of meetings Monday morning and Tuesday evening, Wrangell Medical Center will move ahead with shifting its billing services to an outside company.

The hospital's board of trustees and the Wrangell City and Borough Assembly each approved a contract with TruBridge LLC, based out of Mobile, Ala. Once finalized, hospital staff anticipates the transition will take effect by August.

TruBridge is a business and consulting services company and subsidiary of CPSI, which provides the hospital's accounting software. WMC interim CEO Marla Sanger explained the decision to take on TruBridge's services in a no-bid contract was in part because of this connection, in that it would ensure compatibility and familiarity with the hospital's programming.

Sanger explained another reason TruBridge was approached was the hospital's previously positive experience with its risk assessment services, as well as the company's record in providing billing services for Petersburg Medical Center.

Since taking on the neighboring center's accounts in 2013, TruBridge had brought operating cash levels from a low of $100,000 to roughly $2.5 million, while lowering the amount of accounts receivable from $6 million to roughly half that.

Terms of the contract were negotiated by the hospital's new financial officer, Doran Hammett, and reviewed by the Borough's attorney, Bob Blasco. Wrangell would be entered into a two-year agreement with TruBridge, with the company collecting 2.2 percent of all sums collected for patient services.

Speaking to the Assembly on Tuesday, Hammett explained the contract could cost just under $400,000 based on revenue projections of $9 million per year. The cost would be a trade-off for an improvement in cash flow and an anticipated increase in reserves by reducing Wrangell's receivables total, or amounts owed for services. That total currently stands at around $4 million, and has not shown improvement this year.

Sanger explained this is attributable to staffing. WMC's billing department has three staff members, who also have reception and other front office duties. Coding and bill collection can be a time consuming and complicated business, made more difficult by absences and time off. She told the WMC Board and Assembly simply hiring more staff would not be practical, due to lengthy training times and the possibility of turnover.

“It's not impossible to do in a small hospital,” Hammett said Monday, “but there are some distinct challenges.”

The hospital board expressed some concerns, such as whether TruBridge would have direct access to its banking accounts in light of hacking threats. However, members present at the meeting voted unanimously to back the change.

A sticking point for Assembly members on Tuesday was that the contract, once awarded, would no longer be up for their review so long as it continued to be renewed. Sanger replied that while the contract would allow WMC to conclude services with 90 days notice once the initial two years were completed, the contract did have a self-renewing mechanism.

The Assembly was also disconcerted over outflows of a substantial amount of money from the community through contracting an out-of-state company.

Member Stephen Prysunka wondered whether the hospital ought to create a separate position or two to cover front office and other reception tasks, freeing up billing department staff for their other duties.

Assembly member Julie Decker spoke in favor of contracting TruBridge, citing the urgency of the hospital's financial position.

It was explained the company's larger pool of specialized staff could reduce receivables in ways the hospital is on its own currently unable to, bringing in more money that can build up savings. So by taking on TruBridge's services, the hospital would effectively be spending money to make more money.

However, Decker agreed the issue of local jobs should remain an active consideration, and that a plan should be drawn up for preparing staff to resume billing duties once the contract comes to an end.

“I really think we shouldn't wait for two years to solve the problem in-house,” agreed fellow member Dave Powell.

Decker proposed an amendment putting a condition upon the agreement that the hospital's board and staff draw up a plan for addressing its staffing concerns, to be presented by the calendar year's end.

Even with the amendment, it came to a close 4-2 vote in favor of the contract. The next step will be a four-week transition period, where a TruBridge staffer will fly in to assess Wrangell's accounts and prepare its hospital staff for the new system.


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