GMH, insurers clear up confusion

by Jolene Toves

Guam - In an effort to correct longstanding issues with local insurance companies so there is no confusion and all are on the same page, the Guam Memorial Hopspital met with Calvo's SelectCare, Takecare, Staywell, Netcare and a representative from Medicaid.

GMH introduced new business practices to improve collections and insurer communications, as well as announced the development of new fees for all clinical and professional services. 2010 was the last time the hospital increased its fees.   GHM chief financial officer Allan Ulrich said, "Talk a little bit about the administrative process that we are doing here the changes that we want to implement or we are planning to implement and also to have an audience of all the insurance companies."

Ulrich introduced GMH's new processes which includes payment policies, patient acknowledgement, billing and collections, as well as guidelines for insured and uninsured patients. "How we are improving our registration processes we covered everything relative to registration all the way through their payment and remittances back to us so for us it was very positive," he said.

GMH has made changes to their affordable care policy. By law, GMH must provide examination and stabilization to patients who seek emergency services regardless of the patients' ability to pay. GMH has updated their policy limiting that treatment to emergency related conditions, further modifying the patient payment agreement to allow GMH to reserve the right to not provide any future non-emergency medical services to patients who are not able to pay their bill.

The work session is the first of many, which Ulrich hopes will lead to improved communication and gaining feedback from the insurers and clarifying any misunderstandings. He said, "For instance, we are talking about how we can improve that correspondence coming back from the insurance companies relative to accurate information about their members' eligibility, information what things might be denied by the insurance company because of the terms and conditions of their policies."

Although Ulrich did make mention of the development of new contracts, he says negotiations between GMH and local insurance companies will be addressed separately beginning April 1.