Report | Sept. 16, 2014

Delinquent Medical Service Accounts at William Beaumont Army Medical Center Need Additional Management Oversight

DODIG-2014-112

Objective

Our objective was to determine whether William Beaumont Army Medical Center (WBAMC) properly managed delinquent accounts more than 180 days delinquent (unpaid) by transferring the debt to the appropriate debt collection agency or by actively pursuing collection. This is the second in a series of reports concerning delinquent medical service accounts (MSAs). This report provides the results of our review performed at WBAMC. We reviewed the 25 highest-dollar delinquent MSAs valued at $525,209.

Finding

WBAMC Uniform Business Office (UBO) management did not effectively manage delinquent MSAs. As of May 29, 2013, 1,688 of WBAMC MSAs, valued at $857,003, were more than 180 days delinquent. Of the accounts reviewed, WBAMC UBO management did not transfer any of the accounts to the U.S. Treasury for collection after the accounts were more than 180 days delinquent. Further, WBAMC UBO management did not actively pursue collection for 20 of the delinquent MSAs, valued at $455,775. This occurred because, among other reasons, WBAMC UBO management did not have a system in place to monitor and notify staff of MSAs needing followup.

As a result, WBAMC UBO management missed opportunities to collect $337,752 in delinquent payments due on the highest-dollar accounts. Unless WBAMC UBO management improves collection efforts and takes prompt and aggressive actions to collect the delinquent debt from the MSAs reviewed, including $331,794 worth of other delinquent MSAs, WBAMC UBO will continue to experience rising delinquent balances for future MSAs. WBAMC UBO took corrective actions such as transferring claims, contacting patients on some of the claims in our sample, and performing an internal review.

Recommendations

We recommend the Commander, WBAMC, upon completion of the internal review, provide the results of the internal review, planned corrective actions, and collection efforts for the remaining open delinquent medical service accounts. We also recommend the Commander, WBAMC, provide annual training to staff on MSA guidance, and establish procedures to validate that staff collect accurate and complete demographic and billing patient information before patient discharge.

Management Comments

Comments from the Chief of Staff, U.S. Army Medical Command addressed all specifics of the recommendations. We request that the Chief of Staff, U.S. Army Medical Command provide additional comments on the potential monetary benefits in response to this report by October 16. 2014.

This report is a result of Project No. D2014-D000CL-0089.000.