Pauls Valley, OK, Pauls Valley Democrat

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February 18, 2014

Billing finds clearer path at PVGH

emann@pvdemocrat.com — Time will tell how much can be recovered from a financial turnaround at Pauls Valley General Hospital.

Taking a look at the initial moves made to fix the key problems that plagued the medical facility’s billing department, even the small differences feel like night and day.

This is due to an agreement set in motion by those like Pauls Valley General Hospital Interim CEO Jim Clough and billing entity Equalize RCM.

“What Equalize gives us is an immediate recourse to get bills out the door,” said Clough.

Clough took a moment to clarify key differences between Equalize and McKesson.

Equalize uses its own employees to handle medical billing.

McKesson is a software PVGH used to process medical records. At one point, it was the intention of officials to use the software to meet a federal requirement. That never worked out because of an insufficient number of people on sight to handle it or bad timing.

Clough said this is not a replacement of one for the other, but it allows them to at least address related areas with more hands on deck.

He added how many of the hospital’s financial problems were easier to handle by the software before bankruptcy. If installed and managed right at that time, the billing company would likely not been needed right now.

“When the hospital went away from them it made the billing process a lot more difficult and inefficient,” said Clough. “What Equalize provides us is a lot more billers... processing those claims for us.”

Their new partnership began with approval from the PV Hospital Authority near the end of 2013. It expanded in January, 2014, to help with similar billing problems that had developed through the Valley Women and Children’s Clinic. He noted that the entire process is so complex that if any step of it breaks down along the way, it can and did bring the entire process to a halt.

Clough pointed out when removing the McKesson system the hospital went to a manual system and lost important automated tools. Lost was a claim scrubber that made sure information from a patient’s visit was accurate and some basic coding.

“There was no financial or CEO oversight for that operation at all,” said Clough, mentioning the gaps that occurred when the needed staff was not available be at the hospital or clinic.

“We’ve got a lot of work to do to get that building caught up and make sure we’re doing everything that we’re supposed to be doing.”

Equalize will be using their own computer system. It has significantly helped speed up the whole billing process after being slowed down for so long, according to Clough.

Equalize will act as a supplement to a billing department.

“We are fully engaged with Equalize,” said Clough, noting how Equalize has access to the hospitals system who can receive the documentation they need, whether it is scanned, faxed or e-mailed and it effectively is getting caught up on the old debt as well as taking care of new debt as it occurs.

“We’re starting to get money in the door.”

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