suggestions for changes in the way Grenada Lake Medical Center handles billing for

health care services. "We have had some great suggestions from our patients about how we can make the billing process more understandable and easier to work through, and we really appreciate it." Grenada Lake Medical Center's new statement will show a

Summary of Charges by department, and all Payments and Adjustments. It will also show which insurance carriers we are filing the claim with. "If patients still want an itemized bill, they can call the Business Services Office and we will be glad to furnish them one," noted Lea Hammons, GLMC Business Office Manager.

In addition to the changes made in the actual statement, the Business Services Office has been reorganized to be more responsive to the customer. One of the complaints heard most often by the Business Services Office was how difficult it was to get someone on the phone. Now there will be three people dedicated to just answering phone calls.

"When you process over 90,000 insurance claims a year, you are bound to have questions from customers about those claims. We know how important it is to get a real person on the phone in a timely manner to discuss these issues," said Ms. Longest. And because medical billing is so complicated, the Business Services Office has added more staff to ollow up on customers' claims and questions more timely.

Another change that is being made is to out-source the billing for all claims that the patient/responsible party is directly responsible for paying (this includes co-insurance and deductibles, and all patients who do not have any insurance coverage). This will allow GLMC to focus on filing the insurance claims as quickly and accurately as possible. The billing service being used is Horizons Billing Service out of Jackson, MS. If a customer receives a bill from Horizons, it is important to call them first with any questions and payment arrangements. They will have all of the billing information and can probably help the customer right on the spot.

Longest noted that patients who are educated about their insurance plans can really help the process go much smoother. "As you know, health insurance can be very complicated.

But there are some pointers that, if followed on the front end, can make the billing process much easier for the customer." It is important that you be very familiar with your benefit plan. This is an agreement between you, the company you work for, and the insurance carrier paying your claims. You should have a booklet describing these benefits. If not, you can get one from your company's human resources department."

"It is very important that the Patient Access Office have all the correct information at the time of admission to the medical center," noted Donna deBlois, Patient Access Manager at GLMC. In order to ensure a smooth and timely admissions process you will need to have the following items:

1. Your insurance card(s) (If you have more than one, please inform the clerk which one should be primary),

2. Your Driver's License or a copy of your Social Security Card,

3. Orders from your physician stating the reason for your admission or for outpatient testing the exact tests that are to be performed and why,

4. Pre-certification approval stating that the tests you will be getting are going to be covered by your insurance carrier,

5. Be prepared to pay any co-payments required by your insurance.

Pre-certification

It is extremely important that you know if your outpatient test or procedure must be precertified by your insurance company. If it is not approved in advance, the insurance

company will hold you responsible for the total cost of that test or procedure. What is

required to be pre-certified is generally noted in your benefit plan or on your insurance card. Some plans also require a co-payment for certain services, especially emergency services, at the time the service is rendered. We will ask that you pay any co-payments at the time of your registration."

"With a new year starting, many customers may find they are under a new insurance plan. Please make sure you know how this new plan works, and let us know you are under a different plan when you come to GLMC," added deBlois.

Longest also noted that the medical center has been going through a change in computer

hardware and software of the last year. "Due to this conversion to a new system, the

Business Services Office has gotten behind in filing claims. We estimate that all filing should be caught up in the next few months," said Ms Longest.

If you have any questions about Grenada Lake Medical Center's billing process, please feel free to call our office at the following numbers, 662-227-7586, 227-7152, or 227-7160. If you have any additional comments or suggestions, please call Lea Hammons, Business Services Office Manager at 662-227-7595 or Donna deBlois, Patient Access Manager, at 662-227-7104.