Accounting, billing glitches plague Yale Medical School

Yale Daily News NEW HAVEN, Conn. (U-WIRE) -- A glitch-plagued accounting system coupled with complicated health care billing practices has given the Yale School of Medicine another headache. Last Tuesday, Danielle Baum-Smith testified in Hartford that the medical school billed her more than $11,000, despite the fact that she received Medicaid and was not responsible for the charges. Baum-Smith had received a letter asking for payment for the treatments which Yale provided between 1988 and 1994. Eventually she received a court order declaring that $252 be deducted from her paycheck. Yale was able to resolve the ongoing dispute only half a year ago, and the university returned the money, according to Yale spokesperson B. Jay Cooper. As a response to this and other billing errors, Yale will completely revamp its billing system for the second time in four years. Two years ago, the university spent more than $5 million to update its "antiquated" accounting system. The replacement should be in place by the end of next year, Cooper said. "There have been problems with the billing system for some time now," he said. "There have been some changes, and it's better than it used to be, but not as good as it should be." An added complication to the Baum-Smith case was her eligibility for Medicaid, which lead to both increased paperwork and chances for confusion. According to Medicaid and Medicare regulations, the university must exhaust all outside sources of funds before billing the government programs. "There was difficulty in confirming that there wasn't other insurance that should have been billed," Cooper said. "By the time it was almost sorted out, a collection process had been begun." The complex health care payment systems in the United States are the result of a rapidly growing health care industry. Billing confusion often results from the tangled bureaucracy of both private and government agencies. "The United States has the most complicated health care system in the world, so it also has the most complicated billing system in the world," Cooper said. He acknowledged that mistakes do happen, but stressed that they "should happen less frequently now than in the past, and should happen less in the future with the new system."