Patients recently have been receiving a flurry of hospital bills that date back months, and even years, from CTMH Doctors Hospital and the Health Services Authority.
After a patient posted on the Real Women of Cayman Facebook page that she had received a “very old invoice” from Doctors Hospital, dozens of other people reported that they had also received a bill from that hospital or from the Cayman Islands Hospital.
Both the HSA and Doctors Hospital told the Compass that the late circulation of bills was due to a suspension in sending out invoices to patients last year due to COVID-19.
HSA bills
Lizzette Yearwood, CEO of the Health Services Authority, which runs the Cayman Islands Hospital, said the authority had instructed law firm HSM, which collects the HSA’s bad debts, to temporarily halt its bill collections last year as the islands dealt with handling the COVID crisis.
She said HSM now has resumed efforts to contact people who owe money to the hospital.
“HSM remains retained by the HSA for bad debt collection,” she said. “They were first retained a few years ago for a pilot project which ended in October 2019, then at the beginning of 2020 the new contract was initiated. HSM is methodically going through the collections by alphabet of last name; however, when the pandemic hit we instructed them to suspend collections and they only resumed in August 2020.”
When HSM was first hired for the pilot programme in 2018, the Health Service Authority was owed $94.5 million in unpaid bills.
Doctors Hospital bills
Doctors Hospital also suspended chasing up its bills last year during the health crisis.
Kate Bell, director of finance at Doctors Hospital, told the Compass, “In 2020, because of COVID, the administration decided not to further stress the population and send out statements during a difficult time. We had no idea COVID would last this long.”
She said the reason patients were now seeing invoices from the hospital popping up in their inboxes was because Doctors Hospital has recently begun using a new electronic billing system, called Gateway. Previously, the hospital issued paper bills via the regular mail service.
Bell said some of the online comments she had seen from patients who indicated that their bills seemed to show that their insurance companies had not been contacted about claims were “unfair”, and she insisted that claims had been submitted to the relevant healthcare insurers.
Many of the bills show that the patients had paid their insurance co-pays at the time of treatment, but were now being billed for an additional amount.
Bell said this could happen if the patient had reached the cap on his or her insurance, or if additional treatments or procedures had been done that the front desk was not aware of at the time the bill was being drawn up on the day the patient attended the hospital.
In a subsequent statement issued by Doctors Hospital, Bell said the hospital was “working with all of our patients to investigate denied portions and ideally and retroactively seek reimbursement with insurers – even if patients are no longer with a particular insurance company”.
She added, “Sometimes it just takes a few detailed conversations to convey the medical justifications behind key charges. Either way, we are here to work with our patients through all inquiries, pre-certification logistics, and any questions they may have about their benefits in detail.”
In the statement, Doctors Hospital asked patients who received the bills “not to panic”.
Bell said, “We understand that some customers have raised concerns, and we are currently working around-the-clock to ensure a smooth transition to our new payments portal and to work through settlements. We sincerely appreciate everyone’s patience as we progress through these changes.”
The bills being sent directly from Doctors Hospital date back to the start of 2018. The hospital has handed over outstanding bills from before that time to the Cayman Islands National Credit Bureau to collect.
Bell said, “We are mindful that many patients may not have received previous invoices for a variety of reasons. However, we’ve put a team and resources in place to assist anyone who feels their bill is incorrect or sent to them in error.”
Under Cayman’s Limitation Law, there is a six-year limit on collection of debts.
However, the Health Insurance Law has a clause that specifically relates to medical bills. It states: “Notwithstanding any provision of the Limitation Law (1996 Revision), no sum due to a health care facility or to a registered medical practitioner in respect of medical care provided to a compulsorily insured person, shall be recovered as a debt under subsection (1), either from that person or from the approved insurer, after the expiration of one hundred and eighty days from the date on which the medical care was provided”.
A legal source told the Compass that in cases where an insurance company does not cover a treatment, or if the patient has reached his or her coverage cap and the treatment and procedure costs are not met by the insurers, that sum of money falls outside the realm of the Health Insurance Law and can be treated as a debt that would be subject to the Limit Liability Law.
Patients with concerns about their bills from Doctors Hospital can contact its Accounts Receivable department at [email protected].
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I thought that with the introduction of compulsory Health Insurance, a card must be produced before any medical relief. I have also had to leave a Debit card to cover co-payment. So why so many bills?
hilarious “they are working with patients” I received one of these from CTMH, checked what my provider had paid, which didn’t match what they said. I emailed them back with details and have heard nothing since…..
We always self pay and then have to seek reimbursement from our international insurance company. However bills must be submitted to them within 3 months of treatment.
My policy doesn’t have a co-pay, we get 100% reimbursement. Thus we have no incentive to not pay bills or ignore them.
It was therefore a big surprise to receive a bill for treatment I had supposedly received 3 years ago but had never previously been billed by the hospital. The doctor had supposedly forgotten to submit the invoice to billing.
Naturally angry emails resulted and the matter was dropped.
Seems to me that hospitals have every right to chase customers who have not paid bills. However they have to be responsible for billing for services in a timely manner and ensuring they have the correct address for billing purposes.