New York City Health and Hospitals Corporation

Collection Practices for Inpatient Bills

The New York City Health and Hospitals Corporation (HHC) operates New York City's municipal hospital system. When payment for a bill cannot be collected by one of the eleven acute care hospitals in the system, the bill may be referred to one of several private collection agencies. We examined collection practices at three of these hospitals and found that many of the unpaid bills referred to collection agencies could have been collected by the hospitals instead. For example, for 71 of the 100 randomly selected accounts that we evaluated, the successful actions taken by the collection agencies were the kinds of actions that the hospitals' collection staff were expected to take and frequently entailed nothing more than thorough or persistent efforts to confirm the patient's eligibility for Medicaid. Since a high percentage (70 percent at the time of our audit) of the fees paid to collection agencies by HHC hospitals relate to collections made from Medicaid, and since such collections are relatively easy for HHC hospitals once a patientís eligibility for Medicaid is confirmed, it is possible that the multimillion-dollar fees paid to collection agencies by HHC hospitals could be significantly reduced if collection practices were improved at HHC hospitals.

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