UIHC billing error due to staff shortage, software

A University of Iowa Hospitals and Clinics error that led to $11 million in missed patient billings was due to vacant staff positions and a lack of software automation, according to an analysis of the problem.

UI officials today released the results of a root cause analysis, conducted by hospital leaders after the missed billing were discovered. Hospital officials told the state Board of Regents in April about the problem. All of the money ultimately will be paid, so it will result in no lost revenue, officials have said.

The analysis determined several factors led to missed charges in the hospital's Heart and Vascular Center. The factors include a lack of automatically generated charges in the software program used by the Heart and Vascular Center. For cardiac catheterization lab procedures, a staff member had to manually review the physician documentation and procedure log for each patient to determine what charges were appropriate. There was no automated monitoring system to identify potential missed charges, and during the time period reviewed, support staff for those procedures was one person, as two of the three positions were vacant.

The center will fill those vacant positions on the support staff, and will create ongoing educational programs for department managers to discuss ways to monitor billing activities. The hospital also will develop a charge “dashboard” that allows reviewers to compare daily charges to historical data. Officials also will continue to pursue automation of such activities.

“With continuous monitoring now in place, this problem is very unlikely to occur again,” the report states.

The internal audit discovered that the missed billings began in November. They were corrected in March, officials said. UI Hospitals and Clinics bills about $235 million monthly in gross charges for physician and hospital services.