UIHC audit finds $11 million in unbilled services

IOWA CITY -- University of Iowa Hospitals and Clinics officials said a problem that led to $11 million in missed patient billings was discovered in a recent audit and will be fixed.

Bills have gone out to those patients and some of the money has already been paid, officials said Wednesday. They expect to recover all of the unbilled revenue.

It's unclear how the billings were missed, but hospital leaders have formed a team to find the cause of the problem so they can keep it from recurring, Chief Executive Officer Ken Kates said.

"It goes without saying how disappointed we were," Kates told the state Board of Regents Wednesday during a meeting in Iowa City. "We take these findings very seriously."

The $11 million in unbilled services were in the hospital's heart and vascular center. Hospital officials had requested an internal audit of that area because a new computer management system, called EPIC, had been installed. It's common to do an audit after new systems are implemented to see how things are working, Jean Robillard, UI vice president for medical affairs, said.

The internal audit discovered the missed billings began in November 2009. They were corrected in March 2010, officials said.

It was not a problem with the EPIC computer system, Kates said, but it's unknown if it was human error, if there will be disciplinary action taken as a result, or how the missed billings happened, he said. The hospital team will find that answer in its root cause analysis, he said.

They also are doing spot checks in other areas of the hospital to make sure missed billings are not happening in other units, he said, and developing refresher classes for managers involved in oversight of billing.

UI Hospitals and Clinics bills about $235 million monthly in gross charges for physician and hospital services.

Several regents said they are pleased with the seriousness with which hospital officials are treating the mistake.

Primary findings of the internal audit found missed billings, inadequate monitoring of billing staff, and inadequate documentation of patient vitals in accordance with hospital policy. Hospital leaders expect to complete their plan for correcting the problem by September.