In mid-March, the King of the Prussia, Pa.-based Universal Health Services named Michael CFO of his Phoenix-based Valley Hospital, a private psychiatric hospital, which specializes in chemical and mental dependence care.
With cutting cost, Mr. Coffee told Baker This, in his new role, he is doing zero on a behavioral health industry challenge: fraud enrollment in ACA Exchange Schemes. He said that in the last six to eight months, some patients were incorrectly signed up for exchange schemes, which created a conflict between the Medicade and the commercial insurers on the payment responsibility.
“We have back and forth between two schemes that are going to pay us,” he said. “Insurance companies (will) pay you what they are outstanding for you, but they are looking for details. If they can find a reason that you have not followed the procedures correctly, they are going to seek reasons why they can deny you the payment.”
To compete this, Valley Hospital has started the “double-and triple-checking” patient’s eligibility and medicade plan to ensure that nothing has changed.
“This is something that we are all trying to find ways to handle, (to) can find resources that can help us find out what plans should be made to the patient and to correct it so that everyone can be properly reimbursed,” Mr. Coffee said.
Shri Coffee is also looking for possible policy changes associated with Medicade funding. However, he and his team are being told that there will be no change in funding.
“Of course, two things are going on: the budget process is going on with the Congress, and the things coming out of the White House on possible changes on how they are going to fund things,” he said. “Those two things have to be noted (two) to see how this Medicade is going to affect the population. We are definitely monitoring it every day.”
