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May 13. 2012 6:15PM
Elliot's urgent care center eyes up-front fee
MANCHESTER — The urgent care center at Elliot at River's Edge soon will start demanding up-front payment from patients who have the ability to pay, the hospital president said Thursday.
President and Chief Executive Doug Dean said the hospital is taking the step because of a projected 40 percent increase in bad debts this year.
He stressed the new policy, and as-yet undetermined fee, will not apply to people who have insurance, Medicare and Medicaid patients, or people who qualify for charitable care.
“In urgent care, people are coming in two to three times a week, demanding to see a doctor, but they refuse to take responsibility for the bill they incur,” Dean said.
Only 14 percent of self-pay patients at River's Edge paid anything toward their bill, Dean said. At the Elliot's Londonderry urgent care center, the number was 37 percent.
One potential plan calls for a $150 charge before a self-pay patient can see a doctor, he said.
If implemented, the fee would represent a significant shift in the purpose of the urgent care center, which opened in April 2011 with the promise of quick, on-demand physician care to 40,000 patients a year.
A key aspect of urgent care was the expectation it would take pressure off the hospital emergency room, the expensive hospital portal that is required by law to accept and treat any patient.
Dean acknowledged that if an urgent-care customer refused to pay upfront, the patient could still get treatment at the emergency room. Dean said the emergency room already is flooded with patients.
According to figures provided by Elliot, urgent care centers at Manchester and Londonderry are running about 10 percent below capacity.
Dean said Elliot has not accounted for the surprising increase in bad debts.
As of March 31, bad debts totaled $37 million for the hospital's first nine months in its budget year, he said.
Still, Elliot is breaking even for the first nine months of the budget year, said Rick Elwell, chief financial officer for the hospital.
Dean said insuranced patients, especially those in high-deductible plans or with hefty co-pays, also aren't paying their bills. He believes some aren't aware of the payment details of the plan.
Elliot urgent care centers already request self-pay patients to pay $50 up front, but the Elliot does not refuse urgent-care treatment if the patient doesn't pay.
The hospital provides charitable care to anyone whose income is up to 200 percent of the federal poverty level. That amounts to $46,100 for a family of four, according to the Foundation for Health Care Education.
The hospital offers assistance on a sliding-scale basis for people with incomes from 200 to 400 percent of the poverty level.
Last week, a River's Edge patient told the New Hampshire Union Leader that urgent care clerks had told her about the mandatory $150 up-front payment.
Dean said that some patient-registration clerks may have done so.
He stressed the policy is still being drafted, and hospital officials still have to determine what the charge will be.
“Some clerks jumped the gun,” Elwell said. “Some folks got out in front of this too early. It wasn't finalized.”
A plan may not be finalized before six to eight weeks, Dean said.
President and Chief Executive Doug Dean said the hospital is taking the step because of a projected 40 percent increase in bad debts this year.
He stressed the new policy, and as-yet undetermined fee, will not apply to people who have insurance, Medicare and Medicaid patients, or people who qualify for charitable care.
“In urgent care, people are coming in two to three times a week, demanding to see a doctor, but they refuse to take responsibility for the bill they incur,” Dean said.
Only 14 percent of self-pay patients at River's Edge paid anything toward their bill, Dean said. At the Elliot's Londonderry urgent care center, the number was 37 percent.
One potential plan calls for a $150 charge before a self-pay patient can see a doctor, he said.
If implemented, the fee would represent a significant shift in the purpose of the urgent care center, which opened in April 2011 with the promise of quick, on-demand physician care to 40,000 patients a year.
A key aspect of urgent care was the expectation it would take pressure off the hospital emergency room, the expensive hospital portal that is required by law to accept and treat any patient.
Dean acknowledged that if an urgent-care customer refused to pay upfront, the patient could still get treatment at the emergency room. Dean said the emergency room already is flooded with patients.
According to figures provided by Elliot, urgent care centers at Manchester and Londonderry are running about 10 percent below capacity.
Dean said Elliot has not accounted for the surprising increase in bad debts.
As of March 31, bad debts totaled $37 million for the hospital's first nine months in its budget year, he said.
Still, Elliot is breaking even for the first nine months of the budget year, said Rick Elwell, chief financial officer for the hospital.
Dean said insuranced patients, especially those in high-deductible plans or with hefty co-pays, also aren't paying their bills. He believes some aren't aware of the payment details of the plan.
Elliot urgent care centers already request self-pay patients to pay $50 up front, but the Elliot does not refuse urgent-care treatment if the patient doesn't pay.
The hospital provides charitable care to anyone whose income is up to 200 percent of the federal poverty level. That amounts to $46,100 for a family of four, according to the Foundation for Health Care Education.
The hospital offers assistance on a sliding-scale basis for people with incomes from 200 to 400 percent of the poverty level.
Last week, a River's Edge patient told the New Hampshire Union Leader that urgent care clerks had told her about the mandatory $150 up-front payment.
Dean said that some patient-registration clerks may have done so.
He stressed the policy is still being drafted, and hospital officials still have to determine what the charge will be.
“Some clerks jumped the gun,” Elwell said. “Some folks got out in front of this too early. It wasn't finalized.”
A plan may not be finalized before six to eight weeks, Dean said.
