HSA to change billing system

(CNS): The cost of most hospital services, including doctors’ appointments, pharmacy, and lab work, will not increase when the Health Services Authority (HSA) implements the new Charge Master billing system on 1 October. Fees for inpatient room and board, medical supplies, lab, radiology, pharmacy drugs and physiotherapy also remain unchanged.

According to a government release, while there will be adjustments in some fees, primarily in the cost of surgical procedures, many will still fall below standard rates set by the National Health Insurance Commission. Under the new system, facility fees and procedure charges (which include physician costs, anaesthesia fees, and fees for assistant surgeons if applicable), will each be billed separately. Currently, facility and physician fees are included under one charge. Anaesthesia charges are separate.

Charge Master is an internationally-accepted procedures billing programme used by hospitals and healthcare systems worldwide. Insurance companies also require this method because it efficiently standardises coding. Overall, the application of a common set of health and insurance industry codes will simplify the payment process, the government maintains.

The HSA has received government approval to implement the system, bringing it in line with the global industry’s best practices. With the implementation of Charge Master, fee codes will be updated electronically and annually, and proposed pricing changes authorized by Cabinet. Charge Master comprises 4,000 new procedure codes, ranging from minor to major, allowing the hospital to better expand its future services. However, the HSA will initially use only 1,500 of these codes, which will be billed according to rates set out in the Standard Health Insurance Fees.

Historically, the hospital has billed for services under the Fees Law, which limited HSA’s ability to recover the full costs of services provided to patients in line with real costs. Further, the Fees Law does not allow for the addition of services and programs. As a result, the hospital has been unable to fully cover major overhead costs, or charge correctly for new procedures. In part, this has contributed to the hospital’s deficit.

The HSA has set up a special telephone line to answer patient questions about the new billing system. The public can call 244-2662 for more information.