MISAWA AIR BASE, Japan – By this summer, all Air Force hospitals in the Pacific will be required to use a new billing system that sends medical charges directly to civilian patients’ insurance companies, a standard practice in the States and something customers have long asked for, according to officials.Most bases in Alaska, Guam, Hawaii and Japan implemented the billing service with Benefit Recovery, the company contracted to work with the insurance providers, when the contract was made available last year. The last three - Osan Air Base, South Korea, Yokota Air Base, Japan, and Kadena Air Base, Okinawa - are expected to come on line by July, according to Maj. Tera Carter, with the Air Force Medical Financial Compliance and Policy Division.The change directly impacts government civilian employee “pay patients.” If the hospital isn’t using Benefit Recovery, patients are required to pay the full cost of all of their care, whether a $20 check-up or a $20,000 surgery. Those patients must then work through the paperwork drill with their own insurance companies to get reimbursed. Many have complained that it’s not fair to be forced to pay the whole amount in advance, saying it can often take months to get reimbursed. But under the new system, Benefit Recovery bills the insurance company directly. After the insurance company pays its share, the patient is billed for the remainder. Even though Kadena officials were already directly billing the insurance companies for the patients, they will be required to use the new contract.Yokota officials have said they were going to request a waiver, but Carter said use of the contract is mandatory for all PACAF bases and no waivers will be authorized.Capt. Tania Bryan, Yokota spokeswoman, said last month that the medical group there was happy with its existing billing system.“Our current process continues to remain more than sufficient in terms of maintaining excellent customer service and ensuring we are good stewards of the taxpayer’s money,” she said.She also said the hospital is “always willing to work with patients who owe large amounts of money and are actively engaged with their insurance carrier.”At roughly the same time the PACAF bases were added to the contract last summer, Yokota was struggling to collect thousands of dollars in unpaid bills at the hospital. Base officials announced harsh measures - including taking away commissary, exchange and driving privileges for patients with accounts in arrears. In May 2010, Yokota officials said delinquent accounts for the first five months of the year totaled $30,000 and the base was still trying to recoup $246,000 from civilians for care received in 2008 and 2009.“We have resolved all of our past medical billing issues,” Bryan said recently. “This has been validated by two audits by the Air Force Audit Agency.”Mona Hegarty, a civilian employee at Yokota, said she actually switched insurance companies because it was taking between six months to a year to get reimbursed. While her current provider is easier to work with, she said she would rather have the third-party agency involved, especially with bigger bills. She said she imagines it’s even more important for larger families.“I know there are parents who don’t have cash and that is difficult for them,” she said of paying for 100 percent of the bills while waiting for reimbursement.Mark Madamba, a civilian employee at Yokota, said he’s just too busy to try to work through the insurance forms and has a stack of unfilled claims he’s never sent for reimbursement.“If they take care of it like all the other bases do, then that would be great,” he said. Capt. Pawel Nowacki, resource management office flight commander for Misawa’s 35th Medical Group, said his office immediately and aggressively pursued working with the contractor last year because it’s beneficial to both the hospital and the community. By November, they had worked through the various glitches - mainly with computer connectivity - and sent out the first batch of test bills.Nowacki said the program has been a big success at Misawa. The checks are flowing in smoothly from the insurance companies and the patients are happy because they’re not forced to pay first.“I feel that since the hospital began billing our insurance company for us, it has taken a great deal of stress out of being a pay patient,” said Lori Grant, a civilian employee at Misawa. “I really appreciate having that extra step taken care of for me.” Officials at Osan and Kadena confirmed that they will begin using the new system by the July deadline, pending no system delays. Yokota officials did not to respond to queries as to whether they would be able to meet the deadline.Stars and Stripes reporter Grant Okubo contributed to this story.flackt@pstripes.osd.mil
