POLAND – The chief of the Fire and Rescue Department has put into place a new record-keeping system and town officials are considering a full audit of past medical billing records.

Problems with missing records recently surfaced when a patient’s attorney asked for billing information, confirmed Board of Selectmen Chairman Glenn Peterson. The request has been satisfied, but town officials are working toward getting all past records in order, Peterson said.

Town officials have discussed the problem during executive sessions over the past two months. Peterson said the board is sensitive to the personnel and potential legal issues involved and cannot discuss the matter in open session.

However, Selectman Wendy Sanborn said that Poland residents need to know about the billing problem.

“If the chief hadn’t brought it to our attention, we probably wouldn’t have found out about it,” said Sanborn. “I ran on accountability. My reaction is that it’s costing the taxpayers money for experts to look into records.”

One of the first major changes Chief Willie Rice instituted was hiring an outside billing service for emergency responses. Selectmen voted in May to approve a contract with Medical Reimbursement Services of Windham.

Since then, Rice has required all copies of response forms, billing information, bills issued and receipt statements to be kept in paper form in one location and in electronic form in another location. Rice has also insisted that more than one person is trained to handle and retrieve records.

“There was no one here that knew anything about the previous billing system,” said Rice, who took over as chief of the newly combined fire and rescue departments last winter. “The initial problem was that I just couldn’t find the information when I was asked for it. I just simply needed to satisfy a request that was made to my department.”

The private attorney’s request exposed a previous lack of checks and balances as to how records were kept and how collections were handled, Selectman Sanborn said.

“I want to see a full-fledged audit for Fire and Rescue and for the Town Office,” she said. “That’s different than a cursory audit. We need to start with square one so that the citizens from the town will know that everything is out in the open. I’m not going to be complicit in keeping town secrets.”

The Windham company, which contracts with 28 different Maine towns, took over emergency medical billing in August, said Shawn McPherson, vice president of the company.

In addition, the billing company sends all patients, regardless of insurance status, a bill based on services provided by the local emergency responder. Prior to the contract, Poland traditionally did not bill patients without insurance. However, in order to receive reimbursements from agencies such as Medicare, all patients have to be billed equally and fairly, said McPherson.

While Medical Reimbursement Services also serves as the collection point for payment, it is not a collection agency with authority to pursue payment, McPherson said.

About 75 to 80 percent of bills are paid or partially paid, he said. About 60 percent are paid in cash. Chief Rice said that Medical Reimbursement keeps 8 percent of collections as its fee for service and that the rest of the money goes directly from the billing company to the town’s general fund.

“We never get the money. We never see it,” Rice said. “We don’t want any public perception of any wrongdoing. The reason I asked for an outside billing company in the first place is that I had some ethical issues about how things were done.”

Board Chairman Peterson confirmed that the town has contacted the former employee who handled billing and asked for information. The employee has provided two computer disks, but gaps still exist in the billing records. Peterson added that more information is continuing to turn up.

“We don’t know what we don’t know yet,” said Peterson. “There has been a sign of cooperation. The attorney got what he had asked for. Now we just need to make sure that we have a complete record.”

State law requires agencies to keep records for seven years. Medical Reimbursement Services keeps records in paper form until the contracting town requests them to be returned, McPherson said. The 1996 Health Insurance Portability and Accountability Act requires all records to be kept confidential and in a secured location, said McPherson.

Peterson said that the board is considering hiring a professional forensic auditor to match up information from old computer programs, disks and paper records. He said that the board had not yet discussed the costs of conducting a forensic audit.


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