Billing issue

I have to write this, in case I need a reminder on how effective I am at what I do; on what value I have in this organization that doesn't seem to value what I do, or if it does, it doesn't know how to show it. Most importantly, this is a reminder to myself that I am not inferior to anyone, especially Freddy.

Billing problem
Billing has always been a problem at the hospital. I believe that the problem grew worse as the hospital itself grew in size. For the past few years, a patient can end up waiting for at most three hours to get discharged. This, despite computerization and networking systems within the hospital.

Of course, not all the problems can be traced to the billing staff; patients have their share of the blame as well. The most common problems are:

1. lack of documents required by HMOs;
2. late posting of charges from the ancillary services, such as the lab;
3. lack of sufficient funds to pay the bill; and
4. failure to contact the doctor for a determination or confirmation of his fees.

All these contribute to the delay in finalizing the patient's statement of account.

Problem analyzed
when I met with the Billing section, I was prepared for a long, tiring session of problem analysis. I was suprised to find that the problem had long been identified and studied. It had never been resolved due to:

1. lack of clear policies and guidelines; and
2. whatever policy or guideline that was in place was violated at will by top management itself, especially my boss, the administrator, who'd do anything just to avoid a confrontation.

The overall impression, therefore, is that top management does not support the full implementation of policies and guidelines on the matter.

In this light, who in his right mind would go out of his way to follow the rules when he very well knows that his boss will not, and cannot, stand up for him?

Problem doctors
Among the causes of the delay, the one involving doctors is the most sensitive. Most doctors (and I qualify this with the strongest optimism that I can muster) suffer from a god-complex. Pretty much like lawyers. And most people (again, with a concession that surprises even me) allow doctors to behave accordingly. Situate this against a deeply feudal background and you have -- the Dark Ages.

After listening to the billing personnel's heartaches and travails against doctors, I proposed a solution: If top management appointed one particular person to back the strict implementation of the rules, would the staff go along with it?

They did not give me an unequivocal answer, but it was enough for me. After all, these people are not going to suddenly trust top management to do the right thing overnight.

Freddy as liaison
At that time, I had Freddy's political future (in the hospital, that is) in mind. My objective was, and still is, to get the Board to realize that Freddy was a viable candidate for CEO in the future. Actually, it is to get my boss to realize it. Tough? Only time will tell.

I broached the problem to Freddy. We discussed the issue and he agreed to take on the responsibility. During the Board meeting following, I presented the problem with a proposed solution. Freddy got appointed, of course. He is now the special liaison of the Board to the medical staff insofar as billing is concerned. But it's a simple matter of extending that to other issues as well. Nice.

Freddy and I met with the Billing people and drafted a policy which Freddy presented to the Board. This was unanimously approved.

I prepared a set of implementing rules and regulations to accompany the policy; Freddy presented both to the medical staff last Monday during the group's regular meeting. No objections were raised. On the contrary, it was met very favorably. Not surprising, as the new policy and procedure answered two things:

1. collection of the doctors' fees is now undertaken by the hospital; and
2. the collection and remittance of taxes on the fees are done by the hospital as well.

Under this setup, the doctor no longer has to worry about collecting his fees from the patient and the BIR, to boot. Over all, the hospital maintains its reputation as a doctor-friendly hospital.

On Monday, we dry-run the new procedure. Barring any major glitches, the policy takes effect on the first day of the new year.

Analysis
What are the accomplishments?

First, the hospital's meeting its obligation as a collecting agent for the BIR is assured; secondly, Billing personnel are safeguarded against abuse from doctors who persist in living in the Dark Ages; thirdly, my boss is relieved of the unsavory task of dealing with such doctors, as Freddy takes over as the liaison.

And I did it all. I got all these things to happen. Me.

I saw the pieces on the board and moved them. They weren't even mine. Hell, I wasn't even in the game! But I moved them.

In two months, I did all these.

Of course, I wouldn't have made it without Freddy. He is, after all, the key to all these. And we still have to show that the process works. But Freddy has no doubts that it will. Living in the Dark Ages sometimes has its advantages.

Still, it gives me great satisfaction that the whole thing would not have happened were it not for me.

Why am I writing this? Because right now, I feel very lost. I don't belong anywhere and I'm feeling the need to move on.

I'm looking for a way out.