Introduction:

With the expansion of our in-patient activities and growing receivables, it has become expedient to implement a credit control guideline to ensure that the hospital gets paid by its clients for services rendered to them.

Purpose:

The purpose of this guideline is to provide guidance for credit administration for the Loveworld Medical Centre.

Scope:

The processes stipulated here-in are binding on ALL staff members and must be upheld absolutely. Failure to abide by the provisions of this guideline could result in punitive measures.

Limitation:

This guideline currently covers only cash-paying clients. As the hospital’s operations grow to include HMOs and Companies, a guideline would be designed to cater to the peculiarity of that segment.

Minimum Deposits:

This section clearly defines the minimum acceptable deposits required from patients for admission into any of the wards of the hospital, including emergency services (Deposits would be required from patients’ relatives for emergency services). The deposits are prescribed based on the nature of the accommodation to be enjoyed by patients, which in part is determined by the severity of the illness and the patient’s taste and preferences.

The minimum acceptable deposits are as follows:

• ER and Emergency Care – N150,000 (Note: Life threatening emergencies requiring rescusitation/stabilization will be covered by the section on credit Limit below).
• General wards – N250,000
• Semi-Private Wards – N350,000
• Private Wards (Without Surgery) – N500,000
• Private Wards (With Surgery) – N500,000 + Estimated cost of surgery
• SCBU and HDU (Without ventilator) – N1,000,000
• SCBU and HDU (With ventilator) – N1,600,000
• ICU and NICU (Without ventilator) – N2,000,000
• ICU and NICU (With ventilator) – N3,000,000
• Executive wards (Without Surgery) – N1,500,000
• Executive wards (With Surgery) – N1,500,000 + Estimated cost of surgery.

The billing officers are responsible for ensuring that the above rates are to be implemented for all inpatient cases as defined. Only the COO has the authority to approve the admission of a patient who has not met these deposit requirements.

Ward Rounds

The Accounts Receivable Officer is responsible for daily ward rounds. This involves generating a list of all active admissions and following up with them (if they are healthy enough to have such conversations) or their relations for additional deposits to be made to their accounts. This is to ensure that the customer maintains a credit account balance for their stay in the hospital.

Credit Limit:

This section defines the credit limits for cash-paying clients.

• Outpatients – NO. All services MUST be paid for before they are enjoyed by the patient.
• Emergency Care – NO. This is a short-term arrangement, and all patients are required to make a deposit. Upon stabilization and subsequent discharge (or transfer to a ward), every outstanding bill MUST be settled. If the patient is unable to cover their bill, they should be stabilized and referred to a facility within their budget after paying for any bill incurred for their stabilization.

• In-Patient Wards: Equivalent of 1 day’s expenses for patients on admission for 2 weeks or less and the equivalent of 2 days’ expenses for patients on admission for longer than 2 weeks. Although a credit limit exists for this category of patients (for our own internal knowledge), the receivables officer is to contact the patient (or their relative) for additional payments once their credit balance has reduced to the point of only being able to cover two day’s average fixed expenses (room rate and professional charges). Once this limit is exceeded, the patient’s care will be suspended until further payments are made. If it is deemed that the patient can no longer afford to continue treatment here, they will be referred to a facility within their budget after fully settling any outstanding.

Other Factors to Consider:

Limit Exceeded – Patient Unable to Continue Footing the Bills – If a patient has exceeded their limits but is unable to make further payments, treatment to such a patient will be suspended and the patient will be referred to a more affordable facility to continue care. All outstanding bills must be settled, or an undertaking form duly signed, and guaranteed before the patient is transferred.

Limit Exceeded – Patient Unwilling to Settle Outstanding Bills – In such an event, the receivable officer will work with the patient care manager to resolve all the patient’s grievances promptly while having a conversation with the patient on the need to settle their accounts.

If conversations break down and no payment has been made, treatment will be suspended and the patient will be referred to another facility.

Such a patient will also be blacklisted from the facility for some time (as determined by the COO) and their details submitted to the CRC credit bureau as debtors to the company. The services of a debt recovery firm may also be enlisted to recover the debt (depending on how much it is).

A Doctor or Staff Member Rendering Service Outside the EMR – Any member of staff found to be rendering services to patients outside the EMR to circumvent these guidelines will be subject to punitive measures up to the level of termination of appointment or as may be decided by management.

Discounts:

The hospital provides certain discounts to various patient segments (LMC and PCD staff, other members of the staff community, and church brethren) on specific services (refer to the discount policy 1). No other discount is available, except as is specified in discount policy 2).

NO STAFF is permitted to discuss discounts with patients or make any assurances about the existence of such except expressly approved by the COO in writing.

Discharge of Patients with Outstanding Balances: Upon discharge, all patients are to settle their outstanding with the hospital.

If a patient is discharged and unable to fully settle their bill, they are required to fill out an undertaking form, which MUST be guaranteed by a reputable individual. This form serves as their covenant with the hospital to settle all outstanding within a reasonable time (not exceeding 60 days from the date of discharge).

If a patient fails to uphold their commitment to settle the outstanding within the stipulated time, the hospital’s receivables team will adopt any means necessary to recover the amount being owed to the hospital.