It’s crunch time at YKHC clinics. School is getting ready to start. Children, accompanied by their parents, are waiting for their free vaccinations. Two older children are racing around the waiting room, playing games to kill time until they can go in to be tested—without charge to their families—for their physical exams as part of a school sport requirement. An older man watches as his wife gets her daily free blood pressure check; his turn comes next.
Very few community members who come to the clinic pay full price for the care they receive. I’ve just returned home to Bethel from the Lower 48 where the ability to walk in and receive any care prior to making a determination regarding an ability to pay does not exist. Just a week after arriving, I was seen in one of the clinics and received my medication all in the same day for a $30 co-pay. How can YKHC afford to serve all these people? The answer is through third party payments—private insurance reimbursements, Medicare/Medicaid, Denali Kidcare, etc. YKHC couldn’t survive without them.
The almost universal requirement among third party payers is that the people who actually provide the services—those who are doing the counseling, administering medications, running groups, etc.—be licensed or certified in their fields. This is especially true for healthcare services due to the complexities of the service being provided—the procedure, medication, diagnosis of condition, treatment and, oh yes, let’s not forget travel.
There are many advantages to increasing the organization’s financial well-being:
- Our mission, to have the ability to maintain the highest level of quality healthcare,
- Continuous quality and improvement of services that are specific at addressing our region’s health needs,
- Establishing and maintaining good communications with third party payers and gaining approved provider status that allow us to maintain healthier communities.
Recently, I learned that one of our senior patient accounts representatives, Rebecca Nelson, has recovered more than $4 million in dental third party revenue for years 2009, 2010, and 2011. I think that is a great accomplishment, but she refers to it as “just doing her job.” However, it’s her passion that creates an environment to do her job and do it well for the benefit of the people we all serve. Ms. Nelson is truly a YKHC Champion.