Providence Medicaid Billing and Charity Care Update

Serving those in need, regardless of ability to pay, is the very heart of who we are at Providence. We take this responsibility incredibly seriously. That’s why recent allegations suggesting otherwise have been heart-wrenching for many of us who see firsthand the amazing work our caregivers do every day for patients of all walks of life and socioeconomic status.

Late last year, Providence provided an update on our charity care practices. Since that time, we have taken several important steps to review our Medicaid-related billing practices to ensure the Mission and values of Providence are carried throughout the billing process.

Here is an overview of our actions so far:

• Refunds – As we communicated last year, we discovered on our own that some Medicaid patients had been incorrectly sent to collections. We are refunding these individuals with interest payments and working to ensure no negative impact on credit. We are also reviewing additional files to confirm we have not missed anyone and will continue to provide refunds, as needed. Additionally, we have implemented new processes to write off the balances of Medicaid accounts to prevent these individuals from being incorrectly sent to collections.  
• No aggressive collections measures – For many years, we have been clear with our third-party agencies that they are not to engage in any aggressive measures with our patients. As part of the investigation, we are validating that these agencies are consistently abiding by our policy and interacting with our patients with respect and compassion.
• Review of policies, communications and training materials – We have undertaken a systemwide review of our financial assistance policies, billing-related communications to patients, financial aid applications, and training materials for revenue cycle caregivers. The goal of this review is to ensure we are communicating to patients clearly about the availability of financial assistance and making it easy for them to apply for and access charity care. As part of this process, we are ensuring that the scripting and messages we use with patients reflect our values. In addition, we are continuously improving training for our revenue cycle caregivers.

Despite the pandemic and other external pressures — from the severe national health care labor shortage to inflation — we continue to be here day in and day out serving our communities. Though our cumulative net operating income was a negative $1.1 billion through Q3 of last year, we have continued to live up to our responsibility as a not-for-profit organization. In 2021, we increased our community benefit to $1.9 billion, which is $366 million more than pre-pandemic levels, and we expect the 2022 number to be even higher. To learn more, read our annual report to the community.  

Providence is an organization deeply driven by a call to serve others in their time of need and to do so with excellence, compassion and respect for the inherent human dignity of each individual. We are by no means perfect, but when we fall short, we address it and commit to making sure it doesn’t happen again.  

Applying for financial assistance

We encourage any patient in need of financial assistance to learn more about our charity care program by visiting https://www.providence.org/financialhelp.

Greg Hoffman
Chief Financial Officer