Using a computer called “Blue Balls” to track whether ED patients seeking care paid their bills

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I could not make this up if I tried regarding hardball tactics to collect money when patients are at their most vulnerable.

From Bloomberg News:

Accretive Says It’s Working to Address Minnesota Concern

By Dan Hart and Alex Wayne - Apr 29, 2012
Accretive Health Inc. (AH), a hospitalbillings-collection company, said it’s working with advisers toaddress concerns raised by the Minnesota attorney general’soffice that it puts bedside pressure on patients to pay bills.

The claims “grossly distort and mischaracterize” itsrevenue cycle services, the company said today in a statement.The suggestion Accretive puts bedside pressure on patients topay their bills out of pocket are a “flagrant distortion offact,” the company said.

... Accretive shares tumbled by the most ever on April 25, justafter Minnesota Attorney General Lori Swanson issued a reportalleging Accretive violated U.S. and state patient-privacy anddebt-collection laws. She said patients at Fairview HealthServices, a Minnesota hospital chain, were pressured for paymentbefore they received care in some cases and that Accretive’sdebt collectors didn’t properly disclose their role. Swansonfiled a lawsuit on Jan. 19 against Accretive.

Chicago-based Accretive said in today’s statement itdoesn’t deny access to patient care and the allegation is“flatly untrue.”

There appears to be something to the allegations, though...

 Credit Scores

[Minnesota Attorney General ] Swanson said last week employees at Fairview, a nonprofitchain of seven hospitals based in Minneapolis, were required touse a computer system derisively called “Blue Balls” to trackwhether patients paid their bills. The payment system beganafter Fairview hired Accretive in May 2010, Swanson said in herreport describing the companies’ relationship.

Actions that Accretive used at Fairview included issuingemergency room employees “scripts” for conversations withpatients that “can lead a patient or her family to believe thepatient will not receive treatment until payment is made,”Swanson said.

Employees were instructed to ask for credit card payments,tell patients they’d wait for them to retrieve their checkbooksfrom their cars, or if the patients said they couldn’t pay,remind them that debt-collection activities “can affect yourcredit score,” according to the scripts.

Considering the setting, that sounds like a technique more suited for a movie about mid-30's Chicago then a 21st century hospital.  It seems a not so subtle form of strong-arming someone when they're down.

Accretive said late on April 27 that Fairview had canceledits contract with them, adding it didn’t know yet how thecancellation would affect its business. Accretive said it wouldprovide an update on its May 9 quarterly financial call.

Earlier that same day, Representative Pete Stark, aCalifornia Democrat, asked U.S. health officials to investigateAccretive’s practices.

Federal law prohibits hospitals from denying emergency careto anyone, regardless of their ability to pay.

While no statement is made in this article about care denial, Federal law should prohibit strong-arm tactics and psyops at a time when patients are most vulnerable.  The unpleasantness and added stress are certainly not good for outcomes in the vulnerable.

I note a site has appeared related to this issue, at this link:  http://www.mn-healthcare.com/links

-- SS