By John Rhodes

Guest Columnist

A recent Triangle Business Journal article ("UNC Hospitals paying $9M in bonuses," Sept. 22, 2009) addresses a subject that might be hard for top UNC administrators to swallow. Do bonuses for purportedly meeting benchmarks result in better efficiency within public institutions such as UNC Hospitals?

Problems with billing at UNC Hospitals and UNC Physicians and Associates are legend and long-standing. My recent experience is nothing new.

On May 8, I made a partial payment to a balance due UNC Physicians and Associates, hereafter referred to as "P A." By the end of the month I received a notice from the same. It read, "As of the date of this letter, we have not received payment on your account. In order to avoid further collections activity, please choose one of the options below."

I took P A's letter, which was undated, and wrote on it that I had already made a payment on May 8 and that their notice was incorrect.

I then made a copy of this annotated letter for my records, referencing the date of my notes, June 4, and sent back the original to them with a second payment, asking them to retain my statement for their files.

On June 7 I received notice from NCO Financial Systems, Inc., the collection agency retained by UNC Physicians and Associates to "collect the debt."

I called NCO and pointed out that I already had made two payments and, for this reason, did not understand why they were contacting me. John, the representative assigned to my case, said he would check with UNC.

I followed up later that month and found UNC Physicians and Associates still claimed they had not received any payments from me. The next day, June 30, I faxed John copies of two credit card statements to prove my case. He agreed that I had verified my claim but did not have an explanation for why P A would say otherwise. He took my credit card statements, faxed them to P A and asked for a reply.

It's now going on at least three months since I substantiated I'd been making payments on my account, five months since my first payment was made, and UNC P A has not, from what I know, communicated anything more to the collection agency. I've asked the agency representative whether I should continue to make payments. They've advised that since my case is now in dispute, I am not to make any payments until otherwise instructed.

Some may think it dire to keep the leadership they've got ("UNC leaders get hefty raises," N O, Sept. 8, 2008), but how can the team of William Roper, chief executive officer of the UNC Health Care System, be meeting benchmarks if it keeps shooting itself in the foot?

How can Roper justify rewarding $9 million to hospital employees as part of a long-term plan to "incentivize employees by offering compensation for meeting certain benchmarks," which include "increasing patient and employee satisfaction," when representatives of UNC Hospitals fail to communicate with the collection agency retained to collect money from patients who, regardless of the amount, are actively making payments toward their accounts?

Efficiency? What sort of business sense instructs a paying "customer" (Roper's word for patient) to stop making payments altogether?

The business side of UNC P A isn't the only entity within the UNC Health Care System with benchmark problems.

The system on the "Hospital" side of billing and collections is so antiquated that, for some time, each bill I received for two separate visits (two accounts merged into one) was incorrect.

This, after my calling UNC each month to correct the error, which was always in the hospital's favor. I wonder how much money UNC Hospital collects that it is not due -- including payments from sick and elderly who cannot keep track of billing errors -- as a result of these inadequacies?

Isn't it a little strange that a university with the national ranking of UNC doesn't have the technical manpower to design software so that a single patient's multiple accounts can, at a customer's request, be integrated into one account without the patient having to remind billing to do a "recall from history" the following month (remind billing to make sure all past payments from both accounts are reflected in the revised total)?

The high professional skill of UNC Hospitals' physicians and staff is well known. And some managers with reduced staff are working efficiently to help the public they serve. It's a shame that all administrative functions cannot come close in quality.

One would think Roper is paid enough for the billing experience at his hospital to go as smoothly as the service he says he receives from L.L. Bean.

Is this compensation for "efficiency" or bloated administrative status quo?

John Rhodes is a writer who lives in Efland