News & Opinion » News

County to tackle hospital billing backlog


Monroe Community Hospital has amassed $3.9 million in outstanding patient bills – debts that the county is now trying to settle by hiring an accounting firm that promises to recoup a third of what is owed.

The situation came to light when Democratic county legislators at a Ways and Means Committee meeting of the legislature questioned county and hospital officials about legislation submitted by County Executive Cheryl Dinolfo for a $120,000 contract with the Buffalo firm Freed Maxick to pursue the debt.

Officials explained the backlog grew with the hospital’s switch to a new electronic records management system during a stretch of time that included the hospital’s billing manager being on family leave.

That transition began in 2016 and ended in late 2018,county spokesman Jesse Sleezer said in a subsequent interview. He explained the hospital expected some “operational challenges” from the shift and that all of the bills were more than 180 days old and consisted of Medicaid and insurance claims.

Democratic legislator Josh Bauroth sees the growth in claims that have gone uncollected for more than six months as an oversight issue. And he places part of the blame on Dinolfo, who serves as the lone member of the hospital’s governing board.

Bauroth also noted that hospitals and other health care facilities across the region and the state have been closing or consolidating for financial reasons. Publicly-owned institutions have been among them. Monroe Community Hospital is a community asset that provides well-regarded care, and it needs to stay on top of collecting payments from insurers so it stays viable, he said.

“It’s a tougher environment,” Bauroth said. “It cannot afford this.”

The hospital does typically have a backlog of bills that are past 180 days due, Sleezer said. Its patients have complex needs and with that comes complex billing, complete with denials and requests for clarification from insurers, he said. Typically, the hospital ends the year with between $2 million and $2.5 million worth of bills that are more than 180 days overdue, Sleezer said.

The hospital contracted with a firm to analyze its billing after the new records management system was put in place and that review detected a spike in unpaid bills, Sleezer said. Dinolfo regularly meets with top hospital staff and when she learned of the results, she sought out proposals from firms to collect the claims, Sleezer said.

Hospital and administration officials said that the uncollected debts in question aren’t creating financial hardship for the hospital. They cast anything Freed Maxick would be able to recoup as extra revenue for the hospital.

Jeremy Moule is CITY’s news editor. He can be reached at