Hospital paid commission to debt agency on bills already settled

Cork University Hospital paid 10 per cent commission to a debt collection agency on invoices issued to patients attending the emergency department, even though some patients had paid their €100 charge on time.

The agency, which was given a contract without a tender and is not named, was paid over €58,000 by the hospital from January to December 2011.

An internal HSE audit also found that due to flaws in internal systems and controls, some patients with valid medical cards who attended the emergency department were sent letters threatening legal action over charges they didn’t owe.

The agency issues its first letter 21 days after the invoice. But in a sample of invoices sent to the agency in one week, five patients had paid their bills within a few days. The hospital could have avoided paying commission “if referral to the collection agency had not occurred until a later date”, the audit said.

Emergency department patients without a medical card are liable to pay €100, or €219 if they are non-EU resident.

Internal auditors found patients’ eligibility, particularly medical card status, was not always captured on the inpatient system. “Accounts raised are not vetted before dispatch to ensure they are complete or warranted,” the report said.

“As a result, invoices are issued to patients that are exempt from charges, their details are sent to a debt-collection agency, and letters indicating that possible legal action and/ or risks to the credit rating status of patients are issued by the agency to exempt patients.”