Medical school plans audit of troubled billing procedure

Following pressure from the state Board of Regents, the University of Nevada School of Medicine will begin an internal audit this month of its billing department.

The school's "practice plan," through which faculty physicians bill patients, will be examined over the next two to three months. The school is currently $615,000 in debt.

An external audit by an independent accounting firm will follow, said Dr. David Schapira, senior associate dean in Las Vegas.

The dean said the university decided to do an internal audit first because some outside independent firms tend to look more closely at medical practices rather than educational criteria.

Medical Associates, 2040 W. Charleston Blvd., is the billing department that runs the practice plan. Schapira said physicians bring in between $22 to $24 million a year. Of this sum, a minimum of 75 percent goes to staff and faculty salaries.

Medical Associates, though associated with the medical school, is set up as a separate corporation. Its board consists of chairs from six medical school departments and three faculty members: Schapira, Dr. Stanley Shane in Reno and Dean Robert Daugherty.

At a recent Board of Regents meeting, it was strongly urged that a regent be installed on the practice-plan board and that yearly audits be done.

"I have continually asked for a financial examination of the practice plan," Regent Mark Alden said. "The regents don't have proper oversight over the practice plan. Dean Daugherty mirrors most deans. They are very controlling. You are dealing with a dean that runs everything inclusive."

Alden said all he has seen were summaries regarding the school's practice plan.

Schapira sees the medical school's debt as being caused by human error in operating sophisticated computer billing systems. Collections went from 47 percent to 27 percent due to this error, he said.

"It's a cash-flow problem," Schapira said, adding that cash-flow was the same problem he encountered at Louisiana State University where he was associate dean for clinical affairs.

"This is an important challenge," Schapira said, "but well within our grasp. These are problems we see. We just need to collect the payments we deserve."

Just last month, Schapira said the medical school had $9 million in accounts receivable.

archive