Valley News – Dozens of Dartmouth Health employees are moving to a Texas-based billing company.


LEBANON — About 50 Dartmouth Health employees in Lebanon will begin at the end of next month when Texas-based Confer Health Solutions will handle DH’s billing and collections.

The move, scheduled to take effect Oct. 23, will bring DH Lebanon’s location in line with other locations in the health system, with Confer staff serving as front desk staff to provide patient registration services.

“Managing our enrollment process under one system allows us to improve our patient experience by providing a consistent experience across all Dartmouth Health locations,” DHS spokeswoman Audra Burns said in an emailed statement.

In addition to DHMC, DH includes four other hospitals, a nursing organization and several clinics in Vermont and New Hampshire.

Conifer has worked with DH since 2015. He will now be “responsible for overall ambulatory services and enrollment services provided through radiology on the Lebanon campus,” Burns said.

About 50 frontline workers affected by the change received a letter on September 14 informing them of the transition. According to the letter, employees will be eligible to receive a $1,000 transition bonus, which will be paid in full for the first time after their first six months of employment with Confer. Employment eligibility is based on “satisfactory completion of Confer’s pre-employment screening process.”

An email request for comment to the media contact listed on Confer’s website was not returned by deadline.

Confer has a page on its website thanking DH for a recent award from the Healthcare Financial Management Association, an industry group. In June, DH was one of 27 recipients of the MAP Award, which “recognizes providers who have excelled in meeting industry-standard revenue cycle metrics (…), implemented patient-centered recommendations and best practices (…), and their efforts to improve price transparency through improved patient care.” We are satisfied,” said the HFMA news release announcing the award winners.

HFMA President and CEO Joseph J. “High-performance revenue cycles design business processes around the needs of the user,” Pfeiffer said in a news release. Congratulations to all 2022 MAP Award winners for putting consumers first.

Confer, on its website, celebrates DH achieving 101.9% of its fundraising goal in its five-year partnership with Confer.

The website explains that DH’s business objectives are to increase the efficiency of the revenue cycle and to add new members to the DH system. Specifically, DH seeks to improve fundraising, patient satisfaction, and financial support for uninsured patients, and seeks support from new partners in integrating Epic, DH’s shared electronic medical record.

DH has chosen Conifer to take over the revenue cycle and operational management of the so-called “single business office” for the entire health system, including physicians, outpatient surgery centers and imaging centers.

In a June 2019 news release announcing a new “revenue cycle management agreement” with DH affiliate Alice Peck Day Memorial Hospital in Lebanon, then-DH CFO Dan Janzen credited Confer for “consistently delivering on key performance metrics.”

“Their expertise will help D-HH (DHH formerly known as Dartmouth-Hitchcock Health) maintain a solid financial foundation to realize our vision for a sustainable health system serving New England for generations to come,” Jantzen said in a 2019 release. “As D-HH and APD work to connect people in New Hampshire and Vermont to the rich, integrated care community they expect, we trust Conifer to deliver the high-quality patient financial experience they deserve.”

A 2019 APD release says it is the second DH member hospital to adopt Conifer for “comprehensive” revenue cycle management services, following Cheshire Medical Center in Keene, which engaged Conifer in 2017.

“The impact of our work spans improved margins, reduced costs and more efficient operations,” Confer President and CEO Stephen M. Mooney said in a 2019 release. “As part of the community, we are committed to bringing the highest quality of care to patients and their families whenever and wherever they receive care.”

But some DHS employees are concerned about Confer’s growing role. An Instagram page run by a nurse at Dartmouth Hitchcock Medical Center in Lebanon showed a bride and groom kissing. The bride is named “Confer” and the groom is named “DH”, the woman in the front with a confused face on the camera is named “main table staff”.

The second image on the page includes the text above, “DHIV decides to buy out all registered workers, forcing them to sign new employment contracts or quit.” Below this article is a picture of former President Donald Trump saying, “This is the worst trade deal in the history of trade deals, maybe ever.”

Additionally, some patients struggled with DHI and Confer’s billing practices. May story by Kaiser Health News A 59-year-old Sunapee resident was billed $2,185 for a second colonoscopy at New London Hospital. Her first, six years ago, cost her $0, as required under the Affordable Care Act’s preventive services provisions. The Centers for Medicare and Medicaid Services says polyps removed during a diagnostic colonoscopy, as Melville did, are considered part of the procedure and should not affect a patient’s cost-sharing obligations.

But it was only after KHN contacted DH and Conifer about Melville’s account that Conifer told Melville that her account was being reworked. Melville’s insurer, Cigna, told KHN that Melville would not be responsible for any out-of-pocket expenses.

According to the story, Melville’s situation shows that patients should check with their insurance company before a colonoscopy to find out what costs to expect. Doctors and hospitals are expected to give good consideration to patients before the procedure. And patients must read the paperwork they must sign beforehand.

Melville told KHN that the burden on patients is unfair: “I still feel it’s completely unreasonable for anyone who’s scheduled for a colonoscopy to go through these choices, ask questions and say ‘thank you.'”

Nora Doyle-Burr can be reached at ndoyleburr@vnews.com or 603-727-3213.





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