Implementing a new system for managing patients and billing is one way a former Orangeburg County administrator is working for quality care as chief executive officer of the state's largest community health center.

Donnie L. Hilliard, who most recently served as Santee town administrator, is the new CEO of the Family Health Centers Inc. He was named interim CEO on March 5 following the resignation of Dr. Arthur Kennedy, who is running for president of his native Ghana.

Hilliard says he hopes to promote the center's mission to provide health care services not just to the uninsured and underinsured, but to all.

"We are a health care center ... for all. We have a wonderful health education program here, especially in the diabetes collaborative area. I've been .... getting prepared for a review of our health education component, which, I think, is second to none," Hilliard said.

"I want our patients to be aware of that because I would like to increase the numbers that we're serving. That's a service that's free, and we're not getting as many patients as I think we'd like to have, especially where we can teach them how to prepare themselves for living with diabetes," he said.

A plan to revamp the center's overall billing and patient-management processes has also been implemented.

"We are 30 days into our new patient-management and billing system. Training is going on right now as we speak, the second component of making sure all of the various codes are properly assigned," Hilliard said.

"Encounter forms are now automatic and electronically submitted by the doctors. So, we should eliminate a lot of the errors of the past because once the doctors finish keying in all of their diagnoses, it goes straight to the system. An invoice is created online from there. The biggest problem now is if we could just get HHS (U.S. Department of Health and Human Services) to send us the money back. But they take a while," he said.

Hilliard comes on board as the FHC has experienced inancial challenges. It announced in November a deficit of approximately $250,000. Hilliard said the exact figures are still not known.

"I would like not to use the word deficit because I don't think we have a deficit. What we have is a cash-flow problem. We just finished our audit, and we end up in the red about $72,000. The problem that we were having was no one was really monitoring and making sure that the flow of revenue was done to keep in line with our expected expenditures," said Hilliard, who is working to match them up.

"That's one of the main things that I'll be doing, recognizing that we have a delay in reimbursements from Medicaid and Medicare. Private pay is another area that we have to do a little bit of work on. ... We've got to file with those insurance companies. I don't know whether the industry ... takes 30 or 60 days to pay, but those are cycles that we have to deal with," he said.

The center's continued search for revenue led to a disagreement with the Regional Medical Center. An agreement remains illusive. The center withdrew most of its doctors from the hospital in November after the RMC board refused its request for a payment of $500,000, plus $300,000 in future years.

The RMC board instead agreed to provide FHC with $200,000 over a six- to seven-month period, leading the center to stop serving most of its patients admitted to the hospital. The only services FHC physicians now provide at the hospital are obstetrical and gynecological.

"Currently, the status hasn't changed," FHC Board Chairman Henry Jenkins said. "We are still in hopes of re-establishing a relationship with the hospital. I have spoken with the chair of the board of the hospital; however, we have not made a formal offer to the board of the hospital ... But, it's my intent to re-establish a long-term, ongoing relationship with the hospital."

Of the issue, RMC President Tom Dandridge said, "It just hasn't resurfaced again. We haven't talked to them anymore about that, but I've talked with Donnie plenty about things we can do together to provide extensive pediatric coverage."

"We have two pediatric hospitalists, and the office is covered by another physician. We are talking to Mr. Hilliard about providing some pediatric call coverage here, but it's not related to that original request that they had," said Dandridge, noting that adult patients are largely being cared for by the hospitalist program.

Hilliard said there are other strategic implementations he is eyeing beyond crunching numbers.

"We will be doing a very aggressive patient recruiting campaign this coming fall. Something that I want to look aggressively in trying to create is an emergency room diversion program, where we will provide services to assist the hospital and emergency room and divert those patients to our facility. We could save the hospital money and, at the same time, provide those patient services.

"A lot of times, a person who's in the emergency room doesn't really need emergency room-type services. That's something that I'm going to pursue. I'm going to make a recommendation to the board and then approach the hospital with that," Hilliard said. He said the FHC provides valuable services, including adult medicine, pediatrics and OB/GYN, with the help of seven satellite sites and one school-based site.

"We have pediatrics here and at Laurel Street. We don't have pediatric services at all the other satellite sites, but we can make it available if that person needs it. We now have pediatric services in Denmark on Mondays," Hilliard said.

The FHC has also entered into a new initiative to provide services at Voorhees College in Denmark and is under a contract to conduct negotiations with Denmark Technical College, he said.

"We presently occupy the new Center of Excellence facilities at the Voorhees campus," Hilliard said.

He said general operations at FHC will not change much in trying to improve patient flow and enhance appointment processes.

"There will be some adjusting. There's shifting and reassigning of some functions and some employees. It will be done in the best interest of the organization and based upon the recommendation that I will make to the board and the board's approval," he said.

T&D Staff Writer Dionne Gleaton can be reached by e-mail at dgleaton@timesanddemocrat.com or by phone at 803-533-5534. Discuss this and other stories online at TheTandD.com.

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