WASHINGTON -- Navy medical officials have acknowledged that weaknesses in their record keeping may have allowed private insurers to avoid payment for millions of dollars of services provided at the Portsmouth Naval Medical Center and other hospitals and clinics. 
The Bureau of Medicine and Surgery said it is ``continuously refining the ways we do business'' in response to a General Accounting Office report released last week that detailed gaps in patient records at Portsmouth and two other military hospitals. 
The GAO, Congress' financial watchdog agency, said it found cases in which patients may have fraudulently assumed the identity of a deceased person in order to obtain care at a military facility. In other cases, the military hospitals did not obtain information about patients' insurance coverage or failed to bill insurers for care, the agency said. 
While the bureau of medicine said it generally ``concurs with the overall GAO report,'' the staff at the Portsmouth hospital issued a two-page rebuttal to the findings. The statement blamed one major problem identified in the report -- the possibility that some patients have lied about their military status to obtain care -- on records maintained in a militarywide database outside the hospital. 
``We do the maximum that we can to prevent misuse of the health care system, however we are the users and not the controllers of . . . the verification system,'' the hospital statement asserted. 
The statement acknowledged that a substantial number of the local hospital's outpatient visitors receive care without having had their insurance information verified. 
A new computerized check-in process should reduce the number, and the hospital says it has nearly doubled its collections from insurers -- to $17 million -- in the past three years. 
Still, ``it is doubtful that we will ever obtain all patient insurance information since many are reluctant to provide it for personal reasons,'' the statement added. 
Aides to Rep. J. Randy Forbes, R-4th District, whose district includes the Portsmouth hospital, and Ed Schrock, R-2nd District, who represents thousands of Navy personnel served there, said they'll be asking the GAO and the Navy to update them on efforts to address problems identified in the report. 
Forbes got several briefings from the GAO while the study was in the works, a spokeswoman for the congressman said, and is confident that recent changes in the hospital management will help rectify some of the problems. 
A spokesman for Rep. Janice D. Schakowsky, D-Ill., who requested the GAO study, said Schakowsky and other members of the House Government Reform Committee are considering asking for a follow-up inquiry. It would involve a complete review of record keeping at Portsmouth and the other hospitals rather than the spot checks conducted for the study released last week. 
The committee also may seek to extend the inquiry to other hospitals, the spokeswoman added. 
The Navy fired the Portsmouth hospital's comptroller and reassigned its commander, Rear Adm. Clinton E. Adams, after discovering a potential budget shortfall of $24 million earlier this year. The amount of the shortfall was reduced to around $100,000 after all receipts and expenses were finally tabulated, officials have said. 
Adams left the hospital a week ago Friday to assume his new duties as fleet surgeon for the Atlantic Fleet. 
The GAO report did not focus on the hospital's budget issues, looking instead at its tracking of prescriptions and services provided to patients, and the way in which it deals with insurers. 
The report said Portsmouth has its own form for recording insurance information. But that information was included in only 40 of the 60 inpatient billing files the agency examined. It was unclear whether the information was recorded somewhere else; Portsmouth's rebuttal statement insisted that clerks collect insurance information from everyone admitted to the hospital.