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    improvements in hospitals Where States Stand on Medicaid Expansion and Health Insurance Exchanges Learn how states are responding to Medicaid expansion and their decisions regarding the development of health insurance exchanges Developing a Better Understanding of Healthcare Costs and How to Control them View exhibits detailing estimates of the Medicare Part A Trust Fund balance before and after the Affordable Care Act was enacted as well as variations in Medicare spending for 90 day episodes of congestive heart failure The Transition to Emerging Revenue Models Planning a successful transition from fee for service to new revenue models may be the greatest impending challenge for finance executives of hospitals and health systems Tiptoeing Toward Aligned Incentives The final 2013 physician fee schedule sets in motion a long march toward aligning physician and hospital incentives in the Medicare program Fiscal Strategy in an Era of Reform Hospitals should develop strategies around four forces that will affect their financial performance in the next five to 10 years Strategies for Preventing Readmissions With penalties for preventable readmissions already in place hospitals should consider strategies to enhance quality of care protect revenue and reduce costs Tips for Preparing for a 340B Integrity Audit Learn key action steps hospitals and health systems can take to prepare for a 340B Drug Pricing Program integrity audit SCOTUS and the Voters Have Spoken Where Do We Go From Here With the future of the Affordable Care Act more certain hospitals and health systems should focus on initiatives that improve the patient experience enhance population health and reduce healthcare costs Study Recommends Ways to Protect Revenue While Reducing Surgical Complications Hospitals that reduce surgical complication rates also may reduce their revenue according to a recent study Reprocessing Claims Affected by ACA and 2010 MPFS Changes Providers may be affected by the retroactive increases in payment rates for claims affected by the Affordable Care Act and 2010 Medicare Physician Fee Schedule changes Opportunities and Risks of Participating in the CMMI Bundled Payment Program Providers applying to participate in the CMMI Bundled Payments for Care Improvement initiative need to understand the program and the opportunities and risks associated with participation What Value Based Purchasing Means to Your Hospital CMS s approach for determining whether a hospital qualifies for incentive payments under the Value Based Purchasing program is intricate but it may not produce a fully reliable comparative measure Medicare ACOs No Longer Mythical Creatures The proposed Medicare Shared Savings rule makes ACOs more tangible for providers but it also contains a few surprises Benchmarking Boon Tapping Publicly Available Data to Improve Performance Publicly available data from Medicare can help hospitals benchmark their experience against the experiences of their peers to identify unexpected variations and opportunities for improvement The Oracle Within MedPAC Congress is likely to accept several MedPAC recommendations due to the need for Medicare savings to reduce the federal deficit replace the physician SGR and increase payment for primary care Page 1 of 4 Advertisements HFMA Business Profiles McKesson Leveraging Predictive Analytics to Rein in Operating Costs A leader from McKesson discusses how healthcare reform is forcing hospitals and health systems to take a different approach to capacity management and patient flow HFMA RESOURCE LIBRARY 6 Patient Revenue Cycle Metrics You Should Be Tracking and How to Improve Your Results Patient financial engagement is more challenging than ever and more critical With patient responsibility as a percentage of revenue on the rise providers have seen their billing related costs and accounts receivable levels increase If increasing collection yield and reducing costs are a priority for your organization the metrics outlined in this presentation will provide the framework you need to understand what s working and what s not in order to guide your overall patient financial engagement initiatives and optimize results HFMA Business Profiles Accretive Health Partners with Providers to Excel in a Rapidly Transforming Revenue Cycle Environment Emad Rizk MD president and CEO of Accretive Health discusses the uncertainty facing hospitals and the transitions affecting revenue cycle management HFMA RESOURCE LIBRARY 10 Ways to Reduce Patient Statement Volume and Reduce Costs No two patients are the same Each has a very personal healthcare experience and each has distinct financial needs and preferences that have an impact on how when and if they chose to pay their healthcare bill It s no longer effective to apply static billing techniques to solve the complex challenge of collecting balances from patients The need to tailor financial conversations and payment options to individual needs and preferences is critical This presentation provides 10 recommendations that will not only help you improve payment performance through a more tailored approach but take control of rising collection costs HFMA Business Profiles Conifer Health Solutions Helping Providers and Employers Build a Foundation for Better Health Jim Bohnsack vice president solution corporate development for Conifer Health Solutions explains how the company helps healthcare providers leverage data to deliver better outcomes while optimizing reimbursement for all payment arrangements HFMA RESOURCE LIBRARY Reduce Patient Balances Sent to Collection Agencies Approaching New Problems with New Approaches This white paper written by Apex Vice President of Solutions and Services Carrie Romandine discusses the importance of patient segmentation and messaging specifically related to the patient revenue cycle Applying strategic messaging that is tailored to each patient type will not only better educate consumers on payment options specific to their billing needs but it will maximize the amount collected before sending to collections Further targeted messaging should be applied across all points of patient interaction i e point of service customer service patient statements and analyzed regularly for maximized results HFMA Business Profiles Ontario Systems Optimizing Accounts Receivable in a Rapidly Changing Environment Steve Scibetta senior director of channel sales for Ontario Systems healthcare product line shares insights into effectively managing receivables HFMA RESOURCE LIBRARY The Future of Online Patient Billing Portals This white paper written by Apex President Patrick Maurer discusses methods to increase patient adoption of online payments Providers are now seeking ways to

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    purchasers are seeking a more aggressive approach to measuring and paying for value CPR for Fee For Service Fee for service is not going to disappear overnight and we can make quick changes to our current payment system as we push for bolder deeper changes says Suzanne Delbanco PhD Case Study Becoming Accountable to Patients As AtlantiCare moves to an accountable care delivery model its leaders are clear about what needs to happen Tactics Strategy and the Battle Over Reform Tactics and strategy are both critical success factors but strategy is the key to the future A Positive ROI for Most Physician Group Practice Demonstration Participants Contrary to the picture presented in a recent NEJM article the majority of physician groups in the CMS PGP Demonstration received incentive payments and were able to cover their investment Health Plans Pay MD Practices Incentive Bonuses for Converting to Medical Homes A regional initiative has created patient centered medical homes for nearly half a million New York state residents and provides some pay for performance take aways for finance leaders Providers Speak Healthcare Reform Saint Agnes Medical Center CFO Jeff Rooney discusses the recent healthcare reform and offers tips on how hospital CFOs can better prepare for changes Road Maps for the Value Journey HFMA has been working with academic medical centers aligned integrated systems multihospital systems rural hospitals and stand alone hospitals to define unique road maps to value for each group Cap and Trade A Mechanism to Reduce Healthcare Costs A mechanism for using market forces to reduce utilization and thereby bend the overall healthcare cost curve is described Health Insurance Exchanges Bring Potential Opportunities The introduction of the state health insurance exchanges as provided for in the Affordable Care Act poses many strategic implications for healthcare providers ACOs Look Before You Leap Eight observations about the proposed ACO rule and some thoughts for providers that are considering participating in the program Reform Don t Throw Out the Baby Four worthwhile provisions of the ACA must be preserved Sharp HealthCare Gains Volumes via Employer s Tiered Network Sharp HealthCare has formed a preferred provider value based purchasing arrangement with a major employer and payer forming San Diego County s first tiered HMO network Providers Speak Healthcare Reform and Financial Models Gregory E Scarbrough VP Finance CFO Oconee Memorial Hospital shares his insights on how the recent healthcare reform will change not only the way hospital CFOs conduct business but also the health care models that drive the industry NGHS Reform Readiness Assessment a Wake Up Call A strategic assessment process helped Northeast Georgia Health System sharpen its strategic and financial priorities Understanding the Dollars Tied to Readmissions UMMMC s Approach A detailed financial analysis has helped UMass Memorial Medical Center UMMMC determine how to make up for revenue lost from reducing readmissions Page 1 of 17 Advertisements HFMA Business Profiles McKesson Leveraging Predictive Analytics to Rein in Operating Costs A leader from McKesson discusses how healthcare reform is forcing hospitals and health systems to take a different approach to capacity management and patient flow HFMA RESOURCE LIBRARY 6 Patient Revenue Cycle Metrics You Should Be Tracking and How to Improve Your Results Patient financial engagement is more challenging than ever and more critical With patient responsibility as a percentage of revenue on the rise providers have seen their billing related costs and accounts receivable levels increase If increasing collection yield and reducing costs are a priority for your organization the metrics outlined in this presentation will provide the framework you need to understand what s working and what s not in order to guide your overall patient financial engagement initiatives and optimize results HFMA Business Profiles Accretive Health Partners with Providers to Excel in a Rapidly Transforming Revenue Cycle Environment Emad Rizk MD president and CEO of Accretive Health discusses the uncertainty facing hospitals and the transitions affecting revenue cycle management HFMA RESOURCE LIBRARY 10 Ways to Reduce Patient Statement Volume and Reduce Costs No two patients are the same Each has a very personal healthcare experience and each has distinct financial needs and preferences that have an impact on how when and if they chose to pay their healthcare bill It s no longer effective to apply static billing techniques to solve the complex challenge of collecting balances from patients The need to tailor financial conversations and payment options to individual needs and preferences is critical This presentation provides 10 recommendations that will not only help you improve payment performance through a more tailored approach but take control of rising collection costs HFMA Business Profiles Conifer Health Solutions Helping Providers and Employers Build a Foundation for Better Health Jim Bohnsack vice president solution corporate development for Conifer Health Solutions explains how the company helps healthcare providers leverage data to deliver better outcomes while optimizing reimbursement for all payment arrangements HFMA RESOURCE LIBRARY Reduce Patient Balances Sent to Collection Agencies Approaching New Problems with New Approaches This white paper written by Apex Vice President of Solutions and Services Carrie Romandine discusses the importance of patient segmentation and messaging specifically related to the patient revenue cycle Applying strategic messaging that is tailored to each patient type will not only better educate consumers on payment options specific to their billing needs but it will maximize the amount collected before sending to collections Further targeted messaging should be applied across all points of patient interaction i e point of service customer service patient statements and analyzed regularly for maximized results HFMA Business Profiles Ontario Systems Optimizing Accounts Receivable in a Rapidly Changing Environment Steve Scibetta senior director of channel sales for Ontario Systems healthcare product line shares insights into effectively managing receivables HFMA RESOURCE LIBRARY The Future of Online Patient Billing Portals This white paper written by Apex President Patrick Maurer discusses methods to increase patient adoption of online payments Providers are now seeking ways to incrementally collect more payments due from patients as well as speeding up the rate of collections This white

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    couple of years as a way to gain more leverage during the contract negotiation process says Managing Payer Audits Hospital administrators are not the only ones who think conducting regular audits of managed care payments is a good idea Managed care payers think so as well More on Contract Auditing How to Audit Managed Care Contracts Ask our Expert Managing Risks Under Performance Based Contracts Three critical components help minimize bias in performance based payment contracts accurate coding appropriate risk adjustment and relevant benchmarking Six Target Markets for ACO Type Partnerships As finance leaders consider whether to apply to the Medicare Shared Savings Program they should evaluate the application of accountable care principles to six other markets for value based contracting Ask the Expert How Far Can Plans Make Patients Travel Can a health plan make a patient travel outside a particular service area say 40 miles away to receive care from an exclusively contracted provider P4P Contracting Tips from a Seasoned Negotiator Rush Health s president and CEO shares lessons learned from years of negotiating incentive based contracts with payers and employers Payer Provider Parity Beyond Just Being Fair When a small payer consolidates with a large one contracting hospitals could see revenues from those two payers now one decrease by as much as 10 percent Ask the Expert Calculating Weighted Averages in Favored Nation Clauses Calculating weighted averages in favored nation clauses Cleveland Clinic and Lowe s Arrange Bundled Price for Heart Surgery Cleveland Clinic partners with employer Lowe s in medical tourism arrangement Lowe s is paying a bundled price to the hospital for all cardiac services provided to its employees Ask the Expert PMPM Payments for Case Management PMPM payments for case management Ask the Expert Adjusting and Automating Self Pay Accounts Adjusting and automoating self pay accounts Effective Negotiation Preparation to Maximize Rate Increases How can healthcare finance leaders push for rate increases from private insurers that are in line with hospital consumer price index increases and how can healthcare finance leaders tell their hospital s value story Tips for Preparing for a 340B Integrity Audit Learn key action steps hospitals and health systems can take to prepare for a 340B Drug Pricing Program integrity audit Face to Face Office Visits Average Reimbursement by State The average reimbursement for face to face visits varies across states for both commercial and government payers Washington s Post Election Crunch Providers should prepare for anticipated Medicare and Medicaid cuts by developing the core capabilities required to improve quality and reduce cost Performance Improvement in the Perioperative System Healthcare finance leaders have an important role to play in guiding clinical and financial improvements in hospitals SCOTUS and the Voters Have Spoken Where Do We Go From Here With the future of the Affordable Care Act more certain hospitals and health systems should focus on initiatives that improve the patient experience enhance population health and reduce healthcare costs Developing a Better Understanding of Healthcare Costs and How to Control them View exhibits detailing estimates of the Medicare Part A Trust Fund balance before and after the Affordable Care Act was enacted as well as variations in Medicare spending for 90 day episodes of congestive heart failure Page 1 of 7 Advertisements HFMA Business Profiles McKesson Leveraging Predictive Analytics to Rein in Operating Costs A leader from McKesson discusses how healthcare reform is forcing hospitals and health systems to take a different approach to capacity management and patient flow HFMA RESOURCE LIBRARY 6 Patient Revenue Cycle Metrics You Should Be Tracking and How to Improve Your Results Patient financial engagement is more challenging than ever and more critical With patient responsibility as a percentage of revenue on the rise providers have seen their billing related costs and accounts receivable levels increase If increasing collection yield and reducing costs are a priority for your organization the metrics outlined in this presentation will provide the framework you need to understand what s working and what s not in order to guide your overall patient financial engagement initiatives and optimize results HFMA Business Profiles Accretive Health Partners with Providers to Excel in a Rapidly Transforming Revenue Cycle Environment Emad Rizk MD president and CEO of Accretive Health discusses the uncertainty facing hospitals and the transitions affecting revenue cycle management HFMA RESOURCE LIBRARY 10 Ways to Reduce Patient Statement Volume and Reduce Costs No two patients are the same Each has a very personal healthcare experience and each has distinct financial needs and preferences that have an impact on how when and if they chose to pay their healthcare bill It s no longer effective to apply static billing techniques to solve the complex challenge of collecting balances from patients The need to tailor financial conversations and payment options to individual needs and preferences is critical This presentation provides 10 recommendations that will not only help you improve payment performance through a more tailored approach but take control of rising collection costs HFMA Business Profiles Conifer Health Solutions Helping Providers and Employers Build a Foundation for Better Health Jim Bohnsack vice president solution corporate development for Conifer Health Solutions explains how the company helps healthcare providers leverage data to deliver better outcomes while optimizing reimbursement for all payment arrangements HFMA RESOURCE LIBRARY Reduce Patient Balances Sent to Collection Agencies Approaching New Problems with New Approaches This white paper written by Apex Vice President of Solutions and Services Carrie Romandine discusses the importance of patient segmentation and messaging specifically related to the patient revenue cycle Applying strategic messaging that is tailored to each patient type will not only better educate consumers on payment options specific to their billing needs but it will maximize the amount collected before sending to collections Further targeted messaging should be applied across all points of patient interaction i e point of service customer service patient statements and analyzed regularly for maximized results HFMA Business Profiles Ontario Systems Optimizing Accounts Receivable in a Rapidly Changing Environment Steve Scibetta senior director of channel

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    an important role to play in guiding clinical and financial improvements in hospitals Tips for Preparing for a 340B Integrity Audit Learn key action steps hospitals and health systems can take to prepare for a 340B Drug Pricing Program integrity audit Medicaid Expansions Will They or Won t They It is not yet known how many states will participate in the expanded Medicaid program but initial estimates indicated that as many as half of the newly insured will come from Medicaid expansions Washington s Post Election Crunch Providers should prepare for anticipated Medicare and Medicaid cuts by developing the core capabilities required to improve quality and reduce cost Tool Job Description Clinical Reimbursement Analyst Adapt this medical reimbursement analyst job description for your organization Collections and Revenues by Region This article provides metrics for payer and reimbursement collections and revenues for U S hospitals by geographic region Delivering Value to Multiple Stakeholders 2013 and Beyond Four strategies can help payers and providers give their customers more value for the dollar as health reforms emerge over the next few years Another Form of Medicaid Fraud Attorneys who handle private adoptions are taking advantage of hospitals parents and the Medicaid program say Loyd Welbern A Primer on Medicaid Managed Care A brief overview on Medicaid MCOs along with links to additional Medicaid resources Montefiore s Take on Successful Risk Based Contracts for Population Management An ACO like integrated delivery system Montefiore is a perfect testing ground for risk based contracts and population health management NICU Maximizes Revenue by Navigating Complex Medicaid Payment Requirements By ensuring that services were properly documented and billed at the appropriate level of care a safety net hospital avoided having to shut down its NICU State Positions on Expansion of Medicaid In the wake of the Supreme Court s health reform decision whether to expand Medicaid programs has become a difficult and contentious issue in many states Ask the Expert Accepting Cash from Medicaid Patients Can Medicaid patients choose to pay cash instead of charging Medicaid Preparing for Increased Churn in 2014 A dramatic increase in Medicaid churn is expected to occur when the health insurance exchanges launch causing revenue cycle logjams MetroHealth Seeks Medicaid Waiver to Improve Safety Net Reduce Charity Rolls The Ohio Medicaid waiver is unique in that a health system is spearheading the initiative Straddling the Payment Gap Covering the Cost of Doing the Right Thing for Patients Children s Hospital Boston has used grants and its own dollars to cover the cost of a childhood asthma program while pushing for Medicaid bundled payment funding CenterLight PACE Approach Is Keeping Elderly at Home Reducing Costs CenterLight created a model that helps senior patients receive coordinated care in their homes at a cost to the state that is tens of thousands of dollars a year less per patient than residence in a nursing home Page 1 of 3 Advertisements HFMA Business Profiles McKesson Leveraging Predictive Analytics to Rein in Operating Costs A leader from McKesson discusses how healthcare reform is forcing hospitals and health systems to take a different approach to capacity management and patient flow HFMA RESOURCE LIBRARY 6 Patient Revenue Cycle Metrics You Should Be Tracking and How to Improve Your Results Patient financial engagement is more challenging than ever and more critical With patient responsibility as a percentage of revenue on the rise providers have seen their billing related costs and accounts receivable levels increase If increasing collection yield and reducing costs are a priority for your organization the metrics outlined in this presentation will provide the framework you need to understand what s working and what s not in order to guide your overall patient financial engagement initiatives and optimize results HFMA Business Profiles Accretive Health Partners with Providers to Excel in a Rapidly Transforming Revenue Cycle Environment Emad Rizk MD president and CEO of Accretive Health discusses the uncertainty facing hospitals and the transitions affecting revenue cycle management HFMA RESOURCE LIBRARY 10 Ways to Reduce Patient Statement Volume and Reduce Costs No two patients are the same Each has a very personal healthcare experience and each has distinct financial needs and preferences that have an impact on how when and if they chose to pay their healthcare bill It s no longer effective to apply static billing techniques to solve the complex challenge of collecting balances from patients The need to tailor financial conversations and payment options to individual needs and preferences is critical This presentation provides 10 recommendations that will not only help you improve payment performance through a more tailored approach but take control of rising collection costs HFMA Business Profiles Conifer Health Solutions Helping Providers and Employers Build a Foundation for Better Health Jim Bohnsack vice president solution corporate development for Conifer Health Solutions explains how the company helps healthcare providers leverage data to deliver better outcomes while optimizing reimbursement for all payment arrangements HFMA RESOURCE LIBRARY Reduce Patient Balances Sent to Collection Agencies Approaching New Problems with New Approaches This white paper written by Apex Vice President of Solutions and Services Carrie Romandine discusses the importance of patient segmentation and messaging specifically related to the patient revenue cycle Applying strategic messaging that is tailored to each patient type will not only better educate consumers on payment options specific to their billing needs but it will maximize the amount collected before sending to collections Further targeted messaging should be applied across all points of patient interaction i e point of service customer service patient statements and analyzed regularly for maximized results HFMA Business Profiles Ontario Systems Optimizing Accounts Receivable in a Rapidly Changing Environment Steve Scibetta senior director of channel sales for Ontario Systems healthcare product line shares insights into effectively managing receivables HFMA RESOURCE LIBRARY The Future of Online Patient Billing Portals This white paper written by Apex President Patrick Maurer discusses methods to increase patient adoption of online payments Providers are now seeking ways to incrementally collect more payments due from patients as well as

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    titled Clarification HFMA s Comment Letter to CMS on Hospital Value Based Purchasing HFMA submitted comments to the Centers for Medicare Medicaid Services CMS on the weighting of the HCAHPS domain within the CMS Hospital Value Based Purchasing Program Performance Improvement in the Perioperative System Healthcare finance leaders have an important role to play in guiding clinical and financial improvements in hospitals Washington s Post Election Crunch Providers should prepare for anticipated Medicare and Medicaid cuts by developing the core capabilities required to improve quality and reduce cost CY13 OPPS Final Rule Fact Sheet This fact sheet provides information on the updates to Medicare payment rates for hospital outpatient services paid under the outpatient prospective payment system and the ambulatory surgical center payment system for calendar year 2013 Tips for Preparing for a 340B Integrity Audit Learn key action steps hospitals and health systems can take to prepare for a 340B Drug Pricing Program integrity audit Collections and Revenues by Region This article provides metrics for payer and reimbursement collections and revenues for U S hospitals by geographic region Ask the Expert Billing for LMSW Services in the ED How should we bill for mental health evaluations in our ED by an employed licensed master social worker Delivering Value to Multiple Stakeholders 2013 and Beyond Four strategies can help payers and providers give their customers more value for the dollar as health reforms emerge over the next few years Ask the Expert IME Payments and Terminated Residency Programs When do Medicare indirect medical education IME payments end for terminated residency programs Reporting Medicare Contract Labor The Devil Is in the Details Reporting Medicare Contract Labor The Devil Is in the Details The key difference between reporting regular staff labor and contract labor as part of the Medicare wage mix according to Julia DiFrancesco is that Ask the Expert Medicare Payment for Home Health Medicare does not distinguish payment by hospital based or stand alone home health agencies Ask the Expert When Physicians Terminate Medicare Part B Contracts When physicians terminate Medicare Part B contracts ACE Process Flow Example This document outlines the process data claims and payment flows for Baptist Health System s participation n the ACE demonstration Ask the Experts Answer Medicare Crossovers to Medicaid Bad Debt If Medicaid contractualizes all or some of the amount deemed as coinsurance by Medicare can the contractual amount be claimed as part of the bad debt on the cost report Or are we only able to claim the amount that Medicaid notes as being the copay or deductible on the cost report Ask the Expert Recording Meaningful Use Payments HFMA s Principles Practices Board is is working on publishing guidance on the recording of meaningful use payments ACOs Look Before You Leap Eight observations about the proposed ACO rule and some thoughts for providers that are considering participating in the program Ask the Expert Medical School and Residency Reimbursement Q Is there a specific CMS reimbursement program for medical school practice plans and residency programs Page 1 of 12 Advertisements HFMA Business Profiles McKesson Leveraging Predictive Analytics to Rein in Operating Costs A leader from McKesson discusses how healthcare reform is forcing hospitals and health systems to take a different approach to capacity management and patient flow HFMA RESOURCE LIBRARY 6 Patient Revenue Cycle Metrics You Should Be Tracking and How to Improve Your Results Patient financial engagement is more challenging than ever and more critical With patient responsibility as a percentage of revenue on the rise providers have seen their billing related costs and accounts receivable levels increase If increasing collection yield and reducing costs are a priority for your organization the metrics outlined in this presentation will provide the framework you need to understand what s working and what s not in order to guide your overall patient financial engagement initiatives and optimize results HFMA Business Profiles Accretive Health Partners with Providers to Excel in a Rapidly Transforming Revenue Cycle Environment Emad Rizk MD president and CEO of Accretive Health discusses the uncertainty facing hospitals and the transitions affecting revenue cycle management HFMA RESOURCE LIBRARY 10 Ways to Reduce Patient Statement Volume and Reduce Costs No two patients are the same Each has a very personal healthcare experience and each has distinct financial needs and preferences that have an impact on how when and if they chose to pay their healthcare bill It s no longer effective to apply static billing techniques to solve the complex challenge of collecting balances from patients The need to tailor financial conversations and payment options to individual needs and preferences is critical This presentation provides 10 recommendations that will not only help you improve payment performance through a more tailored approach but take control of rising collection costs HFMA Business Profiles Conifer Health Solutions Helping Providers and Employers Build a Foundation for Better Health Jim Bohnsack vice president solution corporate development for Conifer Health Solutions explains how the company helps healthcare providers leverage data to deliver better outcomes while optimizing reimbursement for all payment arrangements HFMA RESOURCE LIBRARY Reduce Patient Balances Sent to Collection Agencies Approaching New Problems with New Approaches This white paper written by Apex Vice President of Solutions and Services Carrie Romandine discusses the importance of patient segmentation and messaging specifically related to the patient revenue cycle Applying strategic messaging that is tailored to each patient type will not only better educate consumers on payment options specific to their billing needs but it will maximize the amount collected before sending to collections Further targeted messaging should be applied across all points of patient interaction i e point of service customer service patient statements and analyzed regularly for maximized results HFMA Business Profiles Ontario Systems Optimizing Accounts Receivable in a Rapidly Changing Environment Steve Scibetta senior director of channel sales for Ontario Systems healthcare product line shares insights into effectively managing receivables HFMA RESOURCE LIBRARY The Future of Online Patient Billing Portals This white paper written by Apex President Patrick Maurer discusses

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    discussion about transparency How to Reconcile Physician and Practice Management Visit Tallies When physician and practice management visit tallies differ four simple steps and tools can help solve the problem and ensure that practice sites stay on top of charge capture Finding the Right Balance From the President The private sector seems to be leading the way in reforms aimed at promoting coordinated care but it s still a somewhat bumpy road for providers From Medical Home to ACO A Physician Group s Journey The Medical Clinic of North Texas launched a population health initiative in 2010 that has involved working with self insured companies to manage the health of their employee populations Common Issues with SGR Reform Proposals Several pieces of legislation seek to permanently repeal the sustainable growth rate SGR provision a formulaic approach intended to restrain the growth of Medicare spending on physician services Changing Times Call for New Business Models Adding to internal expertise partnering with staffing technology or business intelligence providers or using a combination of these or outsourcing the function entirely will better equip a physician organization to survive within the new reality of rising costs and declining revenue Tiptoeing Toward Aligned Incentives The final 2013 physician fee schedule sets in motion a long march toward aligning physician and hospital incentives in the Medicare program HFMA Comment Letter Second Draft of Sustainable Growth Rate Repeal Reform Proposal Read HFMA s comments to the chairs of the House of Representatives Ways and Means and Energy and Commerce Committees and their respective Health Subcommittees on their drafted framework for legislation to replace the SGR HFMA Comment Letter Second Draft of SGR Repeal and Reform Proposal April 10 2013 The Honorable Fred Upton Chairman Committee on Energy and Commerce 2125 Rayburn House Office Building Washington DC 20515 The Honorable Dave Camp Chairman Committee on Ways and Means 1102 Longworth HOB Washington DC 20515 The Honorable Joe Pitts Chairman Subcommittee on Health Committee on Energy and C Post Election Outlook for Providers A Resource Constrained Environment It matters little who wins the White House or controls Congress after the 2012 election healthcare providers will still face many of the same challenges they are facing today The Physician Value Modifier Pay for Performance is Coming to the Physician Fee Schedule Hospitals should start thinking about how physician value based purchasing will influence physician alignment strategies and utilization of acute care services The Sustainable Growth Rate The Elephant in the Room of Deficit Reduction Ten years of congressional overrides to the SGR have contributed to higher Medicare spending on physician services and have left the federal government with a significant budget deficit exposure The History of the SGR and Efforts to Reform It Since the sustainable growth rate provision was implemented with Balanced Budget Act of 1997 the Congress has made several unsuccessful attempts to reform it Board s Eye View The Government Calls It Bundled Payment Will It Translate into Less Payment for Providers This brief article highlights the bundled payment program and is perfect for time contrained board members Choosing the Right Physician Practices A tool for carefully evaluating the strategic alignment and financial impact of a physician practice can be used to prioritize acquisitions and determine their value Page 1 of 4 Advertisements HFMA Business Profiles McKesson Leveraging Predictive Analytics to Rein in Operating Costs A leader from McKesson discusses how healthcare reform is forcing hospitals and health systems to take a different approach to capacity management and patient flow HFMA RESOURCE LIBRARY 6 Patient Revenue Cycle Metrics You Should Be Tracking and How to Improve Your Results Patient financial engagement is more challenging than ever and more critical With patient responsibility as a percentage of revenue on the rise providers have seen their billing related costs and accounts receivable levels increase If increasing collection yield and reducing costs are a priority for your organization the metrics outlined in this presentation will provide the framework you need to understand what s working and what s not in order to guide your overall patient financial engagement initiatives and optimize results HFMA Business Profiles Accretive Health Partners with Providers to Excel in a Rapidly Transforming Revenue Cycle Environment Emad Rizk MD president and CEO of Accretive Health discusses the uncertainty facing hospitals and the transitions affecting revenue cycle management HFMA RESOURCE LIBRARY 10 Ways to Reduce Patient Statement Volume and Reduce Costs No two patients are the same Each has a very personal healthcare experience and each has distinct financial needs and preferences that have an impact on how when and if they chose to pay their healthcare bill It s no longer effective to apply static billing techniques to solve the complex challenge of collecting balances from patients The need to tailor financial conversations and payment options to individual needs and preferences is critical This presentation provides 10 recommendations that will not only help you improve payment performance through a more tailored approach but take control of rising collection costs HFMA Business Profiles Conifer Health Solutions Helping Providers and Employers Build a Foundation for Better Health Jim Bohnsack vice president solution corporate development for Conifer Health Solutions explains how the company helps healthcare providers leverage data to deliver better outcomes while optimizing reimbursement for all payment arrangements HFMA RESOURCE LIBRARY Reduce Patient Balances Sent to Collection Agencies Approaching New Problems with New Approaches This white paper written by Apex Vice President of Solutions and Services Carrie Romandine discusses the importance of patient segmentation and messaging specifically related to the patient revenue cycle Applying strategic messaging that is tailored to each patient type will not only better educate consumers on payment options specific to their billing needs but it will maximize the amount collected before sending to collections Further targeted messaging should be applied across all points of patient interaction i e point of service customer service patient statements and analyzed regularly for maximized results HFMA Business Profiles Ontario Systems Optimizing Accounts Receivable in a Rapidly Changing Environment Steve

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    patients that the estimated prices do not include physicians fees for the patient s surgeon anesthesiologist or radiologist and that those fees will be billed separately To help the patient access pricing information for these services the website provides contact information for the medical groups that Spectrum Health uses to provide anesthesiology pathology and EKG interpretation services Priority Health Spectrum Health s health plan Priority Health has developed a price transparency tool for its members to support three goals Engage customers in their healthcare decisions Promote accountability among providers Address the fundamental issue of healthcare costs Priority Health contracted with Healthcare Bluebook a company with expertise in developing transparency tools for self funded employers to develop the transparency tool for its members The tool focuses on approximately 200 discretionary and thus shoppable services Approximately 50 percent of Priority Health members require one or more of these services in a given year and these services together represent approximately 20 percent of Priority Health s total medical spend The transparency tool focuses on variations in contracted rates at the facility level As shown in these screen shots color coded lists of healthcare facilities that offer the desired service use green to indicate those that are at or below a fair price yellow to indicate those that are slightly above fair price and red to indicate those that are among the most expensive The list also identifies facilities that will not disclose prices and advises members to contact them directly for pricing information As of December 2013 47 percent of healthcare facilities in the Priority Health network had agreed to have their prices disclosed Priority s goal is to increase this to 75 percent by 2015 The tool was initially offered exclusively to members when it went live in August 2013 As of January 2014 Priority Health is also offering access to providers so they can consult more knowledgeably with patients who need a referral to facilities that will offer the desired level of value in terms of quality patient experience and price Priority Health will continue to improve the price transparency experience for members by Personalizing information for members with cost estimators and benefit summaries Linking the Healthcare Bluebook tool to doctor search tools and patient education Adding to the discretionary shoppable procedures included in the tool Maricopa Integrated Health System In early 2013 Maricopa Integrated Health System of Phoenix a safety net system became the first healthcare system in Arizona to publish self pay prices on its website for the state s 10 most frequent inpatient and outpatient procedures says Mary Lee DeCoster vice president of revenue cycle at Maricopa and a member of HFMA s Price Transparency Task Force To determine the self pay prices Maricopa established its own task force that included Decoster as well as the system s chief medical officer COO vice president of finance vice president of ambulatory services key department chairs and physicians from the system s employed medical group During a period of four months the task force developed a sliding scale with payment categories based on the federal poverty level As of Jan 1 2014 Arizona requires hospitals ambulatory surgery centers laboratories diagnostic imaging centers and urgent care centers to post the direct pay price of the 50 most frequent inpatient procedures based on diagnosis related group or DRG and the 50 most frequent outpatient procedures based on Current Procedural Terminology or CPT code on their websites This example of a Copa Care price estimate shows the price a self pay patient would pay for a breast biopsy Maricopa is also making prices for some services more transparent by offering a single bundled payment for an episode of care The system offers a low cost bundled maternity package that includes the obstetrician s fees as well as the first pediatric visit Patients also receive a discount of approximately 1 000 if they prepay As a result the hospital is delivering 50 to 60 more babies each month In 2014 Maricopa plans to build more bundled packages for elective procedures including some reconstructive surgeries Maine HealthCost The Maine HealthCost website is maintained by the Maine Health Data Organization an independent executive agency established by the Maine legislature in 1996 to collect clinical and financial health care information and to exercise responsible stewardship in making this information accessible to the public The site is one of only two state mandated transparency websites nationwide that received a grade of B from Price Transparency Task Force members Catalyst for Payment Reform and Health Care Incentives Improvement Institute in their 2014 Report Card on State Transparency Laws The other state receiving a B grade the highest grade awarded in the 2014 report was Massachusetts The site is recommended in part because it provides data on actual paid amounts for a variety of procedures and services The Cost Compare function on the site allows comparison of average prices for procedures at different facilities in the state The site s resources page also provides links to cost calculators that health plans offer for their subscribers in Maine Price Transparency Task Force The American Hospital Association fully supports the recommendations of the HFMA Price Transparency Task Force The AHA has long supported the need to provide patients with healthcare price and quality information and has worked with stakeholders including HFMA to provide useful information that will help patients make healthcare decisions We believe that it will take everyone providers insurers employers and government working together to provide patients with the information they need Hospitals are committed to improving how consumers get information on the amount they will be expected to pay for care This includes helping patients understand their hospital bills by finding better ways to explain them in user friendly terms Providing understandable and useful information about the price of hospital care is one of the ways America s hospitals are working to improve the health of their communities Rich Umbdenstock President and CEO American Hospital Association Ensuring consumers have the support and information they need to maximize the value of their healthcare dollars has been a longstanding priority for health plans These recommendations build on health plans innovative tools that empower consumers in their decision making Increased transparency also shines a spotlight on the need for all stakeholders to address the underlying drivers of healthcare costs Karen Ignagni President and CEO America s Health Insurance Plans Transparency in price information is a reflection of our commitment to respect the dignity of the persons we serve Patients and their families deserve complete information about their care and price information is an important component of what they need to make decisions about that care Sister Carol Keehan DC President and CEO Catholic Health Association of the United States The American College of Physician Executives representing more than 11 000 high level physician leaders in all types of healthcare organizations across the U S and 46 countries is pleased to offer its support for the policy recommendations included in this important new study on price transparency The implementation of reform including the Affordable Care Act shined a bright light on this increasingly difficult issue and the time for change is now As patients assume greater responsibility for their healthcare needs the demand for accurate reliable information will continue to grow The healthcare industry has an obligation to all citizens the insured and the uninsured to make the procurement of care as simple and accessible as possible To continue along the current path would risk creating prolonged and greater mistrust of the medical community as a whole As an organization dedicated to the lifelong development and support of physician leaders ACPE is all too aware of the challenges involved in creating greater price transparency We believe the recommendations included in this report are an important first step toward meaningful reform ACPE stands ready to assist in any way necessary as you move forward Peter Angood MD MD FRCS C FACS MCCM President and CEO ACPE Mark Werner MD CPE FACPE Chairman ACPE Board of Directors Engaging patients in their healthcare decisions is a top priority for physicians MGMA is pleased to be part of the Price Transparency Task Force and join with key stakeholders to determine ways that patients can better access price information to help guide healthcare decisions Readily available price and quality information is crucial to helping patients make informed choices about their care Susan L Turney MD MS FACP FACMPE President and CEO Medical Group Management Association As the U S healthcare industry continues to evolve into a more open and transparent care system it has been rewarding to represent a major teaching safety net health system in the recent work related to pricing transparency The HFMA Price Transparency Task Force has included representation from health systems hospitals insurance plans and the consumer in its work to develop guidelines for all constituents affected by healthcare pricing The discussions were thoughtful and energetic the final product establishes the initial baselines to create transparency I endorse the findings and recommendations in this report Mary Lee DeCoster Vice President Revenue Cycle Maricopa Integrated Health System Most Americans agree healthcare pricing is opaque HFMA has provided a great service by convening diverse organizational stakeholders who comprised the task force that developed this report It establishes a common language and puts forth sensible principles both necessary to achieve price transparency This HFMA report is likely to become a must have resource for anyone mounting an effort to establish clear healthcare pricing Mark Rukavina Community Health Advisors LLC The ability for consumers whether insured or not to have easy access to meaningful information about the price of healthcare services and the total expected price of medical episodes or events has become a national priority for good reasons The share of medical expenses paid by individual consumers is at an all time high and projected to increase Consumers should be able to know the price of any service or product purchased before becoming liable to pay the bill The HFMA has taken a bold and important step to lay out the fundamental principles that all industry stakeholders should abide by to get consumers the pricing information they need and deserve HCI3 was privileged to be a part of the team that developed this report and supports its conclusions and calls to action François de Brantes Executive Director Health Care Incentives Improvement Institute Price transparency is important to all of us as healthcare consumers and in our roles as providers or payers of care It has been a pleasure to work with HFMA s Price Transparency Task Force in developing practical solutions for improving price transparency By following these recommendations we can help demystify consumers financial responsibility for their care and equip them to make better informed healthcare decisions Robert Galvin MD Chief Executive Officer Equity Healthcare Operating Partner The Blackstone Group Wisconsin PricePoint Maintained by a wholly owned subsidiary of the Wisconsin Hospital Association the Wisconsin PricePoint system enables patients to do web based wipricepoint org searches by facility for inpatient outpatient surgery emergency and urgent care and other hospital outpatient services Information varies by category but typically provides average and median charges for the provider a comparison of that provider s charges with the charges of other providers at the county and state level and information on the provider s volume for the selected service Patients can also run comparisons between providers At the time of this report a total of 11 states including Wisconsin use the PricePoint system UnitedHealthcare s Price Transparency Tool United s myHealthcare Cost Estimator myHCE launched in 2012 consists of an online and mobile calculator that allows customers to compare the prices of in network hospitals and physicians across approximately 300 Care Paths or treatment episodes The estimates are generated at the Care Path or treatment episode level to help members understand the services they should expect to receive and include the estimated costs of the services that typically make up a treatment episode such as surgeries lab tests radiology tests and office visits Using the member s specific plan design and benefits including any deductible and account balances that may apply the myHealthcare Cost Estimator generates personalized estimates of a member s out of pocket expenses based on the current fee schedule or contracted rates the plan has negotiated with in network providers For services where a fee schedule or contracted rate is not available estimates are based on historical claim averages Participating Organizations This contains a listing of the healthcare organizations that participated in the development of HFMA s Price Transparency initiative Improving Price Transparency An Overview of the Report from the HFMA Price Transparency Task Force Many Americans who are concerned about the cost of health care and want to be better healthcare consumers are also frustrated by the lack of ready access to information on healthcare prices Price Transparency in Health Care Highlights from the Task Force Report Convened by HFMA a task force made up of health plans providers consumers employer groups physician groups and others has released guiding principles and recommendations for improving price transparency in health care Geisinger s MyEstimate Geisinger s MyEstimate product provides patients with a self serve portal for out of pocket estimates on nearly 300 services generally the most frequently used ambulatory diagnostic services Geisinger out of pocket estimates incorporate both employed physician and hospital expenses Patients enter their insurance information and estimates are tailored to their verified benefit coverage and location of the service requested hospital based vs physician office or freestanding ambulatory setting This product answers the consumer s question What will the encounter cost me The portal receives more than 850 hits every month Because the prospective patient s insurance coverage is verified in advance the estimate takes into consideration negotiated insurer rates rather than gross charges The application provides additional information such as pre authorization or primary care physician referral requirements The self serve portal provides insurance verification and out of pocket options for Geisinger s largest contracted payers by volume and Medicare fee for service This example of an estimate for an echocardiogram shows the financial information that a patient would receive through the self serve portal Insert screen shots here For unlisted payers or services such as an out of pocket estimate for heart valve replacement surgery the online portal provides contact options for financial counselor assistance Patients may connect with a financial counselor by creating an on line request by calling or by visiting a local service location Uninsured individuals are connected with a financial counselor to pursue funding options such as state program enrollment interest free payment plans or uncompensated care discounts Financial counselors conduct about 1 000 pricing interviews per month Geisinger financial counselors are CMS Certified Application Counselors CACs tasked with assisting consumers with creating healthcare marketplace accounts and evaluating options to purchase health insurance coverage As of Jan 1 2014 CACs provide presumptive eligibility in Pennsylvania s Medical Assistance program Geisinger s Financial Counselors Certified Application Counselors and MyEstimate comprise its Patient Advocacy program Future enhancements planned for 2014 to the geisinger org portal will provide open access to average Medicare reimbursement rates for selected services i e inpatient and ambulatory surgical ambulatory diagnostic services etc Patients and or prospective consumers will be able to calculate their own out of pocket estimates based upon their unique service and insurance coverage When there is no patient responsibility established for the service in question possibly for Medicare and Medicaid that will be noted There will be links to MyEstimate on every navigation screen for patients who wish to have more exact estimates Geisinger provides a link to the quality report s for quality measures reported by The Joint Commission the Pennsylvania Health Care Cost Containment Council Pennsylvania Healthcare Alliance and Geisinger Health Plan HEDIS Quality reports For example the patient who received the out of pocket estimate for heart valve replacement surgery could access quality information from the Pennsylvania Health Care Cost Containment Council through the Geisinger quality portal This page also provides a link to Hospital Compare reporting which takes the consumer to the Medicare gov site Patients who perform this quality report search would now have both financial and comparative quality information Aetna s Price Transparency Tool In 2010 Aetna introduced its Member Payment Estimator an online tool that enables members to estimate their actual costs based on their plan design their specific medical conditions and the providers they choose Examples of Price Transparency Tools A number of health plans provider organizations state hospital associations and other groups have already developed transparency tools CALL TO ACTION 5 Ways to Develop a Path to Pricing Transparency A pricing system should be simple to administer and communicate should help patients take charge of healthcare purchasing decisions and should gain consumers trust as they seek to compare prices Page 1 of 4 Advertisements HFMA Business Profiles McKesson Leveraging Predictive Analytics to Rein in Operating Costs A leader from McKesson discusses how healthcare reform is forcing hospitals and health systems to take a different approach to capacity management and patient flow HFMA RESOURCE LIBRARY 6 Patient Revenue Cycle Metrics You Should Be Tracking and How to Improve Your Results Patient financial engagement is more challenging than ever and more critical With patient responsibility as a percentage of revenue on the rise providers have seen their billing related costs and accounts receivable levels increase If increasing collection yield and reducing costs are a priority for your organization the metrics outlined in this presentation will provide the framework you need to understand what s working and what s not in order to guide your overall patient financial engagement initiatives and optimize results HFMA Business Profiles Accretive Health Partners with Providers to Excel in a Rapidly Transforming Revenue Cycle Environment Emad Rizk MD president and CEO of Accretive Health discusses the uncertainty facing hospitals and the transitions affecting revenue cycle management HFMA RESOURCE LIBRARY 10 Ways

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    Tips for Preparing for a 340B Integrity Audit Learn key action steps hospitals and health systems can take to prepare for a 340B Drug Pricing Program integrity audit Performance Improvement in the Perioperative System Healthcare finance leaders have an important role to play in guiding clinical and financial improvements in hospitals Fiscal Strategy in an Era of Reform Hospitals should develop strategies around four forces that will affect their financial performance in the next five to 10 years SCOTUS and the Voters Have Spoken Where Do We Go From Here With the future of the Affordable Care Act more certain hospitals and health systems should focus on initiatives that improve the patient experience enhance population health and reduce healthcare costs The Value Journey Phase 2 research from HFMA s Value Project defines road maps to value driven health care for different organization types Ask the Expert Patient Price Estimation Advice for revenue cycle leaders on HFMA and online resources for determining patient price estimation Washington s Post Election Crunch Providers should prepare for anticipated Medicare and Medicaid cuts by developing the core capabilities required to improve quality and reduce cost Delivering Value to Multiple Stakeholders 2013 and Beyond Four strategies can help payers and providers give their customers more value for the dollar as health reforms emerge over the next few years ACO Comparison Table Proposed vs Final Rule This table from CMS outlines the differences between the Proposed Rule and the Final Rule for Accountable Care Organizations in the Medicare Shared Savings Program Value in Health Care Current State and Future Directions The first report from HFMA s Value Project defines value in health care provides an overview of the current state of value in the healthcare industry and maps out future directions for value oriented providers Comparison Shopping for Health Services Is Getting Easier Insurers state governments and vendors are introducing online tools and other services that allow patients to easily compare costs of hospitals and physicians Lessons Learned from Price Transparency Pioneers Both Alegent Health and Spectrum Health began posting pricing and cost information five years ago Hawaii Launches First Ever Statewide VBP Program with Private Payer Evidence that value based purchasing VBP is fast taking hold beyond Medicare demonstration projects Getting OIG s Blessing for a Physician Alignment Strategy Backed by an OIG Advisory Opinion Borgess Medical Center created a limited liability company that allows referring physicians to receive a portion of P4P incentives HFMA s Value Project Web Tool Access strategic and tactics to build the skills that support value driving capabilities HFMA Comments on the CMS Hospital Inpatient Value Based Purchasing Program HFMA commented on its specific concerns with CMS s proposed rule on the hospital inpatient value based purchasing program The proposed rule is associated with the Affordable Care Act Average Cost per Discharge by Payer 2008 The average cost per discharge was 9 100 for all payers in 2008 Medicare discharges had the highest average cost per hospital stay 11 300 Page 1 of 3 Advertisements HFMA Business Profiles McKesson Leveraging Predictive Analytics to Rein in Operating Costs A leader from McKesson discusses how healthcare reform is forcing hospitals and health systems to take a different approach to capacity management and patient flow HFMA RESOURCE LIBRARY 6 Patient Revenue Cycle Metrics You Should Be Tracking and How to Improve Your Results Patient financial engagement is more challenging than ever and more critical With patient responsibility as a percentage of revenue on the rise providers have seen their billing related costs and accounts receivable levels increase If increasing collection yield and reducing costs are a priority for your organization the metrics outlined in this presentation will provide the framework you need to understand what s working and what s not in order to guide your overall patient financial engagement initiatives and optimize results HFMA Business Profiles Accretive Health Partners with Providers to Excel in a Rapidly Transforming Revenue Cycle Environment Emad Rizk MD president and CEO of Accretive Health discusses the uncertainty facing hospitals and the transitions affecting revenue cycle management HFMA RESOURCE LIBRARY 10 Ways to Reduce Patient Statement Volume and Reduce Costs No two patients are the same Each has a very personal healthcare experience and each has distinct financial needs and preferences that have an impact on how when and if they chose to pay their healthcare bill It s no longer effective to apply static billing techniques to solve the complex challenge of collecting balances from patients The need to tailor financial conversations and payment options to individual needs and preferences is critical This presentation provides 10 recommendations that will not only help you improve payment performance through a more tailored approach but take control of rising collection costs HFMA Business Profiles Conifer Health Solutions Helping Providers and Employers Build a Foundation for Better Health Jim Bohnsack vice president solution corporate development for Conifer Health Solutions explains how the company helps healthcare providers leverage data to deliver better outcomes while optimizing reimbursement for all payment arrangements HFMA RESOURCE LIBRARY Reduce Patient Balances Sent to Collection Agencies Approaching New Problems with New Approaches This white paper written by Apex Vice President of Solutions and Services Carrie Romandine discusses the importance of patient segmentation and messaging specifically related to the patient revenue cycle Applying strategic messaging that is tailored to each patient type will not only better educate consumers on payment options specific to their billing needs but it will maximize the amount collected before sending to collections Further targeted messaging should be applied across all points of patient interaction i e point of service customer service patient statements and analyzed regularly for maximized results HFMA Business Profiles Ontario Systems Optimizing Accounts Receivable in a Rapidly Changing Environment Steve Scibetta senior director of channel sales for Ontario Systems healthcare product line shares insights into effectively managing receivables HFMA RESOURCE LIBRARY The Future of Online Patient Billing Portals This white paper written by Apex President Patrick Maurer discusses methods to increase patient

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