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  • About the Patient Financial Communications Best Practices
    Secretary of Health and Human Services Donna Shalala Gov Michael Leavitt and attorney Jamie Gorelick HFMA has established a recognition program that organizations can use to demonstrate that they have adopted these common sense practices Learn more about the recognition program BACK TO PAGINATION Clear communication between healthcare professionals and patients is more important than ever Complicated payment structures dozens of different payers many forms various government programs all lead to confusion in patient financial communications Plus patients are increasingly paying more of their healthcare costs out of their own pockets These common sense best practices bring consistency clarity and transparency to patient financial communications The practices outline steps to help patients understand the cost of services they receive their insurance coverage and their individual responsibility View the best practices The best practices were developed by a steering committee of experts across many fields including representatives of patients hospitals physicians and others Meet the steering committee National policymakers advised the project Sen Tom Daschle Sen Bill Frist former Secretary of Health and Human Services Donna Shalala Gov Michael Leavitt and attorney Jamie Gorelick HFMA has established a recognition program that organizations can use to demonstrate that they have adopted these common sense practices Learn more about the recognition program Please login to add your comments 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 paper shows why patient centric approaches to online payment portals are important complements to traditional provider centric approaches HFMA Business Profiles Optum Enabling Transformative Change Elena White vice president of risk quality and network solutions for Optum discusses how healthcare providers can leverage data and technology as they enable risk in their organization HFMA RESOURCE LIBRARY Payment Portals Can Improve Self Pay Collections and Support Meaningful Use Increased electronic engagement between healthcare providers and patients provides significant opportunities for improving revenue cycle metrics and encouraging patients to access EHRs This article written by Apex Founder and CEO Brian Kueppers explores a number of strategies to create synergy between patient billing online payment portals and electronic health record EHR software to realize a high ROI in speed to payment patient satisfaction and portal adoption for meaningful use HFMA Business Profiles Somnia Bending the Healthcare Cost Curve Toward Improved Anesthesia Value Somnia President and CEO Marc Koch MD MBA explains how hospitals can drive transformative change in the perioperative experience for outstanding clinical and financial outcomes HFMA RESOURCE LIBRARY Large Health System Drives 10 UP Patient Payments and 10 DOWN Billing related Costs Faced with a rising tide of bad debt a large Southeastern healthcare system was seeing a sharp decline in net patient revenues The need to improve collections was dire By integrating critical tools and processes the health system was able to increase online payments and improve its financial position Taking a holistic approach increased overall collection yield by 10 while costs came down because the number of statements sent

    Original URL path: http://www.hfma.org/Content.aspx?id=19958 (2016-02-10)
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  • FAQs about Patient Financial Communications
    organizations and a summary of the potential financial implications for the services rendered including a phone number to call with questions Equally important financially supportive policies should be communicated and made available to the community BACK TO PAGINATION When is it OK to have financial discussions with patients A reasonable attempt should be made to have the discussion as early as possible before a financial obligation is incurred i e before care is provided Timely discussions help ensure that patients understand their financial obligation and that providers are aware of the patient s ability to pay and or the source of payment In the ED setting no patient financial discussions should occur before a patient is screened and stabilized in accordance with the Emergency Medical Treatment and Active Labor Act EMTALA and other federal state and local regulations governing the ED If the medical screening determines that a patient has an emergency medical condition the financial discussion should occur during the discharge process For patients who do not have an emergency medical condition following the medical screening discussion may occur during either the registration or discharge process Outside the ED setting discussions may take place during the registration or discharge process in a location that does not disrupt patient flow Across all care settings if a patient consents to a financial discussion during a medical encounter to expedite discharge the best practices support that choice providing that the discussion does not interfere with patient care or disrupt patient flow Who should participate in financial discussions with patients For routine scenarios such as patients with insurance coverage or a known ability to pay financial discussions should take place between the patient or guarantor i e the person responsible for payment of the bill and properly trained provider representatives For nonroutine or complex scenarios such as uninsured or underinsured patients a financial counselor or supervisor should be involved according to the best practices Health coverage is complicated and not all patients are well equipped to navigate this terrain Patients should be given the opportunity to request a patient advocate family member or other designee to help them in these discussions Do patients have the right to receive care regardless of their ability to pay Yes in the case of an emergency For nonelective services as defined by the provider patients should be informed that their ability to resolve any prior balances or their share of the services they are currently receiving will not affect provision of care In other words ED patients should be informed that their ability to pay will not interfere with treatment of any emergency medical conditions Uninsured ED patients should also be informed that the goal of collecting information is to identify paying solutions or financial assistance options that may assist them with their obligations for the ED visit Now that the Affordable Care Act s insurance marketplaces are fully operational and Medicaid has expanded eligibility criteria in some states it is more important than ever for hospitals to help patients understand their coverage options Inevitably some patients will learn about these new coverage options for the first time when they are in need of emergency care Richard L Gundling FHFMA CMA HFMA Vice President Healthcare Financial Practices Prior to receiving elective services as defined by the provider patients are obligated to make satisfactory financial arrangements Those who have prior balances should be informed if the provider s policies regarding prior balances mean the service will be deferred It is important to note that this doesn t mean patients should be required to pay a prior balance in full before receiving an elective service Instead the best practices call for the patient to make mutually acceptable payment arrangements to resolve the outstanding balance in accordance with whatever policies a hospital may have in place Across all care settings it is important to have clear and publicly available policies on how to interact with patients with prior balances Also providers should have clear definitions of elective and nonelective procedures These definitions also should be made available to the public What topics are typically covered during a routine patient financial discussion Once a patient is stabilized basic registration information including demographics and insurance coverage is gathered and the potential need for financial assistance may be determined The provider representative should review insurance eligibility information with the patient to ensure the information is accurate If appropriate the patient may be referred to a financial counselor and or offered information regarding the provider s financial counseling services and assistance policies Providers should have a widely publicized toll free number for patients to call to receive assistance in financial matters and address any concerns they may have For communications in advance of service the provider should maintain a thread of preregistration discussions and avoid repeated requests for the same information What can providers do to make financial interactions easier for patients The provider should take the initiative to communicate with the patient about financial matters When the provider raises the subject it actually takes a burden off the patient Communication should include verification of patient information mailing address phone numbers email address etc and the patient s preferred methods for future communication Communication should be understandable by the patient and should use standard language Clinicians have long used standard language in patient discussions such as when taking a patient s medical history for example Likewise provider organizations should have standard language to guide finance staff on the most common types of patient financial communications In developing that language providers should take the patient s perspective into consideration Patient privacy should be respected in all patient financial discussions Conversations should occur in a location and manner that are sensitive to the patient s needs Discussions should be reinforced with written information During the registration or discharge process the patient should receive written information about the provider s supportive financial assistance programs and other materials as required by 501 r regulations for not for profit

    Original URL path: http://www.hfma.org/Content.aspx?id=40443 (2016-02-10)
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  • FAQs About the Patient Financial Communications Best Practices® and Adopter Recognition
    based on the best practices Designed for staff who have financial conversations with patients the program features scenario based lessons so staff can work at their own pace along with an online toolkit that includes sample financial policies BACK TO PAGINATION What are the Patient Financial Communications Best Practices The best practices are a comprehensive set of voluntary guidelines that apply to financial conversations with patients in all care settings Topics addressed by the best practices include when and where financial conversations may be conducted who should participate what topics should be covered and guidance for discussing issues such as financial assistance and prior balances How were the best practices developed To develop the best practices a broad group was convened representing consumer and trade groups and other affected stakeholders to serve as a steering committee The committee used a consensus process in its monthly meetings to develop the best practices over the course of a year Their work was informed by public comments received over a six week period in 2013 The project was overseen by an advisory panel chaired by Gov Mike Leavitt R Utah that includes former Sen Tom Daschle D S D former Sen Bill Frist R Tenn former Secretary of Health and Human Services Donna Shalala and attorney Jamie Gorelick What is Adopter recognition Adopter recognition is designed as a way for healthcare providers to demonstrate their commitment to excellence in patient financial communications The recognition is based on HFMA s review of an application and supporting documents that describe an organization s practices It s a self attestation process no on site review is involved The recognition is valid for two years Who is eligible to apply for Adopter recognition All healthcare provider organizations may apply Applications may be at the individual provider level or at the system level For example a hospital system consisting of three hospitals may complete one application for the system or may apply using separate applications for each individual hospital A physician group practice however would apply on behalf of the entire group What is the cost to apply There is no fee to apply or to receive Adopter recognition What communications tools and support are available to Adopter organizations Adopters receive a Communications Toolkit with a sample press release newsletter article web copy emails for employees and Board members and social media posts Adopters may use the phrase Supporter of the Patient Financial Communications Best Practices in their marketing materials They also receive a certificate suitable for framing and display Adopter organizations will be listed on HFMA s website and quarterly in HFMA s flagship magazine hfm How can we assess our readiness to apply for Adopter recognition HFMA has developed a checklist for organizations to use as a self assessment Doing this self assessment can help you identify areas for improvement whether or not you plan to apply for Adopter recognition What communications training should patient access staff receive How often should they receive it The best practices call for annual training on the organization s financial assistance policies for all staff who engage in patient financial discussions including patient access financial counseling and customer service representatives Training may be provided through a variety of forums including web based and in person and may be furnished by qualified internal or external parties as deemed appropriate by a designated quality officer Training must cover the following topics Patient financial communications best practices specific to the staff role Financial assistance policies Available patient financing options Alternative solutions for the uninsured Standard language to be used in patient discussions Laws and regulations such as EMTALA the Fair Debt Collections Practice Act and the Telephone Consumer Protection Act specific to the staff role HFMA has developed a Patient Financial Communications Training Program a complete online training solution based on the best practices Designed for staff who have financial conversations with patients the program features scenario based lessons so staff can work at their own pace along with an online toolkit that includes sample financial policies Please login to add your comments 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

    Original URL path: http://www.hfma.org/Content.aspx?id=40452 (2016-02-10)
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  • Media Resources: Patient Financial Communications Best Practices
    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 paper shows why patient centric approaches to online payment portals are important complements to traditional provider centric approaches HFMA Business Profiles Optum Enabling Transformative Change Elena White vice president of risk quality and network solutions for Optum discusses how healthcare providers can leverage data and technology as they enable risk in their organization HFMA RESOURCE LIBRARY Payment Portals Can Improve Self Pay Collections and Support Meaningful Use Increased electronic engagement between healthcare providers and patients provides significant opportunities for improving revenue cycle metrics and encouraging patients to access EHRs This article written by Apex Founder and CEO Brian Kueppers explores a number of strategies to

    Original URL path: http://www.hfma.org/Content.aspx?id=19962 (2016-02-10)
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  • Best Practices for Communications in the Emergency Department | HFMA
    Summary of care documentation During the discharge process the patient will receive in writing information regarding the provider s supportive financial assistance programs and a summary of the potential financial implications for the services rendered including a phone number to call with questions BACK TO PAGINATION Following is Section 1 of the Patient Financial Communications Best Practices This section addresses communication in the emergency department See the complete Patient Financial Communications Best Practices 1 Patient Financial Communications in the Emergency Department Note All practices must comply with EMTALA and all other Federal State and Local regulations affecting the Emergency Department 1 1 Discussion participants The patient or guarantor will have these discussions with properly trained registration or discharge representative for routine scenarios financial counselor or supervisor for non routine complex scenarios Patient should be given the opportunity to request a patient advocate designee or family member to assist them in these discussions 1 2 Setting for discussions No patient financial discussions will occur before patient is screened and stabilized Once a patient has been stabilized in accordance with EMTALA the following timings and locations are appropriate for financial discussions 1 2 1 Emergent Patients Discussions will occur during the discharge process The discussion can also occur during the medical encounter as long as patient care is not interfered with and the patient consents to these conversations in order to expedite discharge 1 2 2 Patients who do not have an emergency medical condition Following the medical screening provider representative will have a discussion with the patient during the registration or discharge process The discussion can also occur during the medical encounter as long as patient care is not interfered with and the patient consents to these discussions in order to expedite discharge 1 3 Registration insurance verification and financial counseling discussions No patient financial discussions will occur before patient is screened and stabilized in accordance with EMTALA 1 3 1 Registration The provider organization will first gather basic registration information including demographics insurance coverage as well as determining the potential need for financial assistance 1 3 2 Provision of care Patient will be informed that their ability to pay will not interfere with treatment of any emergency medical conditions Uninsured patients will be informed the goal of collecting information is to identify paying solutions or financial assistance options that may assist them with their obligations for this visit 1 3 3 Insurance verification Once screening has occurred and the patient is stabilized the provider organization will review insurance eligibility information with the patient to ensure information accuracy 1 3 4 Financial counseling If appropriate patient is referred to a financial counselor and or offered information regarding the provider s financial counseling services and assistance policies 1 4 Patient share and prior balance discussions These discussions will occur once the provider organization has fulfilled the previous best practice requirements Interactions will not interfere with patient care and will focus on patient education During patient share and prior balance discussions the provider representative will 1 4 1 Patient share discussions 1 4 1 1 Provide a list of the types of service providers that typically participate in the service both verbally and if the patient requests in writing 1 4 1 2 Inform patient that actual costs may vary from estimates depending on actual services performed or timing issues with other payments affecting the patient s deductible 1 4 1 3 If appropriate ask the patient if they are interested in receiving information regarding payment options 1 4 1 4 If appropriate ask the patient if they are interested in receiving information regarding the provider s financial assistance programs 1 4 2 Prior balance discussions NOTE Balance resolution discussion occurs on prior balances that are being pursued for collection by provider collection agency or other organization There will be many scenarios where patients will not have prior balances 1 4 2 1 Discuss with patient the services that led to the prior balance including the dates of service and the resulting prior balance Upon the patient s request provide the patient a written list of the services provided dates of service and the resulting prior balance 1 4 2 2 Ask the patient if they are interested in receiving information regarding payment options 1 4 2 3 Ask the patient if they are interested in receiving information regarding the provider s supportive financial assistance programs 1 4 2 4 Proactively attempt to resolve prior balances through insurance and financial assistance programs 1 5 Balance resolution Once the provider organization has fulfilled the best practice steps as outlined above it is appropriate to inquire about how the patient would like to resolve the balance for the current service and any prior balance the patient may have as well as informing the patient of the timing of collection activity 1 6 Summary of care documentation During the discharge process the patient will receive in writing information regarding the provider s supportive financial assistance programs and a summary of the potential financial implications for the services rendered including a phone number to call with questions Please login to add your comments 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

    Original URL path: http://www.hfma.org/Content.aspx?id=19955 (2016-02-10)
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  • Best Practices for Communications at the Time of Service | HFMA
    of care documentation During the registration or discharge process the patient will receive in writing information regarding the provider s supportive financial assistance programs and a summary of the potential financial implications for the services rendered including a phone number to call with questions BACK TO PAGINATION Following is Section 2 of the Patient Financial Communications Best Practices This section addresses communication at the time of service outside the emergency department See the complete Patient Financial Communications Best Practices 2 Patient Financial Interactions at Time of Service Outside the ED 2 1 Discussion participants The patient or guarantor will have these discussions with properly trained registration or discharge representative for routine scenarios financial counselor or supervisor for non routine complex scenarios Patient should be given the opportunity to request a patient advocate designee or family member to assist them in these discussions 2 2 Setting for discussion Provider organization will have discussion with patient during the registration or discharge process in a location that does not disrupt patient flow The discussion can also occur during the medical encounter as long as patient care is not interfered with and the patient consents to these discussions in order to expedite discharge 2 3 Registration insurance verification and financial counseling discussions Provider organizations will maintain a thread of pre registration discussions that occurred with the patient If pre registration discussions took place these discussions will not occur again 2 3 1 Registration The provider organization will first gather basic registration information including demographics insurance coverage as well as determining the potential need for financial assistance 2 3 2 Insurance verification The provider organization will review insurance eligibility details with the patient to ensure information accuracy Uninsured patients will be informed the goal of collecting information is to identify paying solutions or financial assistance options that may assist them with their obligations for this visit 2 3 3 Financial counseling If appropriate patient is referred to a financial counselor and or offered information regarding the provider s financial counseling services and assistance policies 2 4 Provision of care Provider organizations will have clear policies on how to interact with patients with prior balances choosing to have elective or non elective procedures They will also have clear definitions for elective and non elective procedures These policies will be made available to the public 2 4 1 Elective services As defined by the provider 2 4 1 1 Patient share discussions Patients have the obligation to make satisfactory payment arrangements before receiving care 2 4 1 2 Prior balance discussions Patients with prior balances will be informed by the provider organization if the provider s policies regarding prior balances mean the service will be deferred 2 4 2 Non elective services As defined by the provider 2 4 2 1 Patients will be informed that ability to resolve patient share or any prior balances will not affect provision of care 2 5 Patient share and prior balance discussions Discussions will not interfere with patient care and will focus on patient education During patient share and prior balance discussions the provider representative will 2 5 1 Patient share discussions 2 5 1 1 Provide a list of the types of service providers that typically participate in the service both verbally and if the patient requests in writing 2 5 1 2 Inform patient that actual costs may vary from estimates depending on actual services performed or timing issues with other payments affecting the patient s deductible 2 5 1 3 If appropriate ask the patient if they are interested in receiving information regarding payment options 2 5 1 4 If appropriate ask the patient if they are interested in receiving information regarding the provider s financial assistance programs 2 5 2 Prior balance discussions NOTE Balance resolution discussion occurs on prior balances that are being pursued for collection by provider collection agency or other organization There will be many scenarios where patients will not have prior balances 2 5 2 1 Discuss with patient the services that led to the prior balance including the dates of service and the resulting prior balance Upon the patient s request provide the patient a written list of the services provided dates of service and the resulting prior balance 2 5 2 2 If appropriate ask the patient if they are interested in receiving information regarding payment options 2 5 2 3 If appropriate ask the patient if they are interested in receiving information regarding the provider s supportive financial assistance programs 2 5 2 4 Proactively attempt to resolve prior balances through insurance and financial assistance programs 2 6 Balance resolution Once the provider organization has fulfilled the best practice steps as outlined above it is appropriate to inquire about how the patient would like to resolve the balance for the current service and any prior balance the patient may have as well as informing the patient of the timing of collection activity 2 7 Summary of care documentation During the registration or discharge process the patient will receive in writing information regarding the provider s supportive financial assistance programs and a summary of the potential financial implications for the services rendered including a phone number to call with questions Please login to add your comments 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

    Original URL path: http://www.hfma.org/Content.aspx?id=19956 (2016-02-10)
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  • Best Practices for Communications in Advance of Service | HFMA
    steps as outlined above it is appropriate to inquire about how the patient would like to resolve the balance for the current service and any prior balance the patient may have as well as informing the patient of the timing of collection activity BACK TO PAGINATION Following is Section 3 of the Patient Financial Communications Best Practices This section addresses communication in advance of service See the complete Patient Financial Communications Best Practices 3 Patient Financial Interactions in Advance of Service 3 1 Discussion participants Appropriately trained provider representatives will have these discussions with the patient or guarantor Patient should be given the opportunity to request a patient advocate designee or family member to assist them in these discussions 3 2 Setting for discussion Discussions will occur using the most appropriate means of communication for the patient These discussions may take place via Outbound contact to patient in advance of a scheduled service Inbound contact from patient inquiring about their upcoming service Scheduling Contact center when appointment is made 3 3 Timing of discussion A reasonable attempt will be made for discussions with patients to occur as early as possible taking place before a financial obligation is incurred up to the point at which care is provided Timely discussions will ensure patients understand their financial obligation and providers are aware of the patient s ability to pay and or source of payment 3 4 Registration insurance verification and financial counseling discussions Provider organizations will maintain a thread of pre registration discussions that occurred with the patient If pre registration discussions took place these discussions will not occur again 3 4 1 Registration The provider organization will first gather basic registration information including demographics insurance coverage as well as determining the potential need for financial assistance 3 4 2 Insurance verification The provider organization will review insurance eligibility with the patient to ensure information accuracy Uninsured patients will be informed the goal of collecting information is to identify paying solutions or financial assistance options that may assist them with their obligations for this visit 3 4 3 Financial counseling If appropriate patient is referred to a financial counselor and or offered information regarding the provider s financial counseling services and assistance policies 3 5 Provision of care Provider organizations will have clear policies on how to interact with patients with prior balances choosing to have elective or non elective procedures They will also have clear definitions for elective and non elective procedures These policies will be made available to the public 3 5 1 Elective services As defined by the provider 3 5 1 1 Patient share discussions Patients have the obligation to make satisfactory payment arrangements before receiving care 3 5 1 2 Prior balance discussions Patients with prior balances will be informed by the provider organization if the provider s policies regarding prior balances mean the service will be deferred 3 5 2 Non elective services As defined by the provider 3 5 2 1 Patients will be informed that ability to resolve patient share or any prior balances will not affect provision of care 3 6 Patient share and prior balance discussions Interactions will not interfere with patient care and will focus on patient education During patient share and prior balance discussions the provider representative will 3 6 1 Patient share discussions 3 6 1 1 Provide a list of the types of service providers that typically participate in the service both verbally and if the patient requests in writing 3 6 1 2 Inform patient that actual costs may vary from estimates depending on actual services performed or timing issues with other payments affecting the patient s deductible 3 6 1 3 If appropriate ask the patient if they are interested in receiving information regarding payment options 3 6 1 4 If appropriate ask the patient if they are interested in receiving information regarding the provider s financial assistance programs 3 6 2 Prior balance interactions discussions NOTE Balance resolution discussion occurs on prior balances that are being pursued for collection by provider collection agency or other organization There will be many scenarios where patients will not have prior balances 3 6 2 1 Discuss with patient the services that led to the prior balance including the dates of service and the resulting prior balance Upon the patient s request provide the patient a written list of the services provided dates of service and the resulting prior balance 3 6 2 2 If appropriate ask the patient if they are interested in receiving information regarding payment options 3 6 2 3 If appropriate ask the patient if they are interested in receiving information regarding the provider s supportive financial assistance programs 3 6 2 4 Proactively attempt to resolve prior balances through insurance and financial assistance programs 3 7 Balance resolution Once the provider organization has fulfilled the best practice steps as outlined above it is appropriate to inquire about how the patient would like to resolve the balance for the current service and any prior balance the patient may have as well as informing the patient of the timing of collection activity Please login to add your comments 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

    Original URL path: http://www.hfma.org/Content.aspx?id=19957 (2016-02-10)
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  • Best Practices for Communications in All Settings | HFMA
    they may have 4 16 Provider organizations will have clear policies regarding the handling of patients with prior balances These policies will be made available to the public 4 17 Patient discussions will focus on steps toward amicable resolution of financial obligations BACK TO PAGINATION Following is section four of the Patient Financial Communications Best Practices This section addresses communication for all settings See the complete Patient Financial Communications Best Practices 4 Best Practices for all Patient Financial Communications 4 1 Compassion patient advocacy and education should be part of all patient discussions 4 2 Providers should have standard language to guide staff on the most common types of patient financial discussions 4 3 Where appropriate provider organizations should utilize face to face discussions to facilitate one time resolution 4 4 Availability of supportive financial assistance should be communicated to patients Provider organizations should communicate and make financially supportive policies available to the community 4 5 Service provider should take initiative to communicate with patient 4 6 All personnel engaging in patient financial discussions e g registration staff financial counselors financial clearance representatives and customer service staff will receive annual training on the following Patient Financial Communications Best Practices Financial assistance policies Common coverage solutions for the uninsured and underinsured Customer service 4 7 Provider organizations should ensure broader education and awareness of the Best Practices throughout their organization 4 8 Provider organization should include the perspective of a patient when developing standard language used in patient financial discussions 4 9 Providers should regularly survey their patients to assess performance against the Best Practices Results should be shared with staff and leadership for continuous improvement opportunities 4 10 Communication should be understandable by the patient 4 11 Communication should include verification of patient information mailing address phone numbers email etc and the patients preferred methods for future communication 4 12 Providers should have technology that gives financial representatives up to date information about patient balances and financial obligations 4 13 In all patient financial discussions patient privacy should be respected and conversations should occur in a location and manner that are sensitive to the patient s needs 4 14 Elective procedures should be defined by individual provider organizations to ensure patients are properly informed regarding their financial obligations 4 15 Providers should have a toll free number that is widely publicized that patients can call to receive assistance in financial matters and concerns they may have 4 16 Provider organizations will have clear policies regarding the handling of patients with prior balances These policies will be made available to the public 4 17 Patient discussions will focus on steps toward amicable resolution of financial obligations Please login to add your comments 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 paper shows why patient centric approaches to online payment portals are important complements to traditional provider centric approaches HFMA Business Profiles Optum Enabling Transformative

    Original URL path: http://www.hfma.org/Content.aspx?id=20083 (2016-02-10)
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