HFMA Releases Provider-Patient Financial Communications Best Practices

by Carlton Fields
Contact

Healthcare financial interactions are often complex and confusing for patients and can involve complicated payment structures and various “key players.” As patients become responsible for greater proportions of their healthcare costs, effective communication between providers and patients is more important than ever.

To address this increasingly important issue, on October 28, 2013, the Healthcare Financial Management Association (HFMA) released the final draft of “best practices” to promote consistency, clarity and transparency in financial communications between health care providers and patients. Boasting over 40,000 members, HFMA is a trade organization for healthcare financial management executives and leaders. An initiative of HFMA entitled “Patient Friendly Billing” is a mechanism for promoting clear, concise and correct patient-friendly financial communications.

The HFMA guidelines are the culmination of a process that began in May 2012, when a steering committee was established to develop standards for patient financial interactions.

The steering committee included experts across the health care industry, including patient advocates and representatives from the American Hospital Association, America’s Health Insurance Plans, American Academy of Family Physicians, Harvard Medical School, and the National Patient Advocate Foundation. The steering committee was also advised by national healthcare policymakers including former HHS Secretaries Michael Leavitt and Donna Shalala, as well as former Senate Leaders Bill Frist and Tom Daschle and Clinton Administration Deputy Attorney General, Jamie Gorelick.

Following its 2013 national institute, the HFMA released its newly drafted list of best practices for transparent financial interactions with patients, and opened them for public comment until July 31. The recently released final version of the guidelines incorporates minor changes to the draft released in June. This final publication is the culmination of that process.

The best practices provide detailed guidance on when and how communications should occur between patients and providers about issues related to insurance coverage, financial counseling, financial responsibility for service and existing balances.

Several items listed among the committee's recommended best practices for discussing financial issues with patients — in accordance with EMTALA regulations — include:

  • Gathering basic insurance registration information, as well as determining whether the patient may require financial assistance.
  • Informing patients their ability to pay will not impact their emergency or nonelective care.
  • Reviewing insurance eligibility details to ensure accuracy of payment information.
  • Clarifying that patients must make payment arrangements and may need to pay outstanding bills from the hospital or have elective services deferred.
  • Giving patients the opportunity to include an advocate or family member to assist them in discussions.
  • Giving patients information and phone numbers for financial assistance programs with their discharge paperwork.

Additionally, the guidelines also detail preferred financial communications in several settings – before service, in the emergency department, and in other care settings.

Starting immediately, hospitals, physician practices, surgery centers, and other healthcare organizations have the opportunity to achieve HFMA’s Patient Financial Communications Adopter recognition, designed for organizations seeking to demonstrate a core commitment to the best practices and who self-identify as adopters. Through the evaluation process, organizations will be able to identify which practices they have implemented and which areas need further work. No on-site review by HFMA staff is involved and the Adopter recognition is valid for two years. Organizations achieving this status are allowed to use the phrase "Supporter of the Patient Financial Communications Best Practices" in their marketing materials. Adopter organizations also will receive a certificate and will be listed on HFMA's website and quarterly in HFMA's magazine. It is recommended that health care legal counsel or compliance professional not directly involved in patient financial communications assist with the application.

Additionally, in 2014, HFMA will launch an additional level of recognition that involves an audit and validation of excellence in patient financial communications throughout the provider organization and is designed to recognize mastery of the fundamental components of the best practices.

In an era where patient financial responsibility is expected to continue to grow rapidly as a percentage of overall provider revenue, it is increasingly critical for healthcare providers to collect patient payments in compliance with state and federal law. Likewise, it is also crucial that they understand the huge impact that activities related to patient payment (such as collections) can have on patient satisfaction, patient engagement and clinical outcomes. Provider should consider utilizing the newly issued HFMA best practices as a tool in achieving efficient and effective communication with patients.

DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

© Carlton Fields | Attorney Advertising

Written by:

Carlton Fields
Contact
more
less

Carlton Fields on:

Readers' Choice 2017
Reporters on Deadline

"My best business intelligence, in one easy email…"

Your first step to building a free, personalized, morning email brief covering pertinent authors and topics on JD Supra:
Sign up using*

Already signed up? Log in here

*By using the service, you signify your acceptance of JD Supra's Privacy Policy.
Privacy Policy (Updated: October 8, 2015):
hide

JD Supra provides users with access to its legal industry publishing services (the "Service") through its website (the "Website") as well as through other sources. Our policies with regard to data collection and use of personal information of users of the Service, regardless of the manner in which users access the Service, and visitors to the Website are set forth in this statement ("Policy"). By using the Service, you signify your acceptance of this Policy.

Information Collection and Use by JD Supra

JD Supra collects users' names, companies, titles, e-mail address and industry. JD Supra also tracks the pages that users visit, logs IP addresses and aggregates non-personally identifiable user data and browser type. This data is gathered using cookies and other technologies.

The information and data collected is used to authenticate users and to send notifications relating to the Service, including email alerts to which users have subscribed; to manage the Service and Website, to improve the Service and to customize the user's experience. This information is also provided to the authors of the content to give them insight into their readership and help them to improve their content, so that it is most useful for our users.

JD Supra does not sell, rent or otherwise provide your details to third parties, other than to the authors of the content on JD Supra.

If you prefer not to enable cookies, you may change your browser settings to disable cookies; however, please note that rejecting cookies while visiting the Website may result in certain parts of the Website not operating correctly or as efficiently as if cookies were allowed.

Email Choice/Opt-out

Users who opt in to receive emails may choose to no longer receive e-mail updates and newsletters by selecting the "opt-out of future email" option in the email they receive from JD Supra or in their JD Supra account management screen.

Security

JD Supra takes reasonable precautions to insure that user information is kept private. We restrict access to user information to those individuals who reasonably need access to perform their job functions, such as our third party email service, customer service personnel and technical staff. However, please note that no method of transmitting or storing data is completely secure and we cannot guarantee the security of user information. Unauthorized entry or use, hardware or software failure, and other factors may compromise the security of user information at any time.

If you have reason to believe that your interaction with us is no longer secure, you must immediately notify us of the problem by contacting us at info@jdsupra.com. In the unlikely event that we believe that the security of your user information in our possession or control may have been compromised, we may seek to notify you of that development and, if so, will endeavor to do so as promptly as practicable under the circumstances.

Sharing and Disclosure of Information JD Supra Collects

Except as otherwise described in this privacy statement, JD Supra will not disclose personal information to any third party unless we believe that disclosure is necessary to: (1) comply with applicable laws; (2) respond to governmental inquiries or requests; (3) comply with valid legal process; (4) protect the rights, privacy, safety or property of JD Supra, users of the Service, Website visitors or the public; (5) permit us to pursue available remedies or limit the damages that we may sustain; and (6) enforce our Terms & Conditions of Use.

In the event there is a change in the corporate structure of JD Supra such as, but not limited to, merger, consolidation, sale, liquidation or transfer of substantial assets, JD Supra may, in its sole discretion, transfer, sell or assign information collected on and through the Service to one or more affiliated or unaffiliated third parties.

Links to Other Websites

This Website and the Service may contain links to other websites. The operator of such other websites may collect information about you, including through cookies or other technologies. If you are using the Service through the Website and link to another site, you will leave the Website and this Policy will not apply to your use of and activity on those other sites. We encourage you to read the legal notices posted on those sites, including their privacy policies. We shall have no responsibility or liability for your visitation to, and the data collection and use practices of, such other sites. This Policy applies solely to the information collected in connection with your use of this Website and does not apply to any practices conducted offline or in connection with any other websites.

Changes in Our Privacy Policy

We reserve the right to change this Policy at any time. Please refer to the date at the top of this page to determine when this Policy was last revised. Any changes to our privacy policy will become effective upon posting of the revised policy on the Website. By continuing to use the Service or Website following such changes, you will be deemed to have agreed to such changes. If you do not agree with the terms of this Policy, as it may be amended from time to time, in whole or part, please do not continue using the Service or the Website.

Contacting JD Supra

If you have any questions about this privacy statement, the practices of this site, your dealings with this Web site, or if you would like to change any of the information you have provided to us, please contact us at: info@jdsupra.com.

- hide
*With LinkedIn, you don't need to create a separate login to manage your free JD Supra account, and we can make suggestions based on your needs and interests. We will not post anything on LinkedIn in your name. Or, sign up using your email address.