Stakeholders, including representatives from the Healthcare Financial Management Association and the American Hospital Association, have drafted new best practices for providers to communicate with patients who are becoming increasingly responsible for a greater proportion of their healthcare costs.
New draft best practices designed to help healthcare providers manage patient financial interactions with greater consistency and transparency were announced Sunday at the Healthcare Financial Management Association's ANI conference at the Orange County Convention Center in Orlando.
Speaking to an audience of mainly healthcare finance executives, HFMA president and CEO Joseph J. Fifer, FHFMA, said the best practices are intended to provide guidance to provider organizations for when and how to communicate to patients about their insurance coverage and financial responsibility for co-pays and deductibles.
Calling the practices "critical," Fifer said it is important for providers to communicate clearly and effectively with patients who are becoming "responsible for a greater proportion of their healthcare costs."
Fifer also noted the complexity of the current reimbursement environment for providers who are dealing with complicated payment models from multiple payers in addition to a variety of government programs and said clear guidelines and communication between providers and patients are "more important than ever."
Outlined in the new protocols are guidelines for:
- Emergency department interactions. This best practice provides the needed guidelines for dealing with financial interactions with patients who present in the emergency department.
- Time of service (outside the ED) interactions. This set of best practices provides the needed guidelines for handling financial interactions with patients that take place at the time of service, outside the ED.
- Advance of service interactions. This set of best practices provides the needed guidelines for managing the most sensitive financial interactions with patients that take place in advance of service.
- Best practices for all patient financial interactions. This overarching set of best practices provides the needed guidelines to help provider organizations handle the most sensitive financial interactions with patients.
- PFI measurement criteria. These PFI measurement criteria were developed to guide the evaluation of an organization's compliance with the patient financial best practices.
The new practices were created by a steering committee that includes leaders from HFMA, the Patient Advocate Foundation, the American Hospital Association, Harvard Medical School, America's Health Insurance Plans.
Comments on the best practices are being accepted until July 31, and final best practices will be announced in the fall for voluntary adoption by healthcare providers. View the complete list of best practices.