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Analysis

Give Your Patients This HFMA Guide to Help Them Avoid Surprise Medical Bills

By Alexandra Wilson Pecci  
   November 12, 2018

Hospitals and health systems are encouraged to include the guide in their pre-procedure communications with patients and post it on the billing and payment page of their websites.

The Healthcare Financial Management Association has published a new consumer guide for avoiding surprises in medical bills and is making the guide available to hospitals and health systems to use in their communications with patients.

HFMA, the American Hospital Association, and America's Health Insurance Plans worked together to develop the guide. The American Medical Association also provided input.

"Hospitals and health systems are encouraged to include the guide in their pre-procedure communications with patients and post it on the billing and payment page of their websites—no permission needed," Richard L. Gundling, senior vice president of healthcare financial practices at HFMA, tells HealthLeaders via email.

HFMA says that educating consumers about how to avoid surprise medical bills should be part of a consumer-focused approach to healthcare. This is especially important since patients tend to blame hospitals for high hospital bills.

Still, extending consumer-centric efforts to the basic question of "how much will this cost?" has been a challenge.

The guide puts some of the responsibility for surprise medical bills into patient hands.

"The guide was developed to help consumers understand steps they can take to avoid unexpected out-of-network bills," Gundling says.

The 15-page guide, which is available in English and Spanish, offers a primer on healthcare networks, negotiated rates, balance bills, out-of-pocket maximums, and other pertinent terms, as well as detailed tips for avoiding an unexpected balance bill.

The guide also breaks down treatment, billing, and important insurance and financial questions to ask about three common procedures: Colonoscopy, pregnancy and childbirth, and hip and knee replacement.

In addition to posting the new surprise medical bills guide on their websites, HFMA also encourages hospitals and health systems to post its consumer guide about understanding healthcare prices and adopt its best practices for financial communications.

Alexandra Wilson Pecci is an editor for HealthLeaders.


KEY TAKEAWAYS

Share the new consumer guide online to teach patients the ins and outs of balance billing.

Include tips from the guide in pre-procedure communications to help patients avoid surprise charges.


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