Discussing Patient Financial Obligations

As much as 50% of patient responsibility goes uncollected, but these best practices can help resolve financial obligations and improve communication between patients and providers.

It has been said that as much as 50% of patient responsibility goes uncollected, which could, unfortunately, worsen with confusion from those newly insured under the Affordable Care Act.

To assist, the Healthcare Financial Management Association (HFMA) with help from ACA International and an industry task force of health care providers, account resolution groups and others, created a document of the new best practices for medical debt collection.

These practices offer guidance on resolving financial obligations and improving the communication between patients and providers. Furthermore, these best practices standardize and better coordinate all practices related to medical account resolution.

"These best practices provide a much-needed blueprint for hospitals, physicians, and our partners in account resolution to coordinate their activities in ways that respect and benefit patients," Joseph J. Fifer, FHFMA, CPA, president and chief executive officer of HFMA, said in a statement. "Patients want information that is timely, clear, and concise and deserve a consistent, fair process for resolving payment issues."

The best practices outline ways to help patients understand the cost of services they receive, their insurance coverage and what their responsibility actually is.

The best practices provide steps for three settings: emergency room, at the time of service (outside of the ED), and in advance of service. According to the HFMA, the best practices provide a thorough understanding of what patients can expect during the payment and collection process.

In all settings, the best practices remind that compassion, patient advocacy and education should be a part of all discussions. To ease these discussions, there should be standard language for staff to deal with most types of patient financial discussions. Plus, the provider organization should have a clear policy regarding how to handle patients who have prior balances. Not only should staff be aware of the policies, but they should be made available to the public.

Elective procedures should be defined to ensure that patients are properly informed regarding their financial obligations in these situations, according to the best practices.

"Many consumers are struggling with medical bills today," ACA International CEO Pat Morris said in a statement. "These best practices are a balanced step forward for all of the stakeholders involved to better resolve patient medical accounts."

The best practices also provide measurement criteria, which evaluate the effectiveness of patient financial communications in a health care organization. The full best practices and measurement criteria can be found here.