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Established in 2000, the PATIENT FRIENDLY BILLING[SM] project began as a way to help hospital and health system leaders create a more patient-focused-and friendly--healthcare billing and collection process. The PATIENT FRIENDLY BILLING project was initiated by HFMA with the American Hospital Association as a catalyst for change, starting with providers and extending to all entities that touch the billing and revenue-cycle process.

Purpose

The purpose of the project is to create a healthcare billing and collection process that results in financial communication that is clear, concise, correct, and patient friendly.

Clear. The bill should be easy to understand and written in clear language. The general type of service provided to the patient should be documented. Patient and payer responsibilities should be clearly stated, necessary actions described, and a source of additional help and information provided. Instructions on how patients can get more details on their bill should be specific and accurate.

Patient friendly, In addition to being easy to read and comprehend, the bill should be easily matched with the payer's explanation of benefits. It should be consistent with everyone's understanding of the insurance benefits and the episode of care. Information about other providers who may also bill the patient should be included. Finally, helpful information should be readily available from the hospital's patient representative or from various publications and Internet sources.

The initial project activities resulted in a report developed by HFMA with the AHA and several leading provider and consulting organizations. The report was designed to help hospitals and health systems create action steps for billing and other financial communications that achieve the patient friendly philosophy. That report was distributed to CFOs and CEOs among HFMA and AHA's membership.

Medical Groups

The project's reach has extended since inception. In June 2002, HFMA and the Medical Group Management Association (MGMA) collaborated to extend PA TIENT FRIENDLY BILLING project resources to medical group management professionals. As a part of this initiative, HFMA and MOMA have issued a report for medical group management professionals offering guidance on actions they can take to improve patient billing. The report, which can be found on the project's web site at www.patientfriendlybilling.org (in the news section), explains how to make physicians' billing statements less confusing and how the effort to make billing statements clearer and more accurate can help improve a medical practice's revenue cycle, MGMA has also adapted the project's support materials, originally developed for hospitals and health systems, and additional information, tools, and case studies to help in the crusade to make the billing process more effective from the patient's perspective.

Insights from Patients

Because meeting the needs of the patient-the consumer-is the project's top priority, the PATIENT FRIENDLY BILLING Task Force commissioned a series of focus groups to obtain feedback from patients, caregivers, and family members about how billing can be improved. Seventy-five people from diverse backgrounds participated in this research, which resulted in a strong, uniform message: consumers are frustrated and distrustful of the current system of financial communication regarding their medical care and want a simplified billing process.

Technology Issues

Most recently, the PATIENT FRIENDLY BILLING project has focused on examining the current patient accounting systems and investigating associated vendors that produce and distribute hospital financial communications in order to reach the project's main objective: to create clear, correct, concise, and patient-friendly bills. As a part of these initiatives, the PATIENT FRIENDLY BILLING Vendor Task Force is striving to unite the patient accounting systems, bill-producing vendors, and any other related dealer to produce comprehensible bills, as well as to provide funding for this ongoing effort. The Vendor Task Force includes representatives from companies that design and install information systems for patient accounting systems and other financial communications.

"Information system vendors play an integral role in patient financial communications," says HFMA President and CEO Richard L. Clarke, FHFMA, "and can make a significant contribution to simplifying and standardizing this process. They have a deep knowledge of the processes in question, because they work with clients with diverse needs and conditions."

The Vendor Task Force will develop guidelines to help healthcare providers improve their billing and revenue-cycle processes. This will likely take the form of reengineered billing processes to improve accuracy and reduce redundancy. The task force may also address the effective use of information technology for revenue cycle automation and standardization. The task force's overarching principle is to make the patient the priority. The task force is using consumer research from the first phase of the project to help determine patient priorities. While researching and debating recommendations, the task force asks, "What does the patient see? What's best for the patient? What does the patient want? What are we trying to communicate to the patient? What do we want the patient to do with the communication we send?

# posted by Medical Information : 2:46 AM