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HFMA seeks input on practices that foster early, clear communication about medical pricing and payment

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June 16, 2013, ORLANDO, FL -- The Healthcare Financial Management Association (HFMA) today announced release of new draft best practices that will bring more consistency, clarity and transparency in patient financial interactions. Revealed at the HFMA annual meeting in Orlando, Florida, the new guidelines are open for public comment until July 31.

The new practices were created by a steering committee that met monthly over the last year and included leaders from HFMA, the Patient Advocate Foundation, the American Hospital Association, Harvard Medical School, and America’s Health Insurance Plans, among others (a list of participants is attached).

The Patient Financial Interaction (PFI) best practices can be viewed and comments submitted at www.pfibestpractices.com. The steering committee anticipates robust participation during the public comment period, and will solicit additional patient feedback in the coming months. The resulting final practices will be released in the fall for voluntary adoption by healthcare organizations across the country.

“Healthcare financial interactions can be complex and confusing because of complicated payment structures, dozens of different payers and forms, and varied government programs,” said Joseph J. Fifer, FHFMA, CPA, President and CEO of HFMA. “When you add the reality that patients are becoming responsible for greater proportions of their healthcare costs, clear guidelines and communication are more important than ever. These best practices are a critical component of HFMA’s ongoing effort to establish more consistent financial practices that are fair to all stakeholders while helping patients access and pay for the healthcare they need.”

The practices focus on financial interactions when medical services are scheduled, and during both emergency and non-emergency care. They provide guidance for when, how, and by whom communication should take place about patient insurance coverage, financial counseling, patient financial responsibility for service, and any existing balance the patient may have. The best practices emphasize open and early communication, sharing clear information and identifying a path for financial resolution that is fair for patients and healthcare organizations alike.

“Patients and their families enter the healthcare system when they are most vulnerable, and then they encounter financial processes that are challenging even to veteran healthcare professionals,” said Nancy Davenport-Ennis, President and CEO of the National Patient Advocate Foundation (NPAF) and a member of the group that developed the best practices. “The early, clear financial conversations described in these best practices will help give patients peace of mind and help providers receive appropriate payment—both key objectives for the healthcare system to function with fairness and compassion.”

“Clear financial communication between patients and healthcare organizations is the right thing to do for all concerned, but our complex healthcare system makes clarity a challenge,” says Bert R. Zimmerli, Executive Vice President and Chief Financial Officer at Intermountain Healthcare and a member of the steering committee. “These best practices provide a guidepost that our industry will use to continuously improve these crucial financial interactions.”

The patient financial interactions project was overseen by an advisory panel consisting of Sen. Tom Daschle, Sen. Bill Frist, former Secretary of Health and Human Services Donna Shalala, Gov. Michael Leavitt and attorney Jamie Gorelick. Leavitt Partners facilitated the Steering Committee process, and HFMA will move the project through implementation, with the support of the other steering committee members.

The project is one part of a group of HFMA initiatives designed to promote fair financial practices in healthcare.


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