ACA International and the Healthcare Financial Management Association reconvened this year to update best practices for the fair resolution of patients’ medical bills. Here is a look at patient-friendly billing principles highlighted in the report.

Patient-friendly billing is part of the core framework of best practices recently updated by ACA International and the Healthcare Financial Management Association (HFMA) Accounts Receivable Resolution Task Force. The best practices focus on the fair resolution of patients’ medical bills and address financial assistance policies in response to the COVID-19 pandemic.

The report reflects the task force’s consensus on the equitable resolution of the patient portion of medical bills.

ACA and HFMA worked together on the 28-page report, which updates and extends guidance that was originally published by HFMA in 2014. The report emphasizes the importance of educating patients and ensuring that they understand the account resolution process.

Serving on the task force are ACA’s CEO Mark Neeb, ACA’s Vice President and Senior Counsel of Federal Advocacy Leah Dempsey, and ACA members from State Collection Service Inc.: Tim Haag, president, and Steve Beard, chief business development officer.

With a focus on patient education and communication, the best practices are designed to help patients engage in their health care and become active participants in resolving outstanding accounts.

The report includes best practices for modifying financial assistance policies in response to the COVID-19 pandemic and recommended safeguards to implement before initiating actions, such as credit bureau reporting, that some hospitals and their business affiliates may elect to pursue in accordance with account resolution policies that have been approved by the hospital’s board of directors or other authorizing body.

As part of the focus on patient-friendly billing, the task force’s goal was to identify a common set of account resolution best practices that align with the federal requirements and with HFMA’s patient-friendly billing principles.

The principles are designed to simplify the process for patients, according to the report.

It states that, following the principles, health care financial communications will be:

  • Clear. All financial communications will be easy to understand and written in clear language. Patients will be able to quickly determine what they need to do with the communication.
  • Concise. Bills will contain just the right amount of detail necessary to communicate the message.
  • Correct. Bill items will correctly reflect the patient’s responsibility after the claim has been adjudicated and/or financial assistance or other discounts have been applied, as appropriate.
  • Patient-Friendly. The needs of patients and family members will be paramount when designing administrative processes and communications.

Since the task force’s 2014 report was issued, the group expanded its guidance for conversations with patients to include education and engagement that will provide a clear understanding of what they can expect at every stage of the account resolution process. Health care providers or their business associates should start patient education as early as possible during the account resolution process, but their efforts should not stop there.

“The best practice is for the provider or business associate to offer ongoing education to reinforce the opportunities (e.g., financial assistance, payment plans, other sources of coverage) patients have for positive account resolution,” according to the report. “Therefore, providers and business associates must use every patient communication to engage and educate the patient about their account resolution options.”

The report maps out the entire medical accounts receivable resolution process from preservice to post-discharge, incorporating elements from HFMA’s Patient Financial Communications Best Practices and Patient-Friendly Billing initiative.

The report was developed with the support of State Collection Service.

Members of HFMA’s 2020 Medical Accounts Receivable Resolution Task Force include a diverse group of providers, consumer advocates and collection agencies.

Access the report and additional resources from the task force here: https://www.hfma.org/dollars


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