By Josh Byrd, Director of Marketing


This week HFMA released their final guidelines for Patient Financial Communications Best Practices. In their words, “These common-sense best practices bring consistency, clarity, and transparency to patient financial communications.” While a great start, unfortunately, this document is a bit incomplete because it neglects to address the essential communication that occurs after a patient’s episode of care.

While communication prior to the episode of care is very important, let’s face it, most people receive the most communication about their healthcare through their statement and communication process that happens after the episode of care. We have found that this is where most confusion actually happens. Patients often don’t understand what they are paying for and how to pay which tends to lead to nonpayment, which can lead to serious negative credit implications for the patient. This is where we feel the HFMA guidelines fall short of defining best practices for the entire financial communication process.

But let’s give credit where it’s due and talk about a few of the things that the document does get right. First, the best practices put Patient Care first in every scenario, which is obviously most important. The financial aspect of an episode of care can only come second to the patient’s health being taken care of with the utmost regard. The guidelines also talk about giving patients an estimate of charges upfront, which is a great thing to ensure patients are on the same page about what they are being charged for. This will help clear some confusion when the actual statement comes out after the episode of care. However it does not negate the need for better communication after the episode of care.

Prior balance discussions are also a large part of these guidelines. However, you must have the right technology to have visibility across the entire IDN to be able to have these discussions. Often times, this is not the case. There is a brief mention in these guidelines of having technology in place to pull off these kinds of discussions and gather and interpret this data, but I suspect providers will need more clarity in this area.

So while these guidelines are a good start with the three scenarios presented (Emergency Department, Time of Service, and Advance of Service) there should really be a fourth: “After Service.”

There should be clear communication guidelines as to how the patient should be communicated with through the statement process both in traditional paper methods and electronic. Patients should have proper access to communicate securely back to their provider with any questions regarding their statements or charges. Patients should also have proper access to tools to manage all of their healthcare expenses in one convenient place as well as multiple simple payment options to suit their needs. Most providers today are not up to date with payment options that patients are used to in other consumer industries like easy online bill pay, automated phone payment systems and integrated POS processing systems.

The HFMA guidelines for Patient Financial Communications Best Practices are all about creating a better experience for the patient, as they should be. However, proper financial communication does not stop at the hospital doors. It continues long after the episode of care, until the patient’s financial responsibility is taken care of. That’s why we believe that while the latest HFMA guidelines are a great start, they fall short of fully serving patients in the financial aspect of healthcare.