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Initiatives

Guidelines for Consumer-Focused Hospital Financial Services

June 2015

Making the Financial Interaction Consumer-focused

Compassion, patient advocacy, and education should be part of all patient discussions.

The needs of patients and family members should be paramount when designing administrative processes and communications for financial services.

All financial communications should be easy to understand, and written in language appropriate to the communities and patients served. Hospitals should strive to use standardized terminology. (Refer to the Healthcare Financial Management Association’s Understanding Healthcare Prices: A Consumer Guide, containing common definitions––Page 20.)

Providers should have a dedicated number that is widely publicized that patients can call to receive assistance in financial matters and concerns they may have.

Preparing for the Financial Interaction

Providers should gather detailed information before and at the time of service to prospectively estimate patients’ expected out-of-pocket expenses.

Information gathering should be coordinated with other providers and insurers, and this collection process should be done efficiently, privately, and with as little duplication as possible.

Providers should be transparent about what is included in the estimate and what is not included in the estimate, such as costs for out-of-network services or overhead or facility fees. Elective procedures should be defined by individual provider organizations to ensure patients are properly informed regarding their financial obligations.

Whenever possible, communication of financial information should not occur during the medical encounter.

Providers should maximize the use of technology, such as their website, to make financial services information readily available to consumers and to create a direct line of communication to the appropriate staff support.

Integrating Consumer-focused Financial Transactions as a Best Practice

All personnel engaging in patient financial discussions will receive periodic training on the following:

  • Patient financial communications best practices
  • Financial assistance policies
  • Common coverage solutions for the uninsured and underinsured
  • Customer service

Providers should ensure broader education and awareness of the best practices throughout the organization.

Continuous improvement of the billing process should be made by implementing better practices and incorporating feedback from patients and consumers.

Download a copy
of Principles and Operational Guidelines for Consumer-focused Hospital Financial Services 

June 2015

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