HFMA releases draft patient financial interactions guidelines

The Healthcare Financial Management Association has released draft best practices to help patients sort through increasingly complex, confusing and complicated healthcare payment structures and access and pay for the health services they need.

The draft guidelines, revealed Sunday at the HFMA's annual conference in Orlando, Fla., focus on financial interactions when medical services are scheduled and during both emergency and non-emergency care. They offer guidance on when and how to communicate information 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.

"Healthcare financial interactions can be complex and confusing because of complicated payment structures, dozens of different payers and forms, and varied government programs," Joseph J. Fifer, president and CEO of HFMA said during the announcement.

"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."

Fifer said the best practices are critical to the association's ongoing effort to establish more consistent and financial practices that are fair to all stakeholders while helping patients access and pay for the healthcare they need.

The draft guidelines were developed by a steering committee that included leaders from HFMA, the National Patient Advocate Foundation (NPAF), the American Hospital Association, Harvard Medical School and America's Health Insurance Plans. The public can comment on the draft best practices until July 31. HFMA plans to release final guidelines in the fall for voluntary adoption.

"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," said Nancy Davenport-Ennis, president and CEO of the NPAF.

The patient financial interactions project was overseen by an advisory panel consisting of former Senate majority leaders Tom Daschle (D-S.D.) and Bill Frist (R-Tenn.), former Secretary of Health and Human Services Donna Shalala, former Republican Utah Gov. Michael Leavitt and attorney Jamie Gorelick.

To learn more:
- read the draft guidelines
- access Fifer's announcement