Browse by Topic
More than 40,000 members value HFMA's thought leadership and practical strategies. HFMA is where you need to be.
Get acquainted with the
healthcare finance industry's leading professional association. Find out why our
members rely on HFMA as their go-to source for insight and
Members have many
options for helping them advance their careers. Conferences, seminars,
eLearning, certification, and more -- our education and events will keep you
Connect the dots on today's big issues, explore collaborations, get career-boosting tips, and network with colleagues nationwide at the leading finance conference. Save $100 off the full conference rate when you register by May 8.
Real-time presentations with nationally recognized experts, networking opportunities, and industry solutions—no travel required!
Learn about timely healthcare finance topics and earn CPEs. Most live webinars are free for HFMA members and $99 for non-members. View the latest schedule.
If you're a subscriber to any of our three newsletters, you have access to online education. Learn more or subscribe.
Get the perspectives of leading healthcare finance professionals on today's hottest issues.
Information about leading vendors helps your buying decisions.
Forum members can network during live webinars or access a library of past webinars on topics such as bundled payment, charity care, and ICD-10.
An ever-expanding collection of spreadsheets, policies, job
descriptions, checklists, and more that you can adopt and adapt.
Forum members can submit vexing questions to a panel of experts
using our Ask the Expert service.
Your source for employment solutions.
Find new employment opportunities or
reach out to qualified candidates.
Distinguish yourself as a
leader among your peers and advance your career by earning certification in our
healthcare finance programs.
Get an objective third-party evaluation of products and services used in the healthcare finance workplace.
MAP App is a web-based application that helps organizations improve revenue cycle performance based on industry-standard metrics called MAP Keys.
Find suppliers and products in this comprehensive vendor directory for healthcare finance professionals.
Guidance for understanding and communicating about the price of health care.
Transformation toward value-based healthcare is reshaping the delivery of care, patient expectations, and payment structures.
Improve your revenue cycle performance through standard metrics, peer comparison, and successful practices.
When the economy stumbled in 2009, Sharp HealthCare, a seven-hospital system in the San Diego area, saw its self-pay collections fall by $3.4 million in a single year. Gerilynn Sevenikar, vice president of hospital revenue cycle, pulled together staff members representing a broad range of perspectives—access services, billing, information services, private pay contracts, and others—to brainstorm solutions.The group ended up overhauling the health system’s four billing statements using Patient-Friendly Billing® principles, in addition to adopting other patient engagement tactics The result: Self-pay collections rebounded to their historically normal levels in 2010, even though the economy had not recovered. In addition, phone calls from confused patients fell sharply.“This has definitely been the right thing for us from a patient-relations perspective and from a cash-flow perspective,” Sevenikar says.
Before redesigning the patient bills, Sevenikar, a Lean Six Sigma green belt, organized an information-gathering event to identify problems with the existing documents. The front and back of the bill were taped to poster board, and about 30 front-line staff pointed out problems that patients had with the statements.“I had our customer service unit and self-pay collections staff conduct a gallery walk around the room, documenting the issues that generated the most phone calls from patients who received our statements,” she says. “They represent the voice of our customers. They hear directly what our customers are saying, what aggravates them, what works, what never makes sense, and they know what questions they are answering over and over again.”Sevenikar then accessed HFMA’s Patient Friendly Billing materials, which provide guidance on issues from type size and layout for billing statements to wording. She also reviewed the tapes from patient focus groups that had been conducted a few years earlier and found that patient comments mirrored the feedback from her customer service staff.
Sevenikar then created a draft billing statement that reflected Patient Friendly Billing principles and the issues that Sharp’s staff and patients had identified. Next, Sevenikar and the group took the following steps.A second gallery walk to review the draft. Staff from the customer service unit and private pay collections reviewed the revised draft bill in comparison to the existing bills and made another round of comments.Input from marketing. After that feedback was incorporated into the draft, Sevenikar asked Sharp’s marketing team for input and was advised to make the balance-due information more prominent. Marketing staff members also suggested a few wording changes that Sevenikar found helpful. “They are able to look at it as an audience that has nothing to do with collections,” she says. “So they are able to put themselves into the shoes of a patient probably a little easier than my own team.”Implementation. The new bill was presented to Sharp’s CFO for approval, translated into Spanish, and implemented—just seven months after the health system decided to redesign its bills.
Sharp’s previous bill had a long narrative that went away with the redesign. “Simplify billing statements, keep like information together, make it easy for a patient to see what the bill is for, and keep the narrative to a minimum,” Sevenikar says.The new bill includes a summary of patient charges, which had not been included in the old bills. It also stacks the billed charges and adjustments in a single column so patients can see how the balance due has been calculated.Be patient friendly. Sevenikar’s top priority in redesigning Sharp’s patient bill was to change the tone of the document. “Most important, I wanted to use words that assume the best of our patients instead of assuming that patients are trying to avoid paying their bills,” she says.For example, the new bills include a sentence that apologizes if the patient’s payment and Sharp’s most recent bill crossed in the mail.Do away with misguided statements. Before the overhaul, the first statement that Sharp’s patients received said, “Thank you for choosing Sharp HealthCare to serve your healthcare needs.” However well-intentioned, it irked patients.“Many patients were upset at the inference that they ‘chose’ us when they were brought by ambulance or their physician actually made the decision to come to Sharp and ‘choice’ was never a consideration,” Sevenikar says. “When you get a hospital bill and you don’t have insurance, this statement is a little aggravating.”Another annoyance: The phrase “Balance due now.” “Patients thought ‘I have 20 days to pay, don’t I? How dare you tell me it’s due now?’” Sevenikar says.
In addition to increasing self-pay collections, the redesign accomplished Sevenikar’s goal of decreasing phone calls from patients who had questions about their bills. The call volume to Sharp’s customer service unit immediately dropped when the new bills were introduced.
Equally important, the new bills encourage patients to call if they need help. “They do have a debt, and it’s not going to go away unless they communicate with us,” Sevenikar says. “We want to help patients feel comfortable about making a phone call if they need help resolving the balance.”
While Sevenikar is pleased with the billing statement overhaul, she says Sharp also adopted several other tactics to help the system recover from the rocky patch in 2009. Talking to patients while they are in the hospital. Financial navigators meet with hospitalized patients who have high out-of-pocket responsibilities, or their families, to discuss the funding options that might be available, including financial assistance and charity care. Encouraging compassionate conversations. Sharp provided training to customer service and private-pay collection staff to help them talk to patients about financial issues in a considerate and kind-hearted way. “If we can enter into a compassionate and caring dialogue with patients, then they may be more likely to feel like they have a relationship with Sharp and some responsibility to pay their debts,” Sevenikar says. “In some cases, patients end up contributing something towards their hospital bills, instead of just turning and walking away.”Seeking out other sources of financial assistance. Sharp contracted with an agency to help patients apply for Medi-Cal and other public funding programs in California. In addition, the health system contracted with a company that offers patients low-interest loans so they can pay off their medical debts over time.For Sharp, it was not just a revision of the statements that contributed to the increase in cash flow, Sevenikar says: “It was a comprehensive effort to improve our patient engagement in a lot of different ways.”
View a comparison of Sharp’s previous statement and its newly designed billing statement by clicking on the following links: Sharp HealthCare's Old Statement
Sharp HealthCare's New Statement
Lola Butcher is a freelance writer and editor based in Missouri. Quoted in this article:Gerilynn Sevenikar is vice president of hospital revenue cycle, Sharp HealthCare, San Diego, and a member of HFMA’s San Diego-Imperial Chapter.
Publication Date: Wednesday, May 15, 2013
Tom Myers, chief strategy officer, The SSI Group, discusses the shifting payment environment and how it affects providers' patient access and claims management processes.
Jeff Chester, senior vice president and chief revenue officer at Availity, shares his thoughts on "Revenue Cycle 2.0" and how to best meet its challenges.
Mitch Morris, vice chair and global leader, healthcare, Deloitte, and Michael O'Rourke, senior vice president and chief information officer, Catholic Health Initiatives (CHI), share perspectives on the need for transformational IT in health care today.
Brian Kueppers, founder and CEO, Apex, discusses the importance of a robust patient payment strategy in boosting organization revenue and enhancing patient satisfaction.
Brian Grazzini, CFO, HealthPort, describes the importance of efficient and compliant information exchange and audit management in helping HIM staff spend less time on paperwork and more on mission-critical projects.
Cindy Matthews, executive vice president, Community Hospital Corporation, discusses how rural and community hospitals can use collaborative partnering to position for success through tough market conditions.
Rick Heise, senior vice president, revenue cycle, at Cerner Corporation, discusses the importance of integrating clinical and financial data to excel in health care’s changing payment environment.
Russ Graney, founder and CEO for Aidin, and John Laursen, head of business development for Aidin, share insights on how to improve care transitions between acute and post-acute care settings and incentivize high-quality patient outcomes.
Scott Elston, strategic accounts manager, GE Healthcare Services, describes how substantial cost reduction in health care requires rethinking business strategy and asset use.
Robert Williams, MD, director, Deloitte Consulting LLP, and Arielle Freiberger, product strategist, ConvergeHEALTH by Deloitte, explain how sophisticated retrospective, real-time, and predictive data analytics can inform decision making to reduce costs and improve care.
Stuart Hanson, director of business development (healthcare solutions) at Citi Retail Services, discusses how improving the payment experience can benefit consumers and healthcare providers.
HFMA's print, email, online, and mobile opportunities provide you maximum reach and impact. We will work with you to build a plan that meets your needs. Contact a sales rep.
HFMA offers online, email, and print opportunities to help you recruit the most talented healthcare finance professionals. Place your classified ads today.
Drive down costs while improving quality in a reform environment.
Stay informed about new directions in healthcare finance. Share tools and strategies for improving performance. Be an active participant in your profession. Together, we’ll reshape the business and practice of healthcare. Join us.
©2015 Copyright Healthcare Financial Management Association
HFMA.org is best viewed using IE9 or the latest versions of Chrome, Firefox, and Safari.
Join HFMA today and enjoy: