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.
The processes and technology that Duke is putting into place will improve cash flow and collection practices, regardless of how the consumer-directed health movement develops.
Hawig: A fraction of Duke's total annual collections are received directly from patients, but some projections suggest patient out-of-pocket expenditures will double over the next 10 years, so clearly there is a huge bottom-line impact.
The average self-pay patient liability is less than it was a year earlier, but the average patient liability after insurance increased during the same time period. The mix of patients that owe Duke money is changing, and it may be a sign that high-deductible plans and consumer-directed health care are increasing in our market.
A variety of factors can contribute to patient receivables aging over 120 days. For example, we may be having continuing dialogue with the patient, or we are manually reviewing that account to make sure that all prior activity has been processed appropriately, or we are checking to make sure the patient does not have insurance or does not meet our charity care guidelines. If we don't collect money from patients upfront, we exert significant manual effort after the fact.
Another reason some of these accounts are old is that a patient is paying off the balance via a payment plan. There's an administrative cost to that, of course. And we have a problem with bad addresses, where the accounts get old simply because we cannot find the patients.
Hawig: About two years ago, we performed a labor study of our front-end staff. We had management engineers map out and time the various tasks performed by our registration staff. The goal was to develop a labor standard for our front-end operations so that, if our clinics experience volume changes or we add new clinics, we can better project how to staff that clinic.
An additional benefit of the labor study were the scripting and processing best practices we were able to observe and quantify. For example, some clinics compiled visit documentation for upcoming patient visits the afternoon before the patient arrived, mitigating delays and patient wait lines each morning. We were able to share these best practice scripts and processes across the other clinic locations.
Additionally, the registration labor standard helps us as we consider new technologies and process changes. To calculate a ROI, we need to know how much a certain process is costing us today, and the labor standard provides that information. For example, business cases for technologies such as remote deposit capture devices, kiosks, and web portal registrations were developed because we understand our labor costs so well.
We have also improved the scripting that our front-end staff use, as well as the pre-arrival communication and check-in signage, to make sure that patients understand our financial policies and the options they have. Our goal is to make sure that patients understand our payment expectations.
For example, when a patient presents at check-in, our staff can determine whether any money is owed across the hospital and physician providers we serve and there is a script that prompts the staff member to ask for payment.
And we have rolled out a significant amount of training because we think the responsibilities of our front-end staff are ever increasing. We are training on topics like identity theft and payment card industry regulations so our staff members understand some of the new responsibilities associated with collecting payment from patients.
Hawig: We are using two estimation tools because this technology is still relatively new, and we want to compare the tools in terms of estimation accuracy, integration with our workflow, and ability to provide a global estimate of what the patient will owe both the hospital and physicians. After we evaluate the two, we intend to use a single tool.
If a patient has an estimated liability of more than $350, we call the patient one to three days before the scheduled appointment to inform them of the payment expectation and we ask them if they would like to pay at that time. If the patient balance is estimated to be less than $350, we use an automated call system to notify and request payment.
We also have a web portal that allows patients to schedule and cancel return primary care visits, request appointments for new and specialty visits, advance register, check their account balances, pay by credit card, update insurance information, check lab and radiology test results, and perform several other functions.
Hawig: At this point, we have more than 60,000 accounts established in our web portal, and that is growing by 5,000 to 7,000 accounts a month. More than 11 percent of our web portal log-ins result in payment. That is nearly 3,500 payment transactions a month.
Despite the downturn in our economy last fall, our upfront collections continue to grow, driven by collections on the insured patient's out-of-pocket liability. We believe we are using some effective strategies, including providing an estimate upfront, a web portal that lets people check their balances, and scripting for our front-end staff.
Interviewed for this article: Scott Hawig is divisional CFO of the Patient Revenue Management Organization at Duke University Health System in Durham, N.C. (firstname.lastname@example.org)
Publication Date: Monday, September 21, 2009
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: