Richard L. Clarke, DHA, FHFMA

Remember "Alfie," the song that Dionne Warwick sang back in the '60s?

The song asks, "What's it all about, Alfie?" It's a question about the broader meaning of life, especially given the day-to-day struggles that cause us to focus narrowly on the task at hand.

Revenue cycle work can be like that.

The revenue cycle-in the fullest form-is a series of processes that enable a provider to receive all payments that are appropriately due for services rendered. The processes are complicated, and it's easy to get lost in the details. We sometimes lose track of what it's all about. Why do we focus on ensuring all payments that are appropriately due are made?

Catherine Jacobson, FHFMA, CPA, HFMA's Chair for 2009-10, said it best. It's about "making it count"-her theme for this year. During her speech at this year's ANI, Jacobson used an example of a registrar named Paula at Rush University Medical Center. Paula often talks about her patients. Paula was quoted as saying, "I'm the first person many patients see…and they're often frightened or in pain. I can make them feel better if I listen and given them clear information."

A key element of providing clear information is helping patients and families understand their financial responsibilities for care, and what services or programs are available to help them if needed. Many patients are unaware of how a hospital can help them deal with what often is an unexpected financial obligation. Providers that know what it's all about ensure that staff are trained and resources are available to help patients and their families navigate through these options. One option may be helping them sign up for Medicaid or the State Children's Health Insurance Program. Other options may include help patients understand private insurance options that may be available. And clearly, one option is financial assistance through the hospital's charity care policy.

But during a recent study, we found that some finance executives believe that the hospital's charity care policy often conflicts with the goal of collecting what is due. Although most hospitals have charity care policies, some do not actively promote them for fear they will be used. But isn't using them what it's all about?

Provider organizations must receive sufficient cash flow to ensure sustainability in the long term for the benefit of the larger community they serve. And their community benefit commitments, including the charity care policy, should match what they can afford to deliver given their financial capacity. But within that financial capability, their focus should be on helping patients and their families access and pay for needed medical services. I believe that includes ensuring those who need financial assistance receive it according to a well-published and supported charity care policy.

That's what it's all about.

Publication Date: Tuesday, September 01, 2009

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