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Strategize for success with the nation's top performers at HFMA's Revenue Cycle Conference (MAP Event) from Sept. 25-27 in Phoenix, Arizona. Register now.
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Stay up-to-date in a rapidly changing industry in Fort Lauderdale (Nov.16-18) and Chicago (Dec. 12-14). Register early and save.
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Forum members can network during live webinars or access a library of past webinars on topics such as ICD-10 implementation, CMS audits, bundled payment, charity care, KPIs, and more.
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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.
MultiCare Health System increased point-of-service revenue by $1 million per year through staff training, goal setting, and establishing accountability.
Increase payment frequency and timeliness by consolidating statements for services rendered during a single healthcare encounter.
South Lyon Medical Center reduced A/R days and increased net revenue per patient by using metrics and a dashboard designed for small rural hospitals.
MultiCare Health System developed scripts to help patient access staff feel more confident when encouraging patients to pay their bills and to standardize collection practices across the organization.
Midland Memorial Hospital’s phone triage system helps non-urgent patients locate a less costly alternative to ED care.
Department: Patient Accounting /Insurance Follow-Up Goal Jan 2012 Feb 2012 Mar 2012 Apr 2012 May 2012 Jun 2012 Jul 2012 Aug 2012 Sep 2012 Oct 2012 Nov 2012 Dec 2012 >= 100% 4 Score Score Score Score Score Score Score Score Score Score Score Score 98 -99% 3 97 -98% 2 Result Result Result Result Result Result Result Resu
Patient accounting supervisors at Centra Health use this form to track and assess how well employees follow up on insurance claims.
How do hospitals and physician practices resolve small balance adjustments?
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Adapt this cashier job description for your organization.
Providence Health System developed a patient billing statement that encourages faster payment.
How can we fairly compare two bad debt agencies?
This article provides metrics for payer and reimbursement, collections, and revenues for U.S. hospitals by geographic region.
Implementing a revenue integrity program based on collaboration among finance and clinical departments resulted in additional net revenue of almost $11 million over the past three years.
Header Information Document Body Finance & Business Administrative Policy Manual Policy Name: Finance Ch 04: Claims Follow-up -Insurance Claim Follow-Up Policy ID Number: ADM.04.04.29 Start Date: 02/15/2008 Approval Date: 02/15/2008 Approved by: Joseph Koons Last Reviewed On: 02/04/2011 Document Type: Policy Policy Dep
In the fourth quarter of 2012, existing patient visits brought in more revenue than new patient visits for selected service lines, and had lower denial rates.
By dramatically improving the clean-claim rate and related billing processes and systems, Titus Regional Medical Center reduced overall third-party accounts receivable by 30 percent.
Adding to internal expertise, partnering with staffing, technology, or business intelligence providers, or using a combination of these—or outsourcing the function entirely—will better equip a physician organization to survive within the new reality of rising costs and declining revenue.
The rise in electronic claims submission has expedited receipt and processing of claims and reduced the cost of claims adjudication.
Look for only moderate documentation changes in the transition from ICD-9 to ICD-10, but be alert for several key differences.
By engaging employed physicians in revenue cycle management, hospitals can move the needle on key revenue cycle metrics.
Revenue Cycle Leadership Team & Functional Organizational Chart Vice President Revenue Cycle Executive Director Middle Revenue Cycle Executive Director Revenue Cycle Patient Access Executive Director Revenue Cycle Patient Financial Services EVP & CFO Finance Executive Director Revenue Cycle Business Support Services Ex
Every healthcare organization should consolidate unclaimed property analysis and reporting to reduce compliance risk and generate savings.
Simplified Solutions from Our Sponsor
Six tips to a patient friendly portal
In the world of website design, aesthetics are only a small part of the story. A truly well-designed site is much more than a pretty (inter)face. It is simple for users to navigate, offers effective visual communication, and guides and prompts interaction. Although an attractive appearance may serve as a site’s positive first impression, the graphical user interface (GUI) must join function with form to make a site intuitive and useful for visitors.
This truth becomes increasingly important for websites that provide online payment capabilities and account access.
Intuitive Online Payment
Every color, word, and graphic element must be created and placed judiciously to enhance users’ experiences and influence behavior so they easily conduct business online. Every click should innately lead to the next so that users complete payments barrier-free rather than abandoning their attempts out of frustration.
If your organization is like many in health care, you already have or are planning to introduce a web-based payment portal to capture revenue and provide convenience for patients. Across our industry, we’re seeing providers achieve measurable increases in collections thanks to the simplicity and immediacy of online payment options. Just by having a payment portal, providers increase the odds of receiving settlement from patients. However, imagine how those odds could be improved further by thoughtfully designing the portal for intuitive navigation and ease of use.
How Well Designed Is Your Portal?
Does your portal look and run like something from the MS-DOS era? Is its beauty only screen deep? Or does its form and function work in harmony to evoke action from users, resulting in more revenue for your organization?
Here are some key considerations to ensure your GUI is all it should be and more.
Begin with your brand. If good design is about more than aesthetics, why is branding mentioned first on this list? Your branding represents your organization. From a visitor’s first moment on your portal, they must be assured they’re in the right place and interacting with the trusted entity they sought out. By clearly showing your brand, you provide a virtual welcome mat for your users, offering peace of mind that they are providing payment information in a trusted, secure environment.
Keep it simple. Good design often hinges on what’s left out as much as what’s included. An inviting, well-designed GUI is uncluttered, artfully edited, and free of unnecessary elements so that essential features get the spotlight. There’s typically no need for extensive copy on the home page of a payment portal. Users come to such sites with general working knowledge of expected functionality, so eliminate thick blocks of text and always go with standards of patient-friendly billing. The following example illustrates a simple, yet effective portal page.
Link: PFB page. Use new URL after new site launch.
INSERT EMDEON MYDESKTOPACCOUNT FILE SAVED IN JAN PFB FINAL FOLDER. Source: Emdeon, Nashville, Tenn. Used with permission.
Offer immediate and easy interaction. Make sure the login area of your payment portal is obvious and easy to click on from the main page, and build in prompts to encourage site users to sign in right away. It’s vital for users to login as quickly as possible so that users are primed and ready to access their accounts and make payments.
Communicate through layout and design. Use colors, graphic elements (static or animated), and text call-outs to influence visitor behavior. Draw attention to key, action-oriented information by formatting it in a brighter color and using a bold font. Include visual buttons to invite clicks. These buttons are known in the world of web design to prompt response. Give the page layout enough white space (areas without text or graphics) to ensure that your messaging remains uncluttered.
Mobilize your efforts. Each day, more people are accessing the Internet through mobile devices. Smartphones and tablet computers account for an ever-increasing percentage of web traffic, so be sure your site looks and functions as well on different screen sizes and in various operating systems as it does on a standard desktop or laptop computer. Ideally, your site should have mobile detection so that a mobile-optimized version of the site loads automatically depending on what device is accessing it.
Prioritize secure architecture. Build layers of security into your entire site design. It’s recommended to require authentications and go with a third-party verification service to provide constant assurance to users that their transactions and account information are protected. Include visual reminders of the secure measures you’ve taken to protect your site to give users subtle, constant certainty. Make privacy statements available, as well.
Employing these artful measures when designing (or redesigning) your patient payment portal will provide patients with the ease and convenience of online account status tracking and payments they’ve come to expect in this era of online commerce. Likewise, you’ll be able to capture more prompt, complete payments for your organization. And that’s a well-designed arrangement for everyone!
Emdeon Patient Pay Online is a self-service patient application that provides online billing and payment management. Patients can access their providers' websites and view, manage, and pay their accounts online.
Hospitals that have a policy for paying patients' COBRA payments provide a valuable financial service to patients.
In this Business Profile, Bruce Haupt, president and CEO of ClearBalance, discusses how a patient loan program can increase patient collections, reduce bad debt, and speed cash flow.
In this Business Profile, Jerry Bruno, principal with Deloitte Consulting LLP, discusses the importance of choosing revenue cycle solutions that help an organization meet the challenges of a quickly evolving healthcare environment.
In this business profile, Lane Jackson, a partner in the Grant Thornton LLP Health Care Advisory Services practice, with extensive experience in overseeing system implementations and revenue cycle reorganizations, discusses best practices for elevating revenue cycle performance during an EMR implementation. Grant Thornton LLP is a sponsor of the Large System Controllers Council Affinity Group.
In this business profile, Amy Gross, senior vice president of Key Government Finance, discusses the benefits of private placement transactions to support large-scale financing projects.
In this business profile, Doug Polasky, executive vice president at Xtend Healthcare, explains the importance of having sound workflow processes in a consolidated business office to ensure optimal performance and reduce costs.
In this business profile, sponsored by SSI, Jay Colfer, vice president of sales and marketing, shares how patient access solutions are reversing the trend toward increased bad debt resulting from the rise in high-deductible consumer health plans.
In this business profile of Deloitte Consulting, Matthew Hitch and David Betts explore the potential benefits of elevating the customer experience and outline strategies to change service delivery.
TriMedx helps health systems control costs and uncover savings opportunities by optimizing the clinical engineering function.
Patient financial engagement is more challenging than ever – and more critical. With patient responsibility as a percentage of revenue on the rise, providers have seen their billing-related costs and accounts receivable levels increase. If increasing collection yield and reducing costs are a priority for your organization, the metrics outlined in this presentation will provide the framework you need to understand what’s working and what’s not, in order to guide your overall patient financial engagement initiatives and optimize results.
No two patients are the same. Each has a very personal healthcare experience, and each has distinct financial needs and preferences that have an impact on how, when and if they chose to pay their healthcare bill. It’s no longer effective to apply static billing techniques to solve the complex challenge of collecting balances from patients. The need to tailor financial conversations and payment options to individual needs and preferences is critical. This presentation provides 10 recommendations that will not only help you improve payment performance through a more tailored approach, but take control of rising collection costs.
This white paper, written by Apex Vice President of Solutions and Services, Carrie Romandine, discusses the importance of patient segmentation and messaging specifically related to the patient revenue cycle. Applying strategic messaging that is tailored to each patient type will not only better educate consumers on payment options specific to their billing needs, but it will maximize the amount collected before sending to collections. Further, targeted messaging should be applied across all points of patient interaction (i.e. point of service, customer service, patient statements) and analyzed regularly for maximized results.
This white paper, written by Apex President Patrick Maurer, discusses methods to increase patient adoption of online payments. Providers are now seeking ways to incrementally collect more payments due from patients as well as speeding up the rate of collections. This white paper shows why patient-centric approaches to online payment portals are important complements to traditional provider-centric approaches.
Increased electronic engagement between healthcare providers and patients provides significant opportunities for improving revenue cycle metrics and encouraging patients to access EHRs. This article, written by Apex Founder and CEO Brian Kueppers, explores a number of strategies to create synergy between patient billing, online payment portals and electronic health record (EHR) software to realize a high ROI in speed to payment, patient satisfaction and portal adoption for meaningful use.
Faced with a rising tide of bad debt, a large Southeastern healthcare system was seeing a sharp decline in net patient revenues. The need to improve collections was dire. By integrating critical tools and processes, the health system was able to increase online payments and improve its financial position. Taking a holistic approach increased overall collection yield by 10% while costs came down because the number of statements sent to patients fell by 10%, which equated to a $1.3M annualized improvement in patient cash over a six-month period. This case study explains how.
With the ICD10 deadline quickly approaching and daily responsibilities not slowing down, final preparations for October 1 require strategic prioritization and laser focus.
Read how Gwinnett Medical Center provides clear connections to financial information, offers multiple payment options for patients, and gives onsite staff the ability to collect payments at multiple points throughout the care process.
Read how Orlando Health was able to perform deeper dives into claims data to help the health system see claim rejections more quickly–even on the front end–and reduce A/R days.
To maintain fiscal fitness and boost patient satisfaction and loyalty, healthcare providers need visibility into when and how much they will be paid–by whom–and the ability to better navigate obstacles to payment. They need payment clarity. This whitepaper illuminates this concept that is winning fans at forward-thinking hospitals.
Financial services staff are always looking for ways to improve the verification, billing and collections processes, and Munson Healthcare is no different. Read about how they streamlined the billing process to produce cleaner bills on the front end and helped financial services staff collect more than $1 million in additional upfront annual revenue in one year.
Effective revenue cycle management can be a challenge for any hospital, but for smaller providers it is even tougher. Read how Wallace Thomson identified unreimbursed procedures, streamlined claims management, and improved its ability to determine charity eligibility.
Before launching an energy-efficiency initiative, it’s important to build a solid business case and understand the funding options and potential incentives that are available. Healthcare leaders should consider taking the steps outlined in the whitepaper to ease the process of gaining approval, piloting, implementing, and supporting sustainability projects. You will find that investing in sustainability and energy efficiency helps hospitals add cash to their bottom line. Discover how hospitals and health systems have various options for funding energy-efficient and renewable-energy initiatives, depending on their current financial structure and strategy.
Health care is a dynamic mergers and acquisitions market with numerous hospitals and health systems contemplating or pursuing formal arrangements with other entities. These relationships often pose a strategic benefit, such as enhancing competencies across the continuum, facilitating economies of scale, or giving the participants a competitive advantage in a crowded market. Underpinning any profitable acquisition is a robust capital planning strategy that ensures an organization reserves sufficient funds and efficiently onboards partners that advance the enterprise mission and values.
The success of healthcare mergers, acquisitions, and other affiliations is predicated in part on available capital, and the need for and sources of funding are considerations present throughout the partnering process, from choosing a partner to evaluating an arrangement’s capital needs to selecting an integration model to finding the right money source to finance the deal. This whitepaper offers several strategies that health system leaders have used to assess and manage capital needs for their growing networks.
Announcements from several commercial payers and the Centers for Medicare and Medicaid Services (CMS) early in 2015 around increased efforts to form value-based contracts with providers seemed to point to an impending rise in risk-based contracting. Rather than wait for disruption from the outside in, health care providers are now making inroads on collaborating with payers on various risk-based contracting models to increase the value of health care from within.
Yuma Regional Medical Center (YRMC) is a not-for-profit hospital serving a population of roughly 200,000 in Yuma and the surrounding communities.
Before becoming a ZirMed client, Yuma was attempting to manually monitor hundreds of thousands of charges which led to significant charge capture leakage. Learn how Yuma & ZirMed worked together to address underlying collections issues at the front end, thus increasing Yuma’s overall bottom line.
Kindred Hospital Rehabilitation Services works with partners to audit the market and the facility’s role in that market to identify opportunities for improvement. This approach leads to successes; Kindred’s clinical rehab and management expertise complements our partners’ strengths. Every facility and challenge is unique, and requires a full objective analysis.
As the critical link between patient care and reimbursement, health information enables more complete and accurate revenue capture. This 5-Minute White Paper Briefing shares how to achieve cost-effective revenue integrity by your optimizing HIM systems.
Speedier cash flow starts with better CDI and coding. This 5-Minute White Paper Briefing explains how providers can improve vital measures of technical and business performance to accelerate cash flow.
Qualified coders are getting harder to come by, and even the most seasoned professional can struggle with the complexity of ICD-10. This 5-Minute White Paper Briefing explains how partnerships can help improve coding and other key RCM operations potentially at a cost savings.
The point of managing your revenue cycle isn’t just to improve revenue and cash flow. It’s to do those things effectively by consistently following best practices— while spending as little time, money, and energy on them as possible.
How Lucile Packard Children’s Hospital Stanford increased payments received within 45 days by 20% and reduced paper submission claims by 70% by using ZirMed solutions.
The reasons claims are denied are so varied that managing denials can feel like chasing a thousand different tails. This situation is not surprising given that a hypothetical denial rate of just 5 percent translates to tens of thousands of denied claims per year for large hospitals—where real‐world denial rates often range from 12 to 22 percent. Read about how predictive modeling can detect meaningful correlations across claims denials data.
Emergency Mobile Health Care (EMHC) was founded to be and remains an exclusively locally owned and operated emergency medical service organization; today EMHC serves a population of more than a million people in and around Memphis, answering 75,000 calls each year.
Since the Physician Quality Reporting Initiative (PQRI) introduction, CMS has paid more than $100 million in bonus payments to participants. However, these bonuses ended in 2015; providers who successfully meet the reporting requirements in 2016 will avoid the 2% negative payment adjustment in 2018, so now is the time to act! Included in this whitepaper are implications of increasing patient responsibility, collections best practices, and collections and internal control solutions.
Getting paid what your physician deserves—that’s the goal of every biller. Yet even for the best billers, achieving that success can be elusive when denials stand in the way of success, presenting challenges at every turn. Denials aren’t going away, but you can learn techniques to manage and even prevent them.Join practice management expert Elizabeth W. Woodcock, MBA, FACMPE, CPC, to: Discover methods to translate denial data into business intelligence to improve your bottom line, determine staff productivity benchmarks for billers, and recognize common mistakes in denial management.
Physician practices must improve organizational efficiency to compete in this era of reduced reimbursement and escalating administrative costs.
Many healthcare organizations are pursuing next-generation health information systems solutions. Learn more about Navigant's work with University of Michigan Health System.
The proper implementation of healthcare information technology systems is crucial to an organization’s financial health.
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