By Richard L. Clarke, DHA, FHFMA
In November 2002, the HFMA Board received and approved the report of the Patient Financial Services Task Force. The task force, which was created by 2001-02 National HFMA Chairman Ron Long, FHFMA, examined issues surrounding the patient financial services (PFS) profession, including an analysis of current demographics (age, gender, length of service, education), needs, and expectations of employers, including CFOs. The task force also identified industry gaps and recommended ways to fill these gaps. The task force members include HFMA Chairman-Elect, David P. Canfield, FHFMA (the task force chairman); Ronald D. Anspaugh, FHFMA; Keith Eggert; Bobette M. Gustafson; Diane M. Hart, FHFMA; John A. Orsini, CPA; and Brenda Snow.
Although the purpose of the task force was to recommend actions to enhance the overall performance of the PFS professional and the PFS function, it became clear that these professionals have a key role related to the revenue cycle.
The task force created several foundational documents to help define and support the revenue cycle and the PFS function. In these documents, the task force examined the changing role of the PFS manager from a billing and collections supervisor to an important leader in the revenue cycle. The PFS manager must help integrate these new revenue-cycle responsibilities within the finance team, enhance data management skill sets, move the business office focus from collections to front-end data management, improve customer service, effectively use electronic data interchange, and foster integration and support for effective collection of clinical information.
Several other resources have grown from the task force's efforts. An in-depth article, "A New Day for Patient Financial Services," which appeared in the September 2002 issue of Healthcare Financial Management, summarizes many aspects of the redefined revenue cycle. "The Patient Financial Services Profile," released at 2002 ANI, represents the perspectives of industry leaders and 274 survey respondents. This report was made possible through the efforts of HFMA's Patient Financial Services Forum Advisory Council, task force members, and HFMA staff. Also, HFMA initiated a new fall Revenue Cycle Strategies Conference in part from information generated by the task force. That meeting was so successful that another conference will be held on April 27-29, 2003, in New Orleans.
The task force's work culminated in several recommendations related to the changing role and needs of the PFS professional based on a new definition of the revenue cycle. That definition includes the following considerations:
- Emphasis on gathering complete demographic, insurance, and clinical information in advance of the healthcare encounter.
- Support of the revenue cycle through coordination and integration of operational, clinical, and financial data gathering.
- Enhanced measures of the quality and accuracy of the revenue-cycle process.
- Seamless integration of information collection.
- Emphasis on customer service and meeting customer needs and expectations.
- Enhancement of web-based initiatives that facilitate easy but confidential access to information by patients.
- Support of continuous development and training of revenue-cycle staff.
- Use of appropriate technologies that facilitate charge capture and insurance eligibility and benefits verification.
- Use of patient-friendly financial communications consistent with the PATIENT FRIENDLY BILLING® guidelines.
- Emphasis on achieving the mission of the organization, continuous improvement, and anticipating trends in revenue-cycle management.
HFMA will incorporate the work of the task force into its various activities. Included will be a communication plan that will reflect the realities of the new revenue cycle and the need for effective leadership of this process. Additionally, HFMA will develop a robust competency model for financial leadership and staff positions within the redefined revenue cycle. Finally, HFMA will develop and gain acceptance of key performance indicators that should be used by revenue-cycle professionals to effectively manage the process.
Publication Date: Wednesday, January 01, 2003