California Sutter Health Case Study Sou

Topics: Health care, Patient, Health care provider Pages: 7 (1497 words) Published: December 9, 2014


Case Study Sources
Danielle Recoder
ACC281: Accounting Concepts for Health Care Professionals
Instructor: John Istvan
2 Dec 2014

There is so much information out there on the Healthcare reform, healthcare finances, healthcare debt, and ideas on how to fix these things or make them better. I have a few articles that I will briefly summarize to help a future case study. These articles detail several different ways that upfront cost collection from patients before services will benefit the patient and the health care organizations.

The first article, A Reform-Era Revenue Cycle, discusses several different aspects of patient friendly billing It discusses charge capture, pricing, patient access, and the different systems some hospitals are putting in place to make up front billing easy for patients and effective for their organization.

It discusses what Concord Hospital, in Concord N.H., is doing to ensure the most correct patient charges. To do this, several hospitals are creating charge specialists and proving training to make sure these specialists can verify that charges are posted correctly the first time on a more consistent basis.

‘Now more than ever, IT systems than can obtain the documentation and the reports that are required to generate charges are critical for hospitals. Without such systems, it could be all but impossible for hospitals to meet their margins under reform.” (Health Financial Management Association, 2010) The article goes on to say that charge opportunities can make up upwards of 10%, and sometimes more, in net revenue for hospital departments. This is why it is so important for hospitals to get this right.

With a more centralized charge capture, it will make it easier to track charges from the moment a patient begins receiving services to the moment the patient is discharged. It allows teams to monitor what is being charged to make sure the same charge isn’t put on there more than once and that all appropriate charges are included. This system also allows errors to be identified immediately, rather than a few days or weeks later.

Before the hospitals can charge anything, pricing needs to be agreed on. ‘Providers have done more to meet reform goals for enhanced accountability and transparency of hospital pricing, in hopes of helping consumers understand not only what services will cost, but also how much they will have to contribute out of pocket.” (Health Financial Management Association, 2010) Integris Health, a 14 hospital system uses a Consumer Price line. This allows prospective patients to call and get an accurate price for what services would cost. This allows patients to sort of shop around at different hospitals. This kind of system tells patients up front what they can expect to pay and what insurance will pay. It also allows the hospital to collect exactly what the patient owes or gives them a jump start on getting the patient government assistance or qualified for charity care before they ever come in for their health service.

The article goes on to explain that with pricing and payment up front, it actually makes patient access easier. Patients are more likely to come into the hospital to seek treatment if they know up front what it will cost them. It eliminates the shock of getting a huge unexpected bill weeks later, in turn, patients are more satisfied.

In the next article, Patient Friendly Billing Project: Putting the Patient First, explains that the hospital bill itself is not only confusing for patients, but frustrating. It explains that a healthcare bill should be four things: clear, concise, correct and patient friendly. It breaks these down further into the following explanations.

Clear means that it’s written to easily be understood. It clearly covers exactly what services the patient received. The responsibilities of the patient and or the person paying the bill are clearly stated and easy to understand along with...

References: Clarke, R. (2000). Patient-friendly billing. H&HN: Hospitals & Health Networks, 74(10), 86-86.
This journal explained exactly what the patient friendly billing project was set up to do. It
explained barriers in the billing system and how patient friendly billing would identify those issues and rectify them.
HFM. (2001). Patient Friendly Billing Project: Putting the Patient First. Hfm (Healthcare Financial Management)., 55(12), 56-60.
This article explains how to make a better bill. It covers that a bill should be clear, correct, concise and patient friendly. It breaks each of these down and explains how they can be implemented. It gives examples of each and discusses other regulatory changes that need to be made in order to make patient billing for effective and less confusing.
Patient Friendly Billing Project: Developing a culture of revenue cycle excellence. (2010). Healthcare Financial Management: Journal Of The Healthcare Financial Management Association, 64(11), 1-7.
This article discusses the importance of correct charge capture, pricing and how the two make patient access easier. It discusses how different healthcare organizations have implemented methods to create the most accurate bill for patients. It goes over why better billing creates happier patients and discusses ways organizations can continue to improve their billing process.
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