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 By Lesa Klepper, FHFMA
Central Business
Office Director
Triad Region, Novant Health
Winston-Salem, N.C.
Providing a Better Billing Experience for Patients
Prompted by the Patient Friendly Billing® Project, an industry-wide initiative led by the Healthcare Financial Management Association (HFMA), we realized that our patients were, indeed, having a hard time understanding our statements, delaying payments for their share of the bill. Although we couldn't change what patients were charged, we knew we could at least improve the patient billing experience at Novant Health, a not-for-profit integrated healthcare system serving North Carolina and neighboring states.
Like many other healthcare organizations, our process was riddled with difficulties. Patients received hospital bills in the mail that they did not understand. They would call the business office, sometimes enduring long waits and engaging in prolonged discussions with a customer service representative. At the end, patients still might not understand the bill or how much they owed — and would become dissatisfied with the entire care experience.
We also came to the conclusion that the billing process was not doing our organization any favors either. Because the statements were acting as a barrier to payment, our organization endured high customer service costs, reduced cash flow and even increased levels of bad debt.
Rethinking Billing Practices
We decided that we needed to start from scratch and develop a customer-centric billing process that would truly meet not only the needs, but also the wants, of our patients. Here's how did we did this.
 Assigned a project team that included representatives from finance,
patient accounting, patient access, information technology and
marketing. This team worked on assessing the problem and
finding solutions.
Obtained patient input. To get a better idea of what patients wanted,
we conducted multiple patient focus groups. We discovered what
patients wanted on their statements in terms of content, clarity
and detail. We found that about 80% of patients wanted online
billing functionality.
Selected a vendor. Through a request for information and in-person
interviews, we selected a vendor based on the following four key
criteria: services provided and levels of automation; internal
control processes; HIPAA compliance; and price.
Implemented an online billing option. With this alternative, patients
have around-the-clock access to updated account information, online
payment and expanded communication capabilities.
Results of Our Patient-Friendly Intervention
Through the revamping of our entire billing process, we have been able to achieve significant results at Novant Health's Triad Region, including:
Reduced bill processing costs. Healthcare organizations can save
up to $1 per bill by converting a paper-based transaction to
electronic. At Novant Health's Triad Region, self-pay payments
have increased from $23M in 2003 to almost $29M in 2007. We are
averaging about $450K per month utilizing the online self-pay
payments process — with 250 new households registering for
the service each month.
Improved cash flow. Because patients understand their bills and
have access to an online option, they pay their bills more quickly —
which improves cash management hrough reductions in days in A/R
and bad debt. In addition, because the bills provide information
about how to apply for assistance, patients who are eligible for
charity care are more likely to pursue such assistance, reducing
bad debt even more.
Enhanced patient satisfaction. The online functionality offers
our patients an increased level of customer service — they
can access account information and pay their bills during
non-business hours. After-hours access would be too difficult
and expensive to provide through traditional phone and
in-person communications.
The revised paper statements and the ability to pay online using RelayHealth's Patient Compass™ solution are making it much easier for patients to understand and pay their bills. The redesigned statements clearly delineate what patients owe and what third-party payors have paid, making it easy for patients to settle their accounts. Our efforts to improve the billing experience have not only resulted in bottom line gains, but have also helped improve patient perception of the overall care experience at Novant Health.
Lesa Klepper is the Director of the Central Business Office, Triad Region, for Novant Health, located in Winston-Salem, N.C. She has held this position since 2000 and has A/R responsibilities for four acute-care facilities, an outpatient surgical center, and two long-term care facilities. Prior to joining Novant Health, she held positions at the University of Tennessee Medical Center, Williamson Medical Center, and Hawkins County Memorial Hospital over an 18-year period. She is active in HFMA, having served as President of the Tennessee Chapter, held a four-year term on the National Board of Examiners, and participated in HFMA Abroad's inaugural trips to China and Russia. She currently sits on the NC Hospital Association's Medicaid Technical Advisory Group.
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