The right patient.

This article offers professional opinions and advice on how physicians should prepare in order to protect themselves and their practices during this turbulent time in healthcare reform. This article presents real-life scenarios to help physicians understand what they may face and what actions they should take in anticipation of the future in healthcare. The article focuses on the concept of "the right patient," defining the characteristics of patients that benefit the financial aspect of a practice and those who do not. Its purpose is not to encourage physicians to deny care to patients who are poorly insured or uninsured, but to guide in the establishment of a smart and safe balance between the two. Strategies are discussed on how to attract the right patient and what these patients mean to the practice. The importance of practice marketing is also highlighted, along with an emphasis on the necessity of change in order to survive in the future healthcare environment.

Patient payments.

Patients are on the hook for more of their healthcare costs. And it's changing how practices look at collections and their payer mix.

Online payments in the new retail environment.

Virtual business offices are a key part of many hospitals' web strategies. Patients are ready and willing to pay their hospital bills online. Web-based payment centers can help cut self-pay days in A/R and increase collections. Proper marketing is essential to attract patients to a hospital's online business office.

They see bad debt rising. With 72 million people struggling to pay health bills, providers may be in for nasty weather as those figures are predicted to rise.

With the economy appearing to be in a recession, healthcare providers are expecting more bad debt coming their way. "We're not a financial institution and not in the business of financing the provision of care," says Neil Bertrand, chief financial officer for Longmont (Colo.) United Hospital.

How Memorial Hermann's Online Payments Are Boosting Patient Loyalty and Revenue.

The Houston-based health system has implemented new workflows and technology in 14 of its hospitals and across its care delivery network to make the payment process more patient-friendly and build consumer loyalty.

Improving the implementation of cost recovery for health: lessons from Zimbabwe.

In the current debate over health financing policy in developing countries, governments are increasingly focusing on cost recovery--having patients pay part or all of their health care costs--as a way to mobilize more resources for health, improve equity by selectively charging the wealthy, and increase efficiency by encouraging reinvestment of fee revenues into cost-effective primary care. Zimbabwe offers an important example of a country with a tradition of levying fees in government health facilities, but where enforcement became lax in the 1980s. In 1991, policymakers resolved to resuscitate and strengthen cost recovery, as part of a broader economic reform program. This paper discusses the strengths and weaknesses of Zimbabwe's cost recovery system, its potential for improvement, and the obstacles to change in revising the fee structure and billing and collection procedures. It argues that cost recovery can help to achieve Zimbabwe's health objectives, but only in conjunction with other measures to redirect public spending to essential public health and clinic care and improve the efficiency of government services. The paper finds that during the 1980s, the fee schedule became badly misaligned with actual medical care costs and created distortions in patient referral patterns. Billing and collection were also weak, because of deficiencies in personnel and information systems and lack of incentives for revenue generation. The paper concludes that if key steps were taken to raise the collections-to-billings ratio, recover fees from privately-insured patients, and adjust fees in line with medical cost inflation, recoveries could increase fourfold, from 5% to 20% of government spending for clinical care. At the same time, access to government health services for the poor could be maintained by improving exemption procedures.

Hospitals put teeth into efforts to collect bad debt.

The growth of bad debt and accounts receivable is prompting hospitals across the county to adopt more stringent collection policies. Some hospitals that have gotten tough are finding that these programs can significantly increase cash flow. But experts warn that such measures invite public criticism. Many hospital administrators, however, are finding they have no choice except to go after patients who have the means to pay.

Taming the remittance beast electronically.

The next step in coralling the back-office-beast is automating remittance processing. Before taking any steps in that direction, healthcare providers need to establish new procedures for cash management and patient accounting. Opportunities exist for related uses of electronic data interchange (EDI), which will provide additional benefits but will also trigger fundamental changes in the way healthcare providers do business.

Patient accounts managers prepare for change.

Automated data processing and electronic data interchange have become necessary and increasingly vital aspects of the processes of admission, registration, billing, and collection. A recent survey of patient accounts managers found they feel they may need to improve their technical skills to meet future challenges.

Sizing up the role POS (point-of-sale) devices will play.

As more providers attempt to automate such health care transactions as eligibility verification and claims filing, many are taking a look at point-of-sale terminals. POS devices provide low-cost, user-friendly access to a variety of on-line information. But critics say personal computers and practice management software are better suited to complex claims processing. Still, some say there may be a place for both, with POS terminals in physicians' and dentists' front offices and PCs for claims processing in the back offices.

The pride of the Yankees. A Maine hospital's willingness to barter gives new life to an old idea.

Many people in rural Maine are long on pride but short on health insurance. Thanks to an innovative barter program at Franklin Memorial Hospital, they can keep their pride, get the care they need, and offer their talents to the hospital in exchange for services. It's a win-win situation for everyone.