Hospital administrator should ensure that clear, early, complete and simple financial communication is provided both at the admission and at the discharge occasion to create patient-friendly financial services for customer delight. This effort shall enhance both the brand value and bottom line of the healthcare organisation

1. Strategy
Health Biz India January 201728
By: Dr. AK Khandelwal
T
he importance of
patient financial
services or billing staff
in a healthcare organisation
is often not given due
importance by a healthcare
administrator. In the present
era of healthcare delivery
system where around 70% of
healthcare in our country is
provided by private healthcare
providers and patient seek
their healthcare from out-of-
pocket expenses, financial
service staff often are the
first and last healthcare
organisation service providers
to interact with patients.
Needless to say, their
performance can significantly
influence the satisfaction
of patient and their family
members. This encounter will
determine whether the patient
will revisit your healthcare
organisation for healthcare
services or spread good name
by words of mouth.
Unfortunately, often
the billing staff is viewed
as clerical staff who only
enter billing data. Hospital
administrator should not
overlook their importance
and realise that a bad initial
experience of the patient and
their family members can
adversely affect the hospital
brand value and hurt the
bottom line significantly.
Problems
Patient billing is a significant
problem for patients and
providers. Experience
of healthcare recipients
revealed that billing activities
are full of confusion and
chaos, time-consuming and
frustrating. Consumers
today expect billing to be
simple, transparent, quick,
and patient friendly. Present
healthcare delivery system lags
behind many industries in this
activity.
Early and transparent
communication: Patients
want that they should be
Drivers of Healthcare DeliveryFinancial service staff can be the drivers for delivery of patient
centric services
Benefits of
patient-friendly
billing
Increase of sale
Increase in brand value
Customer delight
Excellent patient
experience

3. Strategy
Health Biz India January 201730
informed regarding the
expected cost of expenditure
before they incur the cost.
Even NABH has prescribed
in chapter – Patient Rights &
Education in standard PRE.6.
that patients and families
have a right to information
on expected costs. And its
Objective element-c. mentions
that the patient and/or family
members are explained about
the expected costs. It is also
mentioned in Objective
element-d. that patient and/or
family are informed about the
financial implications when
there is a change in the patient
condition or treatment setting.
Providers should
communicate earlier, so that
patients understand their
financial obligation before
they undergo treatment.
Patients who may have
difficulty paying their medical
bills can look for medical
insurance, charity care, or
other financial assistance
programs. Delaying financial
discussions with these patients
will reduce their ability to
access these programs and will
adversely affect both parties.
Needless to say, this is painful
for both the patient and the
provider alike.
Billing should be simple:
Complex billing systems
not only create chaos and
confusion at the time of
discharge but can also
result in the uncaptured
billing and dissatisfaction of
customer. Both badly hurt the
bottom line of a healthcare
organisation.
Lack of clinical and
financial staff’s
collaboration: The lack
of collaboration between
clinical and financial staff is
widely prevalent in hospitals.
In today’s scenario of costly,
competitive and consumer
centric healthcare, effective
collaboration between clinical
and financial staff is the key
to improve the healthcare
organisation’s performance
and bottom line.
Lack of multiple payment
options: Healthcare
recipients are not provided in
many healthcare organisations
with multiple payment
options as practiced by other
industries.
Solutions
Identify: Hospital
administrator should identify
the problems of financial
services. Direct observation
and feedback from customers
can be utilised to identify
process require improvement.
Literature mention that
main processes are customer
registration, communication
technique.
Develop solutions: Brain
Storming Sessions, Delphi
Technique, Nominal Group
Technique, and Devil’s
Advocacy. General guidelines
for developing customer
centric financial service:
1. Hiring for a financial
service staff is critical and
always more difficult than
it seems. Health care
organisations should Look
IDEA
IDENTIFY
PROBLEM
DEVELOP
SOLUTIONS
ALIGN
EDUCATE
Make your team
member aware
of your goals
Monitor how
they are
performing
Analyse the
progress and
take remedial
measures
Top management should ensure that all team
members are aware about the organisation
vision, mission and goals.They are also well
informed about the organisational goal of patient
friendly financial services
It should be ensured that progress of strategy is
analysed and deficiency is identified and correc-
tive measures are taken. Hospital administrator
should continuously re-evaluate and re-adjust
strategic alignment in response to changes in
their environment
A well-structured monitoring programme helps to
align the individual performance with organisa-
tion goals. Identification of key process indicators
and their monitoring not only identifies the
progress of the process but also helps in decision
making process to improve the process
Three Step Method

4. MEDIA PARTNER

5. Strategy
Health Biz India January 201732
for persons with great
communication skills,
strong customer service
experience, empathetic
attitude and IT skill. The
job may require two or
more employees.
2. Privacy should be
maintained.
3. In emergency settings, no
financial communication
should be made before
stabilising patient as per
guidelines of Supreme court
of India.
4. Communication is
an important tool for
successful alignment to
improve organisation
function. Both top
down and bottom up
communications are
imperative to align all
stake holders with the
organisational goal of
patient-friendly financial
services. Literature
mentions that early
financial communication is
recommended. It should be
preferably before the care
is provided. This ensures
that care recipients are
aware about their financial
obligations.
5. Administrator should
ensure that a collaboration
between different category
of staffs should exists.
Collaboration removes
bottle necks and makes the
billing process hassle free
and smooth.
6. Healthcare organisations
should maintain convenient
billing office hours
that match the needs of
consumers.
7. Appropriate use of IT
should be used to facilitate
the financial services
delivery. Healthcare
organisations should adopt
best practices prevailed
in other industries. In the
era of demonetization,
healthcare organisations
need to upgrade their
IT technology to ensure
multiple payment options
like e- wallets, debit cards,
credit cards, electronic bank
transfers, and such.
8. Ensure patient friendly
collection. Practice the tool
of three C’s (see fig.)
9. It is recommended that
healthcare organisations
should study the needs of
the community to improve
the patient billing process.
Feedback should be taken
from patients, caregivers,
employees, physicians,
and other members of the
community.
Educate
Hospital financial service staffs
should be provided regular
training. Emphasis should be
provided on patient friendly
communication, available
patient payment options, and
standard language to be used
in communication.
Align
Top management should
involve all stakeholders,
patients and family members,
healthcare providers of
all levels for ensuring
implementation of developed
standards. Each member
of the organisation should
understand the organisation’s
goal of patient friendly billing
and should be committed
to achieve these. Top
management should ensure
that awareness, acceptance
and application of patient
friendly billing policies and
procedures are integrated
with the organisation culture.
It is recommended that a
Three Step Method (see fig.)
can be used for efficient
alignment. Barriers should be
identified and management
should develop methods for
addressing them.
Conclusion
When majority of healthcare
recipients are paying from
their pocket in our country,
the importance of financial
communication cannot
be denied. In the present
era of competition, the
financial communication is
more important than ever.
Hospital administrator should
ensure that clear, early,
complete and simple financial
communication is provided
both at the admission and
at the discharge occasion to
create patient-friendly financial
services for customer delight.
This effort shall enhance
both the brand value and
bottom line of the healthcare
organisation. HBI
Care Compassion Communicate
We should be careful of our
sentences, body language,
and tone of voice
We should commiunicate
well in a simple language
We should be compassionate
and sensitive
-Front office illing staff
gives estimate of
expenditure
Clinical staff provide
services
Back office billing staff
capture charges
Cashier receives
payment
Biilling executives
prepare final bill
Collaboration
amongst all
stakeholders
About the author
Dr. Ashok Kumar
Khandelwal is the
Medical Director,
Anandaloke Hospital &
Neurosciences Centre,
West Bengal. He is a
trained Assessor from
the National Accreditation
Board for Hospital and
Health Care Provider
(NABH). He carries
around two decades of
experience in the hospital
industry and 15 years of
experience as a hospital
administrator.