PHOTO: Director of Business Services Karli Wright (at right) with Teresa Leddon-Minch (left), one of two patient financial counselors available at GRH, visit outside of Teresa’s office in the main hospital lobby.
LA GRANDE (May 23, 2016) -- Grande Ronde Hospital (GRH)received great news about its efforts on patient-friendly billing practices. Director of Business Services Karli Wright wants to make sure the public understands that this good news is driven by GRH’s long-standing commitment to best serve its patients’ financial needs.
Over the past year, Oregon hospitals have worked to implement standards for providing good-faith estimates to self-pay and out-of-network patients as part of a three-part transparency initiative. According to information released this month by the Oregon Association of Hospitals and Health Systems (OAHHS), GRH is ahead of many of Oregon’s hospitals in service estimate cost, price transparency and billing practices.
During the first quarter of 2016, OAHHS conducted a secret shopper survey on price transparency and patient-friendly billing practices by calling each of Oregon’s 62 member hospitals. When results of that survey were released May 11, GRH was advised they were one of only four hospitals in the state that met all Tier 1 standards in full.
For several years, GRH’s Patient Financial Services Department has been providing cost estimates for scheduled procedures to self-pay and out-of-network and insured patients, says Wright.
“We have always been proponents of price transparency and go out of our way to ensure we understand our patient’s insurance benefits, so we able to effectively assist them in navigating the financial side of healthcare. We work closely with our clinics and see that our uninsured, underinsured and commercially insured patients are contacted in advance of scheduled hospital procedures. We provide these patients with an estimate of costs to be incurred, an understanding of their insurance benefits and discuss out of pocket expenses. Our goal is to expand this service to all scheduled services in the next few years,” Wright explains.
The Tier 1 standards adopted by all Oregon hospitals last year are based upon recommendations by the national Healthcare Financial Management Association (HFMA) in their Price Transparency Task Force Report. Oregon hospitals were among the first in the nation to voluntarily adopt these recommendations on price and quality transparency.
The Tier 1 standards by which each hospital was assessed during the secret shopper survey were:
- Good faith estimates are provided to self-pay and out-of-network patients upon request for all scheduled services, excluding lab or radiology.
- Estimates include all applicable disclaimers including, at minimum,
- Reference to the fact that some services may not be included in the estimate
- Notice of the potential for out-of-network charges
- Reliance on the accuracy of stated benefits
- Based on the applicability for the patient, the availability of financial assistance and location of financial assistance information on the hospital’s website is communicated to patients at the time of the estimate.
- Estimates are provided within three business days of receiving all applicable information.
Wright’s reaction to the good news, about being only one of four Oregon hospitals to fully meet Tier 1 standards, was that it is indeed “encouraging to know GRH is a bit ahead of its peers,” but that the purpose for the policies already in place at GRH have always been about the patient.
“We want our patients to have a solid understanding of what to expect when receiving services at GRH, we are hopeful that this leads to better overall patient satisfaction,” adds Wright.
In addition, with GRH’s progressive payment plan options and the availability of financial assistance through the Patient Financial Services Department, Wright says there is no reason for any patient to struggle paying their GRH medical bills or go into collection for non-payment.
“The message I want to make sure people hear from this news is that we are here to help them, it really is as simple as making a phone call,” adds Wright.
Anyone interested in learning the potential costs for services and available payment options, provided at GRH, can call the Service Estimate line at 541-963-2845.
For more information and a comparison of Oregon hospitals’ commitment to patient quality and transparency, visit the new OAHHS hospital transparency website www.oregonhospitalguide.org.