Is Your Billing Statement ACA Section 1557 Compliant?

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What for-profit healthcare providers need to include in patient billing statements.

As a for-profit hospital or healthcare provider, this is an expectation you can’t afford to ignore.

Parsing through billing statements has always been a source of frustration for many patients. In recent years, many providers have recognized the need to send out patient-friendly billing statements that not only ensure clear communication but also stay compliant with the latest regulations.

One of these regulations that affect most, if not all, healthcare providers is Section 1557 of the Affordable Care Act.

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What’s Section 1557 of the Affordable Care Act (ACA)?

Section 1557 prohibits discrimination on the basis of race, color, national origin, sex, age, or disability in certain health programs and activities.

All entities within the healthcare industry are required to include “significant communication” of this law in vital communications such as a patient statement or any other patient materials in order to stay compliant.

How to Keep Your Patient Billing Statement Compliant with Section 1557

Your patient billing statement needs to be compliant with the final rule of section 1557 by including a notice and tagline concisely stating that your organization doesn’t discriminate and provides language services to all patients.

The Notice of Nondiscrimination outlines what patients can expect from a provider and how they can seek help if they need to file a complaint.

The tagline, available in different languages, informs individuals with limited English proficiency of language assistance services.

The law requires that both the notice and the tagline be printed in conspicuously-visible font size and included in communications targeted to beneficiaries, enrollees, applicants, or members of the public.

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For small-size significant publications, there are provisions that permit the following:

  • The use of smaller font size.
  • The inclusion of a nondiscrimination statement in lieu of the full notice.
  • The use of taglines in two non-English languages that are most prominent in the providers’ geographic location in lieu of all taglines.

Designing a Patient-Friendly Billing Statement

The requirements set forth by Section 1557 are good starting points for considering how you can improve the overall patient experience through a betting billing procedure, a large part of which depends upon transparent communications in your billing statements. For instance:

  • Consider the legibility of bills and other documents, such as Explanation of Benefits. Their design and layout should be simple, logical, and easy-to-read.
  • Financial communications should be in a format and language that can be easily understood.
  • Include an easy-to-understand summary of services. Avoid abbreviations, medical jargon, and other specialized terminology.
  • List appropriate contact information so it’s easy for patients to seek assistance.
  • Include URL or other means for patients to obtain additional billing-related information.
  • Educate patients on your billing processes, such as credit and collection policies, patients’ responsibilities, and structured payment policies. Include your practice’s financial counseling and payment options, as well as contact information for arranging an extended payment program.
  • Make it easy for patients to make payments, e.g., include a return envelope with the statement and offer different payment options.
  • Study the needs of your community to see if you should include languages other than English in your statements.
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A well-designed billing statement can help improve patient experience, reduce patient questions, minimize errors, increase the percentage of collections of billed charges, and result in faster collections of the balances owed.

To ensure that you’re sending out patient-friendly billing statements that are ACA compliant, consider using a third-party invoice design and printing service to deliver statements that are consistent with HFMA’s Patient Friendly billing Initiative.

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Hugh Sullivan is the CEO of MailMyStatements, an industry-leading healthcare billing, and payments company. He has over 25 years of experience as a seasoned healthcare executive, was the co-founder of ENS Health — a highly successful national healthcare electronic data interchange company, and has served in various leadership roles within Optum, a UnitedHealth Group company. Considered as an industry thought leader, Hugh is an expert in using health IT to improve healthcare information exchange, which can enhance the quality of care, improve efficiency, and reduce costs.

#PatientStatements

You can follow Hugh on Twitter @hughdsullivan

Sources

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MailMyStatements is a technology-driven statement, payment, and collection vendor that specializes in simplifying the client billing process. #patientstatements

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