Please enable JavaScript.
Coggle requires JavaScript to display documents.
PATIENT REVENUE CYCLE (FRONT END: patient access (Scheduling and pre…
PATIENT REVENUE CYCLE
-
MIDDLE: charge integrity
Pricing
-
DOLLAR BASED PACKAGE: DEFINED BY PRICE TAG TO TREAT A SPECIFIC MEDICAL CONDITION, USUALLY FURTHER DEFINED BY LIST OF EXCLUSION
-
-
WARD PRICE DEPENDS ON: ACCOMMODATION, NURSING, LINEN AND MEALS
CHARGING FOR EARLY DISCHARGE AND LATE DISCHARGE:
- before 1pm: no charge imposed
- after 1pm: quarter day ward charge
- after 6pm: full day ward
-
-
Coding
-
-
-
Benefits: shift time of job processing when less busy ; avoid idling resources with min-by-min manual intervention and supervision ; keep high rate of utilisation, amortises IT system ; allow system to use different priorities for batch and interactive work ; allow effective use of manpower, key entries only once
Key concerns: quantity cannot be zero ; services must be performed within length of stay ; zero priced items are allowed ; when service codes not available, use miscellaneous codes may be used
Disadv of manual entry services: human dependent and prone to error ; subject to availability of staff to perform the work as opposed to automated entry by system
EXPLODING/BATTERY CODE: input of single code, similar to macro, will automatically expands into multiple services. Primary purpose: save time and effort in entering multiple keystrokes for data entry staff
BILL SUMMARY CODE: used for purpose of presentation on Summary Bill. Does not display individual items consumed for a particular episode. Items must be grouped within a bill summary code
SERVICE CODE: unique code describing services/item with a price ; billing staff enters a service into the billing system to post a charge
3rd party reimbursement
-
Civil Service: payment for employee medical benefits (government officers, pensioners and their dependants
- Medical Claims Proration System: government restructured hospitals, SOCs and polyclinics
- Medical Billing System/MBS@Gov: GPs and Dialysis centres
-
CPF - Patient's own
- Medisave for hospital bills or for Chronic Disease Management Programme (CDMP)
- Medishield Life
CPF - Central Claim Processing System (CCPS)/Mediclaim System
- Medisave
- Medishield Life
- Integrated Shield Plan (IP)
-