Please enable JavaScript.
Coggle requires JavaScript to display documents.
Lesson9: Billing (Different bills (Downtime bill (Occurs when billing…
Lesson9: Billing
Different bills
Bill cum receipt: displays services consumed and the payment details as well
Typical hospital bill: displays both billing and payment details on the same page
Information found on receipt portion of hospital bill:
payer name
bill amount
payable amount
adjustment amount
due date
important to display the information in one document for the purpose of medical employment benefits and insurance claim
Private class bill: subsidy figure not displayed on the bills
Subsidised class bill: subsidy figure is displayed on the bill and GST is absorbed
Detailed inpatient bill: bill summary codes description and service codes description are displayed
Summary inpatient bill: bill summary codes description are displayed
A&E or emergency dept bill
A&E facilities meant for patients with emergency conditions, subsidies accorded to all emergency patients regardless of citizenship and/or residential status of the patient
Subsidy rate set at 50% of the norm cost of treating an emergency case, other 50% are to be recovered from patient's charges
Fee is a single flat fee system applying to both emergency and non-emergency patients
Cost of treating emergency case is far higher than that of a non-emergency case [patient with minor ailment should be deterred from clogging up A&E departments. applicable only to cash paying customers]
Downtime bill
Occurs when billing system is out of service due to server issues etc
Information: name, case, date of visit, service code, description, price, total amount, payment received, counter staff name and signature
Pricing catalogue must be printed and given to the billing staff [important to update catalogue in the event of a fee revision exercise]
Alternate to downtime: permit patients to depart from clinic without billing patient [generated when billing system is returned to normal]
Only applicable for outpatient setting and collection in advance and deposits
Downtime billling ensures that payment is collected: manual process will extend payment and queue time [subsidised patients: GST must be absorbed --> billing staff have to ensure that the right prices is selected for computation --> pricing catalogue has to include both GST inclusive and exclusive prices --> ease of computation]
Back page: offers value space to communicate important information [phone enquiry lines, emails, payment options] (faint print to prevent intensity of text from distorting front page of bill)
Original vs duplicate: duplicate prevents patient from claiming from more than one insurance companies
Rounding down cents: pricing computation is down at every service item level resulting in cents (do not collect 3 cents: odd cents must be adjusted or absorbed for self payer)
General info
What?
generation of an invoice for the purpose of payment collection from a customer
Sample of typical bill
patient information
description of service rendered
amount of the service
total payable amount by 3rd party (if any)
total payable amount by patient
Types of bill
Unbilled stage (interim bill): period when the bill or invoice is open to addition of new charges
Provisional bill: period when the bill or invoice is closed to addition of new charges but not yet ready for generation [submitted via CCPS --> claiming against Medisave, Medishield and Private Medical Insurance]
Final bill: when all services rendered has been keyed into the system, returns from CPF Board and is ready for generation [original bill printed and given to patient, extra copies of the bill would be duplicate copies]
Cancelled bill and re-bill
cancelled bill: period when bill or invoice is re-opened for addition of new charges
patient received first bill: must be advised of the re-bill via verbal or written means
rebilled considered as new bill to the patient as there are changes to the charges in the bill
original invoice will be given for rebilling
reopening or cancellation of bill required to incorporate late charges
late charge is common for inpatient billing (hundred of services involved)
over/under charging of patient due to untimely updating of services rendered
Codes
Billing category: categorisation code used to group service code in a pricing catalogue
Bill summary code: code used for purpose of presentation on a Summary Bill [summary bill does not display individual items consumed for a particular episode. must be grouped within a bill summary code]
Service code: unique code which describes services or item with a price [staff enters service into billing system to post a charge]
Types of cap
Fee cap inpatient
for class B2 and C patients
purpose: subsidised patients not put to excessive difficulty in meeting the revised hospital charges due to unnecessary tests/investigations
currently applied on surgical operations, laboratory tests and specialised investigations, x-rays, rehabilitative services and standard medications
Approaches to fee cap
Traditional method or 3 individual fee caps
Modern approach or one major fee cap/3 in 1
Subsidy cap for implant
for implants and prostheses
all class B2/C patients given 50% subsidy for these items up to a maximum subsidy of $500 as long as certified that there is no other cheaper alternative suitable for the patient
meant to help subsidised patients as previously they would need to pay full cost for non-standard implants and prostheses
GST impact for subsidised cases
subsidised patients do not need to pay GST for bill [inpatients (B2+/B2/C), day surgery, outpatients (SOC and polyclinic)]
funding of GST absorbed by gov healthcare institutions for these subsidised patients is provided by MOH
IRAS requirement
GST registered supplier: must issue tax invoice for every cash sale transaction made to GST registered customer
Sale value is above $1,000
Include basic details:
name, address, GST registration number
invoice number
invoice date
the words "Tax Invoice" stated prominently
customer's name and address
description of goods and services supplied
value of supply before GST
GST amount
value of supply after GST
Must not omit customer's name and address [indicating 'cash sale' as the name of the customer is not acceptable] --> so GST registered customer can hold a valid tax invoice for the purpose of claiming input tax on business purchases
Sale value does not exceed $1,000
Simplified tax invoice showing lesser details:
name, address, GST registration
invoice date, identifying number
description of goods and services supplied
total amount payable including GST
Should issue only one original tax invoice/simplified tax invoice to customer for each sale transaction [may issue duplicate copy if original is lost --> duplicate copy must be clearly marked 'Duplicate' or 'Copy']
non-GST registered customer: allowed to issue receipt instead of tax invoice as a GST-registered supplier who mainly sells to a non-GST registered customer
Serially printed receipt must be issued for each sale transaction:
name, address, GST registration number
receipt date
total amount payable including GST
the words "Amount payable includes GST"