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Financing for Healthcare (Lesson 8 - Charging (Batch interface of services…
Financing for Healthcare
Lesson 9 - Billing
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Fee Cap Inpatient
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to ensure that subsidised patients would not be put to excessive difficulty in meeting the revised hospital charges due to unnecessary tests/investigations.
fees are applied on surgical operations, laboratory tests and specialised investigations, x-rays, rehabilitative services and standard medications
Types of Bills
Provisional Bill
period when the bill or invoice is closed to addition of new charges but it is not yet ready for generation
the bill or invoice is submitted via CCPS or Central Claims Processing System for claiming against Medisave, Medishield Life and Private Insurance
Final Bill
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once the bill is finalised, an original bill will be printed and given to the patient
Bill stamped with 'Certified true copy' will be acknowledged by the staff will be treated as the original copy
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Subsidy Cap for Implant
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All Class B2/C are given a 50% subsidy for these items up to a maximum subsidy of $500 as long as the consultant-in-charge certifies that there is not other cheaper alternatives suitable for the patient
help subsidised patients as previously they would need to pay full cost for non-standard implants and protheses.
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Bill Summary Code
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a summary bill does not display the individual itesm consumed for a particular episode, items must be grouped within a bill summary code
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Lesson 8 - Charging
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Cater for different kinds of services, e.g. package, discount
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Charge form
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Consist of patient information, item description, quantity, service code and acknowledgement of data entry completion
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Late charge
bill has to be opened or cancelled if it has already been closed or billed, before any late charge can be entered
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subvention and CCPs submission of claims will be compromised by the issuance of debit or credit notes
Closing bill
instruction issued to the billing system to stop accepting service entries or charge code entries for an account
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Lesson 12:Off-site payment, refunds and outstanding payment
Account Types
AR - Accounts Receivable
Money owed by patients (individuals or corporations) to another entity in exchange for goods or services that have been delivered or used, but not yet paid for
AP - Acounts Payable
Debts that must be paid off to another entity within a given period of time in order to avoid default
At the corporate level, AP refers to short-term debt payment to suppliers and banks
GL - General Ledger
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The ledger holds account information that is needed to prepare financial statements, and includes accounts for assets, liabilities, owner's equity, revenue and expenses
P&L - Profit & Loss
A financial statement that summaries the revenue, costs and expenses incurred during a specific period of time - usually a fiscal quarter or year
These records provide information that shows the ability of a company to generate profit by increasing revenue and reducing costs
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Outsourcing
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For public healthcare like NHG and SingHealth, certain business functions are consolidated to Finance Shared Services (FSS) which processes for institutions under the same cluster
For example: Bank reconciliation, Refund can be processed directly from the bank, payment posting outsourced to other financing companies
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Bank Reconciliation
When the amount in the Handover Confirmation Report tallies to the amount credited to the bank, Business Office Assistant will perform clearing to the Main Bank account on a regular
Business Office Assistant will prepare the Bank Reconciliation monthly to be reviewed by the Supervisor and Executive
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Account Receivables
AR or accounts receivable is the money owed to a healthcare institution by any 3rd payor and patients
After a service is rendered to a patient, a bill is sent to the respective 3rd party payer or patient requesting payment
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If these outstanding bills are not paid within a specific period, they will be term as bad debts
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'Working' on AR
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Additionally, determine the minimum level for small balance write-off
Finally, whatever system use to work on the AR, ensure that it covers each and every account
Avoiding AR
Provide staff at the checkout with the insurance payment schedule for those services provided, along with the pre-calculated co-payment amount
The most effective way of reducing your AR is to collect charges at the time of service. all payment should be collected at the time of registration, before the physician sees the patient
Patient with co-payment (e.g. the 80% of the insurance, 20% out of pocket by patient) could be charged at the time of service