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Lesson 8: Charging (Charge Capture Process) (Good Characteristics of a…
Lesson 8: Charging (Charge Capture Process)
Good Characteristics of a good charging process
Flexible
Timely
Robust
Accurate
Comprehensive
Complete
Capturing the charges
Record
Key In
Reconcile
Charge Form
Patient Information
Item Description
Quantity
Service Code
Acknowledgement of data entry completion
2 Approaches (Charge Capture Process)
Centralized Revenue Management Approach
Single staff is responsible for the data entry work (e.g. Charge Analyst)
Data entry clerks are sited in an area away from where the services are performed
Advantage:
Sense of accountability for appropriate charging from the Charge Analyst
Disadvantage:
Possibility of higher cost due to resource of a Charge Analyst
Decentralized Revenue Management Approach
Data entry clerks are sited in the wards or where he services are performed
A team of staff is responsible (e.g. doctors, nurses, PSA/PCA
Advantage:
Manpower need is lower through multitasking of staff
Disadvantage:
Daily charge reconciliation is often delayed/not performed at all as clinical staff may not understand the revenue
Two modes of service code input
Batch/online interface of services from ancillary medical system to billing system (entry of service items by various service stations)
Direct entry of services into billing system by billing staff
Batch Interface (Benefits)
Keeping high overall rate of utilization, it amortizes the IT system
Allowing the system to use different priorities for batch and interactive work
Avoiding idling the computing resources with minute by minute manual intervention and supervision
Allowing an effective use of manpower, key entries only once
Shif time of job processing to when the computing resources are less busy
Concerns of online data entry
Services must be performed within length of stay
Zero priced items are allowed
Quantity cannot be zero
When the service codes is not available, miscellaneous codes may be used
Packages
Dollar based package
Defined by price tag to treat a specific medical condition
Antenatal Package
package covering all pregnancy-related consultations after your 20th week pregnancy
Item based package
defined by a list of items and quantity
Maternity Package
Either normal or caesarean section
Late Charge
The bill has to be opened or cancelled if it has bee closed or billed before any late charges can be entered.
Debit or credit note are not raised to manage late charges
Subvention and CCPS submission of claims will be compromised by the issuance of debit or credit notes
Deviation from normal pricing
Surcharge Service Code
Conditional Code
Discount Service Code