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PAYMENT COLLECTION - Coggle Diagram
PAYMENT COLLECTION
CLAIMS PROCESSING
For MediShieldLife patients have to inform hospital staff that they wish to claim from MediShield Life then the hospital will submit for them, CPF board or the private insurer pays the hospital directly and remaining amoun can be paid using medisave or cash
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Manual Submission (some insurers & employers do not have electronic claims submission or direct billing arrangements claims for outstanding has to be done manually via compiling receipts & associated claims forms)
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CHARGING PROCESS
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CHARGE FORM - Document nurses use to record the services rendered for patients
DATA ENTRY OF SERVICES - Performed by billing staff reading from the charge form
RECONCILE - Services entered into bil with charge form
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CODING
harge review looks at the prices on services, consumables & medication
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setting up correct international classification of disease (ICD) or diagnosis related group (DRG) for items used for subvention & casemix purposes
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BILLING
Payment collection includes
- Patient information
- Description pf services rendered
- Total payable by 3rd party
- Total payable amount by patient
FEE CAP
- Ensure that subsidised patients would not be put to excessive difficulty in meeting the revised hospital charges due to tests/investigations
- As cost go up they control certain charges
- only private patients affected
3 Types of Bills
Interim bill (Unbilled stage/Cancelled bill & Rebill, can still add in charges/change)
Provisonal Bill (when bill is closed & no more changes as bill is sent to Medisave, MediShied Life, it is when the bill/invoice is closed but not ready to be generated)
Final bill (when the money is collected from 3Ms & the bill will come back, patient pays $0 after all 3rd parties have covered and certify a true copy, when services has been rendered & keyed in system the bill returns from CPF board, once finalised original bill will be sent to patient if patient requests for an extra copy, it'l be a duplicate copy)
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