Management of Medical Billing System

Detailed analysis of an established billing and accounting system for a health care organisation. Payment options, flexible payment barriers, billing data collection method, debt recovery procedure, subsidy payments, doctor's compliance with MBS requirement, and cash flow information.

Running head: MANAGEMENT OF MEDICAL BILLING SYSTEM
MANAGEMENT OF MEDICAL BILLING SYSTEM
Name of the Student
Name of the University
Author’s Note:

1MANAGEMENT OF MEDICAL BILLING SYSTEM
In this essay, detailed and descriptive analysis will be provided for an established billing and
accounting system for a health care organisation.
Description and name of health care practice: The name of the health care organisation
that is selected for this report is ‘Billing and accounting system in Hospital’. Hospital is a
health care organisation which provides specialised treatment to the patient through trained
and professional medical and nursing staff and medical equipment.
Payment options: Provision of different and various payment options to client is a very good
business strategy. The payment options are:
 Cash payments
 Cheques
 Bulk billing for Medicare
 HICAPS
 Bank Debit Card
 Third Party Cover like private health insurance
 Credit cards from MasterCard, VISA and American Express
Payment barriers and options for flexibility: Patient and clients sometimes face some
challenges or barriers at time of discharge or settlement. These barriers can be overcome if
the patients are provided with flexible choice of options (NSW Technical and Further
Education Commission, 2015). Following Table 1 describes the payment barriers and their
respective flexible options to overcome the barriers.
Table 1: Payment barriers and their respective flexible options to overcome the barriers
Barriers Flexible options or solution
Patient is not able to lump sum amount at a
time.
 Offering discount
 Easy instalment plan

2MANAGEMENT OF MEDICAL BILLING SYSTEM
 Offering Medicare for rebate.
Patient is ignorant about the mechanism of
billing and accounting system
 Offer assistance for the paperwork
 Detailed explanation of how it works
Medicare payment delay due incorrect
information
 Utilization of integrated or Medicare
Online
 Input of data in real time so that
error in information can be rectified
immediately and delay can be
avoided.
Name and provider details for billing and accounting system: The name of the provider
of the billing and accounting software system is Clintel – intelligent clinical software. They
have various product created for the health care organisation (Clintel, 2019). In this particular
scenario, the product is tailor made for being used in hospitals. The software name is
CareRightTM Hospital (Hospital Management Software, 2019).
Billing data collection method by the billing and accounting system:This system is an end
to end solution platform and can handle and manage all the parameters of Patient
Administration, System Management, Clinical Information, Billing and Finance, and
Utilities. In this software, billing can be retrieved by case, event, item, or any other variables.
This auto calculation engine can calculate parameters like Electronic Health Fund Claims.
Medicare Online is integrated with this system (Hospital Management Software, 2019).
Following Figure 1 shows the sample billing invoice and data which will be collected at time
of billing.

3MANAGEMENT OF MEDICAL BILLING SYSTEM
Figure 1: Sample invoice for billing
Debt recovery procedure and policy: Debt is an integral part of any business venture.
However, bad debt needs to be collected for the betterment of the business. This debt
recovery can be conducted through the following procedures:
 Issue of overdue letter and send them to the respective clients
 Reminder and communication through telephone.
 Use of debt collector or debt collecting companies.
 Legal action

4MANAGEMENT OF MEDICAL BILLING SYSTEM
Similar like any business procedure, this debt recover policy need to be monitored to make
certain that the debt recover policy remain effective and efficient. To achieve this, a certain
level of debt tolerance has to be acquired and action should be taken on risk. In regard to this,
debt will be categorised in three risk group namely low, medium and high. Action on high
risk debt has to be taken first (NSW Technical and Further Education Commission, 2015).
Source information on subsidy payments: The hospital has to remain updated with the
information of various subsidy payments as it will be required during the billing procedure.
Client can achieve subsidy from various governmental agencies and third party organisers
(NSW Technical and Further Education Commission, 2015). Therefore, it is vital to remain
up to date about this information and the names of the sources are:
 Payments for older Australian
 Veteran affairs information
 Aged care Subsidies
 Childcare
 Medicare
Doctor’s compliance with MBS requirement: Review programs have been put in place to
ensure that the doctor’s are using Practice Incentive Payment (PIP) correctly to adhere with
MBS requirements. Name of these programs are ‘Practitioner Review Program’ and
‘Professional Services Review’ (Health.gov.au, 2019).
Cash flow information: Cash flow is important for any business organisation and it is very
vital for the organisation that minute details should be recorded for each cash incoming and
outgoing information need to be maintained. Following Figure 2 provides an example of
record keeping for cash flow information.

Running head: MANAGEMENT OF MEDICAL BILLING SYSTEM
Figure 2: an example of record keeping for Cash flow information. Source: (Business.gov.au, 2019)

Running head: MANAGEMENT OF MEDICAL BILLING SYSTEM
References:
Business.gov.au. (2019). Cash flow statement. Retrieved from
https://www.business.gov.au/planning/business-plans/writing-a-business-plan/cash-
flow-statement
Clintel. (2019). Clintel | Clinical Software Solutions | Australia. Retrieved from
https://www.clintel.com.au/
Health.gov.au. (2019). Department of Health | Billing accurately under Medicare. Retrieved
from http://www.health.gov.au/internet/main/publishing.nsf/Content/billing-
accurately-medicare
Hospital Management Software. (2019). Hospital Management Software | Clintel | Clinical
Software Solutions. Retrieved from https://www.clintel.com.au/solutions/hospital-
management-software/
NSW Technical and Further Education Commission. (2015). Manage health billing and
accounting system (1st ed.). New South Wales: NSW Technical and Further
Education Commission.