Health Billing System Report: Cash Flow and Debt Recovery

This report comprehensively analyzes the health billing system, particularly within the Australian healthcare context. It examines various aspects, including how the Human Service Department and health professionals handle billings, the mandatory requirements for workplace safety and compensation, and the methods used by providers for billing applications. The report delves into overcoming barriers to healthcare access, such as delays in care and financial burdens, and explores strategies for improving cash flow management in medical practices, including the Practice Incentive Program (PIP). It also discusses the two commonly used accounting and billing systems and the top technologies used in Australia. Furthermore, the report assesses debt tolerance, debt recovery strategies, and the role of Medicare in Australia's universal healthcare system. It outlines the funding mechanisms, the importance of the Australian health care system, and the number of people with health insurance. The report provides insights into systems for ensuring doctor compliance with MBS requirements, sample reports on cash position and cash flow of a healthcare business, and relevant references.

Running head: HEALTH BILLING SYSTEM
Health billing system
Name of the Student:
Name of the University:
Authors Note:

2HEALTH BILLING SYSTEM
Table of Contents
Task 1...............................................................................................................................................3
Task 2...............................................................................................................................................7
Reference.......................................................................................................................................13

3HEALTH BILLING SYSTEM
Task 1
Answer 1
a.
Human Service Department only pays for the services that are accepted generally by
relevant professionals for medical needs and proper treatment of the patient. The health
consultant professionals for covering expenses pay over half of the billings on Medicare. In case
of certain practice receiving half the benefit the responsibility of health professionals to pay the
total amount that goes with the paid incorrect Medical benefit1.
b.
If there is access to a workplace in Australia then it is mandatory for improving safety, health,
and arrangements of compensation for the workers. It does not enforce or regulate WHS
legislation. WHS requirements must be met and set out according to the regulations and acts in
the territory or state by the business owner themselves. If the requirements are not fulfilled then
they may lead to penalties2.
1 Wager, Karen A., Frances W. Lee, and John P. Glaser. Health care information systems: a practical approach for
health care management. John Wiley & Sons, 2017.
2 Fleming, Neil S., Edmund R. Becker, Steven D. Culler, Dunlei Cheng, Russell McCorkle, Briget da Graca, and
David J. Ballard. "The impact of electronic health records on workflow and financial measures in primary care
practices." Health services research 49, no. 1pt2 (2014): 405-420.

4HEALTH BILLING SYSTEM
Answer 2.
a.
The providers determine to take the decision on the method of billing application for a
particular client. The psychologists who provide Medicare services may set the fees according to
their will. The rebate Medicare for a particular item is of a fixed amount, these are indexed
mainly in the month of November every year3.
b.
The process of signing up for payment and invoice is easy and quick. It helps in getting
paid faster. It must be taken in the knowledge that before settling funds the bank account has to
be verified. More documentation can be needed. There is a quick settlement of funds helping in
the increase in paying vendor invoices, paying staffs and decreasing the level of stress. There is
total security involved when the payment is processed.
Answer 3
Barrier Strategy for overcoming barrier
Appropriate Care receiving is
being delayed
The private and public sector donors and partners must
collaborate among themselves. An expertise must be
created for addressing key barriers related to a health
3 Avelino, Joy Nathalie M., Celina T. Hebron, Ara Leann E. Laranang, Paulo Noel G. Paje, Ma Mystica Flodalyn
Bautista, and Jaime DL Caro. "Requirements gathering as an essential process in customizing Health Information
Systems for small scale health care facilities." In Information, Intelligence, Systems and Applications, IISA 2014,
The 5th International Conference on, pp. 184-189. IEEE, 2014.

5HEALTH BILLING SYSTEM
issue.
Preventive service is not able
easily
It must be ensured that access equity for primary
health check-up must be same for remote and rural
areas.
Financial burdens Innovative Programmers and medical tourism should
be aimed at preventive and wellness cares.
Answer 4.
a.
The biggest challenge of the management of medical practice is managing the cash flow.
Although it looks simple generally as a service is provided and payment collected, it is not so
easy process. Practically cash flow practice must be viable otherwise problem occurs due to
insurance paperwork, poor planning, and lack of trained employees and high deductibles of
patients. Many strategies are proven now for the improvement of cash flow4.
b.
4 Langabeer II, James R., and Jeffrey Helton. Health care operations management. Jones & Bartlett Publishers,
2015.

6HEALTH BILLING SYSTEM
The PIP, commonly known as Practice Incentive Program help in measuring the
percentage of change in the rate of exchange of a pair of currency and is calculated based on its
ending decimal point.
Some of the schemes of special payment that are supported by the Australian
Government are Asthma Incentive, Incentive of Cervical Screening, and Incentive on the access
of Aged Care, Diabetes incentive, GP payment procedural and much more5.
c.
The 2 commonly used accounting and billing system by the healthcare industry in
Australia is the guide on particular evidence and the range of the statement.
The top three technologies for billing in Australia are Navicure, Eclipse, and Insta HMS.
Answer 5.
a.
The level of debt tolerance accepted by the business of healthcare is related to saving
precious time and money. They also help in gaining of payments fast and freeing up of the
internal resources. There is also lower overheads and chance to work with people who are
specialists.
5 Kaplan, Robert S., and Mary L. Witkowski. "Better accounting transforms health care delivery." Accounting
Horizons 28, no. 2 (2014): 365-383.

7HEALTH BILLING SYSTEM
b.
The strategies for recovery of the debt in the business of healthcare can be churned
through the collections made Worldwide or Medico collections. They can also be recovered
through patient debt, retention of customers, cost, management of the account, accessing online,
Litigation, Invoicing and other processes6.
c.
A generic debt recovery letter is effective as it performs two functions. It helps in
warning about the eventual actions of the legal court and also tells about the default payments.
Task 2
Most relevant health care in Australia
The Universal health care system in Australia is Medicare. It is basically a scheme that is
primary and subsides with the Australian medial cost that is afforded by the citizen.
Australia HealthCare is payable
In most regards, Medical Care is payable in Australia. In some cases, there can be found
delay in payment. It is an advantage of the Medicare provided to you that treatment could be free
6 Fairbanks, Rollin J., Robert L. Wears, David D. Woods, Erik Hollnagel, Paul Plsek, and Richard I. Cook.
"Resilience and resilience engineering in health care." Joint Commission Journal on Quality and Patient Safety 40,
no. 8 (2014): 376-383.

8HEALTH BILLING SYSTEM
of cost by the doctor appointed by the public hospital. The health insurance companies who are
private cover the health insurance costs that Medicare is not able to cover7.
Possession of National Health Care Service in Australia
Medicare is Australia’s main health care system for the public. They offer low cost, free
hospital care and medical facilities to the permanent citizens as well as the residential citizens.
Medicare Levy that accounts 1.5% on individual taxable income of the residents funds the
service of Medicare8.
Funding of Australian health care system
The insurance scheme for the health care of the public in Australia refereed as Medicare
is administrated and funded by the Government of Australia. They mainly contain medical
services through the medical practitioners and General practitioners.
Basic needs of health care system in Australia
The health care system in Australia is needed as universal access is provided through
them for a vast range of various services. They are funded largely through the general taxation.
The Government of Australia has the federal system running having a nationalized Government
with two territories and six states.
Free healthcare service in Australia
7 Pearlson, Keri E., Carol S. Saunders, and Dennis F. Galletta. Managing and Using Information Systems, Binder
Ready Version: A Strategic Approach. John Wiley & Sons, 2016.
8 Schneider, E.C. and Hall, C.J., 2017. Improve quality, control spending, maintain access—can the merit-based
incentive payment system deliver?. New England Journal of Medicine, 376(8), pp.708-710.

9HEALTH BILLING SYSTEM
A combination of the health insurance privately and funding of the Government helps the
health system to grow in Australia. The funding of the Government by Medicare scheme helps in
providing access for treatments in hospital totally. Government funding is through the Medicare
scheme makes treatment in hospitals free of the fund. It is only 9% of the total GDP of Australia.
Cost of Australia’s health insurance
The cost of health insurance of singles in Australia per month ranges in the premium is
from $43.55 to $384.91, which is differentiated as $341.36. The cost cover in the level of top
combined for singles is by Bupa starting at $69.80 and ending up by HBF Health at $672.05.
Definition of health care funding in Australia
The programs of the Government of Australia pay in healthcare organization like
Medicaid and Medicare. The health insurance plans are provided by the funds of the persons or
employee is taken into consideration9.
Importance of Australian Health Care System
Health Care System or Health System in Australia is termed as the people’s organization
helping in providing services of health care that meets all the needs of the people for getting a
better health. In certain cases, the planning of health system is distributed among the market
participants.
Number of people having health insurance in Australia
9 Zlotnik, Alexander, Miguel Cuchi Alfaro, and Maria Carmen Pérez Pérez. "Lifting the weight of a diagnosis-
related groups family change: a comparison between refined and non-refined DRG systems for top-down cost
accounting and efficiency indicators." Health Information Management Journal 44, no. 2 (2015): 11-19.

10HEALTH BILLING SYSTEM
An additional health cover other than that provided by the Medicare is the Private Health
Insurance. They help in reimbursement the incurred ancillary service by an individual or the
hospital cost. According to statistics, there were over 9.7 million people having private insurance
on health in 2011-12. Out of the 57.1% were people above the age of 18 years.
Systems that have been put in place to ensure that doctors are complying with MBS
requirements or charging correct item number to gain the Practice Incentive
Payment(PIP).
The requirements on MBS are not considered as an attack on the Medical profession. It is
quite evident that Medicare is not providing patients with optimal care appropriately.
The health professionals in Australia are trusted members of the community and the current
system has increased their frustration. Both patients and doctors making it friendly can lodge
personal opinions and views10.
The patients are able to tell the policymakers and doctors if they feel the procedure or
service related to the funding of Medicare is useful for the improvement of lifestyle and health of
an individual.
The public for Governments review about medical colleges, consumer groups, Greens
and health insurers supports this method in recent times. They have achieved fame although
some had determined in framing it as a threat for the doctors.
10 Cui, Tiansong, Shuang Chen, Yanzhi Wang, Qi Zhu, Shahin Nazarian, and Massoud Pedram. "Optimal co-
scheduling of HVAC control and battery management for energy-efficient buildings considering state-of-health
degradation." In Design Automation Conference (ASP-DAC), 2016 21st Asia and South Pacific, pp. 775-780. IEEE,
2016.

11HEALTH BILLING SYSTEM
Provide sample reports that provide information regarding the cash position and/or cash
flow of a healthcare business
It is time-consuming to receive payments from the slow payers as it adds up all the time
spent on emailing, calling, posting statements sending invoices and messages. They also indulge
in a huge amount of money being spent.
A health business to prosper must contain the dedicated person and excess time and
money. Faster payment is prompted in invoices every month ranging to million dollars for the
clients' benefit. It is a guarantee that there is an improvement in the flow of cash within 3
months, helping in better and faster payment of business.
A simple sample that can provide with all details implies that the cash flow for the year
ending of 2011.
The statements on financial status are mainly a financial report for general purpose,
prepared with the help of the Act of 1994 named as Financial Management and approved by
AASs, which is Australian Accounting Standard, and by the Australian Accounting
Interpretations. The reports standard financially is included with AASs. They also comply with
FRDs known as Financial Reporting Directions that are authorized by the Finance and Treasury
department. The Finance Minister also authorizes the SDS known as Standing Directions that are
relevant. It must be kept in mind that the service of health industry is not at all at all profitable
entity. The financial statement annually was authorized and issued on August 22, 2011, by the
South West Healthcare Board.

12HEALTH BILLING SYSTEM
The statement of cash flow is accordingly classified on regard to their financing,
investing and operating activities. There is consistent classification under the statement AASB
107 cash flow.

13HEALTH BILLING SYSTEM
Reference
Avelino, Joy Nathalie M., Celina T. Hebron, Ara Leann E. Laranang, Paulo Noel G. Paje, Ma
Mystica Flodalyn Bautista, and Jaime DL Caro. "Requirements gathering as an essential process
in customizing Health Information Systems for small scale health care facilities." In Information,
Intelligence, Systems and Applications, IISA 2014, The 5th International Conference on, pp. 184-
189. IEEE, 2014.
Cui, Tiansong, Shuang Chen, Yanzhi Wang, Qi Zhu, Shahin Nazarian, and Massoud Pedram.
"Optimal co-scheduling of HVAC control and battery management for energy-efficient buildings
considering state-of-health degradation." In Design Automation Conference (ASP-DAC), 2016
21st Asia and South Pacific, pp. 775-780. IEEE, 2016.
Fairbanks, Rollin J., Robert L. Wears, David D. Woods, Erik Hollnagel, Paul Plsek, and Richard
I. Cook. "Resilience and resilience engineering in health care." Joint Commission Journal on
Quality and Patient Safety 40, no. 8 (2014): 376-383.
Fleming, Neil S., Edmund R. Becker, Steven D. Culler, Dunlei Cheng, Russell McCorkle, Briget
da Graca, and David J. Ballard. "The impact of electronic health records on workflow and
financial measures in primary care practices." Health services research 49, no. 1pt2 (2014): 405-
420.
Kaplan, Robert S., and Mary L. Witkowski. "Better accounting transforms health care
delivery." Accounting Horizons 28, no. 2 (2014): 365-383.
Langabeer II, James R., and Jeffrey Helton. Health care operations management. Jones &
Bartlett Publishers, 2015.

14HEALTH BILLING SYSTEM
Pearlson, Keri E., Carol S. Saunders, and Dennis F. Galletta. Managing and Using Information
Systems, Binder Ready Version: A Strategic Approach. John Wiley & Sons, 2016.
Schneider, E.C. and Hall, C.J., 2017. Improve quality, control spending, maintain access—can
the merit-based incentive payment system deliver?. New England Journal of Medicine, 376(8),
pp.708-710.
Wager, Karen A., Frances W. Lee, and John P. Glaser. Health care information systems: a
practical approach for health care management. John Wiley & Sons, 2017.
Zlotnik, Alexander, Miguel Cuchi Alfaro, and Maria Carmen Pérez Pérez. "Lifting the weight of
a diagnosis-related groups family change: a comparison between refined and non-refined DRG
systems for top-down cost accounting and efficiency indicators." Health Information
Management Journal 44, no. 2 (2015): 11-19.