Regulatory, Financial, and Billing Analysis for Ramsay Healthcare

This report provides a comprehensive analysis of the billing and accounting systems within Ramsay Healthcare. It delves into the regulatory and legislative requirements governing healthcare billing, including key acts and standards that ensure security and accountability of patient information. The report explores various payment options available, such as bulk billing, HICAPS, and credit cards, along with the necessary equipment for invoicing and payment processing. It identifies and discusses financial barriers that patients face, such as affordability and lack of awareness, and suggests solutions like payment plans and clear communication. The importance of a well-defined cash flow policy is emphasized, along with the role of government incentive programs. The report also examines debt tolerance levels and effective debt recovery strategies, including reminder letters and debt collection services. An analysis of established billing systems, processes, and guidelines is presented, highlighting the importance of customer needs, technology, and legislation in developing an effective billing system. The report concludes by summarizing key findings and emphasizing the importance of adapting billing practices to meet both customer needs and regulatory requirements.

Assignment

Table of Contents
INTRODUCTION...........................................................................................................................3
TASK 1............................................................................................................................................3
Question 1...............................................................................................................................3
Regulatory and legislative requirements for covering Ramsay healthcare business..............3
Requirement of regulatory and legislative for billing in Ramsay healthcare company.........3
Question 2...............................................................................................................................4
Payment options in Ramsay healthcare company..................................................................4
Equipments required to invoice and payment for service rendered......................................4
Question 3...............................................................................................................................4
Three barriers related to financial matters .............................................................................4
Question 4...............................................................................................................................5
Importance of clearly stated policy regarding cash flow........................................................5
Practice Incentive Program and support from Australian government and special payment
scheme....................................................................................................................................5
Name of two billing and accounting system..........................................................................5
Question 5...............................................................................................................................5
Debt tolerance levels that Ramsay healthcare accepts...........................................................5
Debt recovery strategy for Ramsay healthcare company.......................................................5
Practise of debt recovery strategy...........................................................................................6
TASK 2............................................................................................................................................6
(A) Analysis of established billing and accounting system ,processes or guidelines............6
CONCLUSION................................................................................................................................9
REFERENCES..............................................................................................................................10

INTRODUCTION
Manage health billing and accounting system helps in streamlined the organisation's
process. It helps in improving efficiency of the entire organisation and reduces the efforts of
employees and redundant data entry (Raleigh, Headwater Partners, 2014). This project is based
on Ramsay healthcare that deals in health care sector. this report will explain the regulatory and
legislative requirement for billing , list of the payments options in a medical practise and
equipments that are used healthcare sectors for rendering the services and barriers related to
financial matters which prevents patient from accessing practises services.
TASK 1
Question 1
Regulatory and legislative requirements for covering Ramsay healthcare business
There are many laws related to billing that are apply in Ramsay healthcare company.
There are many laws ,regulation and legislation that increases the security and
accountability when it comes to patient medical information specifically. It is used by mostly
company for securing the information of patient. It is used in collecting, gathering and
transferring of any or all patients. Some of them legislation are as follows-
 Australian Accounting Standards Boards that provides information related to the
accounting requirements for the business (Singh and Chana, 2013).
 Commonwealth Consumer And Competition Act Of 2011 that protect the rights of
consumers and helpful in providing the justice to them.
 Medicare has website for billing and accounting through patient can take information.
 Contract Regulation Act NSW that deals with contract related matter.
 Fair Trading NSW that regulates the company and ensures that it is dealing fairly and
with-transparency.
All above act made by the government of Australia that every company have to follow it
for running the business activities with out any interuption.
Requirement of regulatory and legislative for billing in Ramsay healthcare company
The main legislative requirement is assignment of brief. If service provider selects to
bulk-bill, the patient assigns to the practitioner as full payment for the medical services that they
received.

Legislative requirement of private billing include reporting income and GST to the
Australian Tax Office that helps in preventing the barrier that may occur in payment system and
with this person may have payments and billing system that is almost debt proof.
Question 2
Payment options in Ramsay healthcare company
If Ramsay healthcare will provide adequate payment options then it need not to do extra
expenses (Toffoli, Rudge and Barnes, 2011). Some payment options are as follows which is
adopted by Ramsay healthcare company-
 Medical Bulk billing
 HICAPS
 VISA
 Cash payment
 EFTPOS
 Credit cards etc.
Equipments required to invoice and payment for service rendered
To select payment method is depend on to condition of business. The types of equipment
could vary from a standards manual cash draw to electronic computer generated machines. The
system software that is common from many responses from the survey is the HIC software for
Medicare bulk billing etc. (Mihoob, Molina–Jimenez and Shrivastava, 2011)
Question 3
Three barriers related to financial matters
 Patient cannot afford lump sum amount at one time for this offer payment plan and
should provide gap for payment.
 Patient don't know about health billing system work so for it explain to them how it
works.
 Patient don't have enough cash or can not afford to keep cash in pocket for this should
provide EFTPOS online payment system.

Question 4
Importance of clearly stated policy regarding cash flow
It is important for Ramsay healthcare for operating diligently. It is it's ability to pay of
debts that increases the well-being of the business.
Practice Incentive Program and support from Australian government and special payment
scheme
It may provide special payment options for pensioners, senior citizens such as 20%
discount for those card holders (Boxall And et.al., 2014).
For special payment, patient can get written approval of treatment is sought after an
initial consultation but before any treatment.
Name of two billing and accounting system
 Manual system in which account ,ledger is created at the same time. It is also known as
one write system.
 Electronic system in which transactions are recorded electronically.
Billing technology is easy claim technology ().
Question 5
Debt tolerance levels that Ramsay healthcare accepts
There are many business in which some business can absorb some shortage of cash over
time while other business can not absorb it. For deciding the tolerance of debt, Ramsay
healthcare should be able to accept the decision of business owner. From the survey it is seen
that debt tolerance for that business was nil as it is cash up front.
Debt recovery strategy for Ramsay healthcare company
The best debt recovery strategy is that business will work with higher tolerance of debt
than a business that has difficulty in recovering bad debts.
The other best solution of this is that no debt tolerance, no credit. All paid on delivery
from patients.
This strategy should be outline procedures and follow up required for streamlining the
income.

Practise of debt recovery strategy
From a survey, a practises for debt recovery strategy are as follows-
 Send reminding letter that includes the debt amount.
 Send solicitor letter.
 Debt collector.
Yes it is effective because it reminds about the debt that has been taken from lender that
helps in repaying the debt amount easily and quickly (Singh and Chana, 2013).
TASK 2
(A) Analysis of established billing and accounting system ,processes or guidelines
Billing system is that system that are designed to handle time and billing tracking as as
well ass invoicing customers for services and products. It is helpful in tracking the work of
employees that are done by them as well as expenses associated with projects or clients.
Receiving payment-
There are many ways that can be used by business for their rendered services. Mostly
doctors use a combination of following billing types which are as follows -
 Direct billing or bulk billing Medicare
 Direct billing the department of veterans 'affairs
 Grants
 Private billing like billing the patients
 Private billing to a third party that involves work cover ,employers ,insurer etc.
After completion of research ,I analysed that there are three task in billing process that
are as follows -
 Collecting the information
 creating invoice
 And issuing them to customers.
I analysed that types of billing is very important that the practice balances client needs
and practice needs as well as legislative requirement while developing a billing system. For
removing the barriers ,the practise debt should be decreased and the cash flow should be
increased. While developing billing system it should consider the following points which are as
follows -

 Customers needs.
 Technology requirements
 Market situation
 Legislation etc.
According to me ,Customers need will include advertised fees before taking services
 Early payment turnaround for claims
 Ease of use etc.
According to me ,every company have to follow legislation that are made by government.
These laws protects the rights of patients as well as of the service provider. There has been some
changes recently that are very important to practise billing. Changes are as follows-
 A contract should be made between service provider and service receiver for the
assignment of benefits.
 This contract will work as a evidence of service taking.
 The patient is required to sign the form.
 A copy of contract should be given to patient so that they can use in future.
So every company should follow these legislation if they will not then they will be liable
for penalty that are pre specified by the government.
I am working as care taker in Ramsay healthcare and I use various payment option for
receiving payment from patients. These option helps ion reducing expenses and unnecessary
pressures from trying to make more sales for generating more cash flow. This option is good for
the business because it saves time and money. I use the following payment options-
 Debit card or credit card
 Medicare bulk billing
 NEFT
 Client account
 check etc.
Bulk billing become a part of business that are used by mostly healthcare organisation. If
service providers does bulk billing then other charges like administrative fees or accessories can
not be charged to the client. This benefit is available only to those patient who holds specific
benefit card such as pensioners ,health care card holders.

I provide the account to the customers in which they have to pay amount on the due date.
If the client is able to claim some of the expenses from their health provider they will submit and
once a cheque has been received the client will forward to your business the payment along with
any other amounts that total the original account thus payment is finalised.
Practice billing software-
These billing software has also affect the option fro electronic Medicare claiming. I
integrated this software with with latest Medicare technology so that it's practice can take more
benefits of the fast payment and and convenience of easyclaim technology. These software helps
in removing the duplication and manual entry of past direct bill claim forms. I know it is the
same information or data but there is less 'leg work' for employees. Employees need not to
complete information about the client like his date of birth ,name etc. manually but it can be
done automatically.
This software automatically allocates fees which means that the only information the staff
members needs to know is the item number. I follows the following steps for the manual options
which are given below-
 Check the patient 's Medicare card.
 This card will be printed out in three copies.
 Copies of firm.
 I fill out the following information before the patient sees the service provider which are
as follows-
◦ Expiry date of card
◦ Patient's reference number
◦ Date
◦ doctor's name and provider number
 When patient is checked by doctor then I fill out the item number and the amount of fees.
 After it ,patient has to sign it and after signing it,it can not be changed by anyone.
 At last I give this vouchers to patient and one copy keep it as record.
There are many practise that are helpful in reducing client debt load and helps in preparing or
developing the debt recovery strategies. For recovery the debt ,I outlines the procedures and
follow up required for all stream of income. There are very less no. of people who like or enjoy
to collect the the debt amount. It is necessary procedure if I does not select bulk billing.

In company, I try to convenience and encourage the patient to pay at the time of visit. For
it I keep some electronic payment system like credit cards ,EFTPOS, Easy claims etc. I adopts
this method according the customers need and their requirement.
CONCLUSION
Ramsay healthcare offers a complete billing solution for long term care and assisted
living facilities. This billing system helps in learning and adopting new process easily and
effectively. From the above project it is concluded that there are many rules and legislation that
affects the billing system so company should follow these rules and regulation and it should
adopt that payment method that are easy for the customers and according to the legislation. If
company will adopt payment method according the requirement of then it can easily get the
desired objective or success.
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