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Question1

Briefly describe the regulatory and legislative requirements for billing covering a health care business.If you have access to a workplace then, discuss the regulatory and legislative requirements for billing for your business?


Question 2

a. List all the payment options a medical practice has when requesting payment for services rendered (for e.g. Medicare). 
b. List all equipment required to enable a health care business to invoice and payment for services rendered


Question 3

List at least three barriers related to financial matters which may prevent patients from accessing practice services, as well as a strategy for overcoming each of the barriers you have identified.

Question 4

a. Why it is important for a health care business to have a clearly stated policy regarding cash flow and viability of the practice?.

b. What is The Practice Incentives Program (PIP). Name few Australian government supported and special payment schemes or practice payment scheme that need to be considered while developing or implementing the medical billing system.

c. Research and name at least two commonly used billing and accounting system in a health care business. Also name three billing technologies that support a practice’s billing and payment system.

Question 5

a. What are the debt tolerance levels that a health care business accepts.

b. List the possible debt recovery strategies for a health care business.

c. Most of the health care business follows the practice of sending generic debt recovery letters to the same party multiple times, do you think is effective or not? Explain your answer.

Questions:

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 benefit

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 penalties.

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 year.

 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.

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 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.

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 flow.

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 more.

Question 1

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.

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.

 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 processes.

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.

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.

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 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 cover.

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 Medicare.  

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.

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.

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.

Question 2

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.

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 consideration.

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.

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 views.

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.

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.

Question 3

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.

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. 

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.

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.

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