Head Billing

• Overall Supervision and functioning of the department to deal with billing clarifications with respect to Cash, TPA, corporate. Ensure staff training in billing & Billing audit Policy. Improve processes to achieve quick and error free billing.
• Ensure all the services provided in hospital are mapped in HIS with their tarrif as per bed category and payer category

Deposit Collection

Ensure that the admission deposit is collected as per policy at the time of admission

Ensure that the surgeries are proceeded only after collection of OT clearance amount

IP Service Posting

Ensure that the services provided to patients are posted in HIS on regular basis

The respective stakeholders are informed regarding pending service posting and ensure the same is completed within 12 hours of informing

OT billing

Ensure the OT billing is closed within 4 hours of surgery completion.

In case of items where GRN is pending, ensure that the OT billing is closed within 24 hours of surgery completion

OP/IP Billing

Ensure that all the patients leaves the hospital only after paying complete bill and bill closure in HIS and discharge clearance is issued to all the patients

In case the service is not available in HIS and has been posted as "Unlisted services", the new service request is created as per Service Code creation SOPs. The billing manager has to ensure that no service is posted under Open billing without their approval

Keep track of Open bills of discharged patients and get them closed within 24 hours

Credit Billing

In case of credit/corporate patients, the bill must be closed after receiving Final authorisation from the TPA/insurance company and clearing the patient payable amount from the patient

Ensure that the required Document are sent as soon as possible and any query is resolved within 24 hours

Discounts

Ensure the staff, clinicians and their next of kin are given discounts as per policy

Authorize the discounts as per policy for cash patients and ensure that the discount remarks are entered properly in HIS

Ensure the discount approvals are taken in designated forms and authorization is taken from respective authorities as per policy. The scanned copies of forms are uploaded in HIS for future reference.

Bill cancellation & refund

Authorize the bill cancellations due to billing error, admission cancellation or any other reasons. Document the same in HIS under reason for cancellation

Ensure the refund is processed within 24 hours of bill cancellation

Outstanding

Ensure that the Daily monitoring of bill status and collection of outstanding is done without failure

Bill Audits

Ensure that 100% of the bills are audited before closing the bills.

Re-counseling

In case the interim bill of patient goes beyond the estimate, ensure the staff informs the financial counsellor for re-counselling of the patient

Financial Counselling

Monitor conversion against estimate provided to patients

Ensure that recounselling is done to the patients whose interim bill exceeds the counselled amount and who has any deviation in treatment plan

Check reasons for gap between estimates and final bill and address the issue to keep it under check as per HCG policy

Admission & Bed management

Increase the number of planned admissions by effectively putting in place the planning process & by identifying and rectifying the reasons for unplanned admissions

Monitor the daily planned & Unplanned admission ratio & beds booked.

Authorise & Monitor upgradation/downgradation and shifting back of patients to requested category.

Ensure provision of Bed & counseling upon admission in timely manner

Wards

Monitor planned and unplanned discharges, adherence to discharge planning.

Monitor TAT for patient discharges (Payor type wise)

Improve discharges planned a day prior, Ensure non clinical discharge activities are completed on the day of planning.