HospitalRevenueCycleManagement医院营收周期管理.pptVIP

Hospital Revenue Cycle Management医院营收周期管理 Health Systems Management 医疗系统管理 Sylvia Pan United Family Hospital and Clinics Vice President The Revenue Cycle is the how a medical facility is reimbursed for its services 营收周期是指一个医疗机构从提供服务开始,到获得收入补偿的全过程- usually the first and last encounter a patient has with the institution.通常患者在医院最先和最后接触的都是从事这项工作的人员 (如: 前台,收银人员) Admissions -Registration患者 – 登记 Registration注册登记 Registration is the collection of the appropriate demographic information to required to submit a clean claim to a insurance provider. Two types of registration: 注册登记是为了获取适当的信息, 向保险公司提交清晰的资料. 分为两种: 1. Pre-registration: Where the facility had advance notice for the elective procedure. 预先注册: 医院可以预先通知为某个诊疗进行注册 2. Site Registration: Registration that occurs at the time of service. 定点注册: 在提供服务时进行注册 Demographics 登记注册的内容 Name, address, phone number, email 姓名, 住址, 电话号码, 电子邮件地址 Insurance carrier, identification number 是否购买保险, 保险号 Emergency contact 急沴联系人 Referring physician 推荐医生 Employer 雇主 Guarantor 保证人 Registration Collections注册信息 Does patient have co-pays, deductible or co-insurance ? 确认患者是否有自付部分或绝对免赔额 Must know payer contracts 务必了解付款者的合同 Review insurance cards 核查保险卡 Build into pre-certification process 设定预先通知系统 Does patient have balances due on other service? 确认患者是否有其它到期未付的诊疗费 Delay or deny service if they can’t pay? 如患者不能支付费用，是否需要延期或拒绝提供服务 Charge Capture收费信息的获取 Charging accurately for the services and supplies used to treat the patient. 确保对所提供的服务和治疗用品准确收费 Super Bills 帐单 Bar Coding 条码 Manual entry to I/S system 人工录入I/S系统 Late Charges 延期的收费 Charges entered after bill has been created 开出帐单后， 录入费用 Require rebilling 与保险公司再次核对赔付额 Some insurers will not accept Late Charge Reports – Tracking 建立延迟支付保费报告, 并对支付进行跟踪 System based electronic charging eliminates most late charges 系统应尽量杜绝延迟支付的费用 Late Charges延期的收费 Days o