Financing for Healthcare by Eugene Seah https://padlet.com/eugene_seah/hde3vta7wm0v P01 to P12 Mindmap en-us 2019-07-27 13:27:00 UTC 2025-03-15 10:34:57 UTC hello@padlet.com P02 eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372442297 2019-07-27 13:27:00 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372442297 P01 eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372442298 Financing for Singapore Healthcare]]> 2019-07-27 13:27:00 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372442298 P03 eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372442299 Medisave]]> 2019-07-27 13:27:00 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372442299 P04 eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372442300 Medishield Life]]> 2019-07-27 13:27:00 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372442300 P05 eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372442301 Medifund]]> 2019-07-27 13:27:00 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372442301 P06 eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372442302 Financial Counselling]]> 2019-07-27 13:27:00 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372442302 SINGAPORE HEALTHCARE SYSTEM eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372442303 2019-07-27 13:27:00 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372442303 eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372442304 MEDISAVE
o   Can take from children
o   Est. April 1984
o   National Scheme help individual set aside part of their monthly income in to Medisave account to meet medical expenses
o   This amount is to help pay their medical bills (CPF)
o   Increase demand for healthcare service, medisave usage is expanded due to increase of ageing population

MEDISHEILD LIFE
o   Revamped in 2015
o   Insurance
o   Basic health insurance scheme

MEDIFUND
o   Medisave use up, cash use up than use Medifund
o   A set up to help the poor or the needy
o   Safety net
o   To qualify must be Singaporean, under the Subsidies  and Regulations

 ELDERSHEILD
o   For 40 years old and above
o   Only effective when you are disabled
- Stroke, cannot move etc
o   Call insurance to apply Eldershield
o   For 72 months 
o   To risk pool against the financial risk of a severe disability
o   Provide monthly cash pay out
- Will be revamped with Careshield Life in 2020

Examples of  SUBSIDIES
o   CHAS, Pioneer Generation, Merdeka Generation

SUBVENTION
o   Government pays through subvention
o   Government grant gives to the hospital. Example: $100 medical, patient pay only $20. $80 government pay



]]> 2019-07-27 13:27:00 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372442304 PHILOSOPHY eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372442305 Singapore healthcare financing philosophy

Offer universal healthcare coverage to all citizens
Individual responsibility and affordable healthcare to all citizens (multiple tiers of protection)
Promoting competition and transparency

]]> 2019-07-27 13:27:00 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372442305 eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372442306 Challenges Singapore healthcare system
Ageing population
Increasing incidence of chronic diseases
Increasing demand for the more healthcare services
Increasing demand for more affordable healthcare

MOH Committee of supply Debate 2019

1. Keeping Healthcare Sustainable & Affordable

- Supporting Aspirations and Needs of our MG
- Enhanced CHAS
- Extension in Medishield Life coverage

2. Enhancing our Primary Care Foundation

- Strengthening our Primary Care Foundation
- Building Communities of Care to support ageing in place

3. Empowering Singaporeans to live healthily

- Managing Diabetes
- Encouraging Screening
- Supporting Women's Health
- Strengthening Community Mental Health Services

4. Equipping Professionals & Providers

- A progressive,  future ready workforce to meet healthcare demand
]]> 2019-07-27 13:27:00 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372442306 Centralization creates cost savings through consolidation eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372442307 o   Group purchasing office (GPO):
Allows for bulk buying of medical consumables and materials. Consolidation of purchases greatly increases leverage of hospitals to demand lower prices.
Standardization of cost prices throughout the cluster.

o   Finance shared services (FSS):
an outsourced account payable,
account receivable and payroll service provider to various institutions under NHG or SHS group and other related companies.
Back end accounting functions are consolidated or shared to reduce the manpower and operating  cost

o   IHIS or integrated health information system was conceived in 2008 by the ministry of health to be the central employer for all public healthcare IT professionals.


]]> 2019-07-27 13:27:00 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372442307 eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372442308 Competition creates price diversity

Keep to the ruling 
Different institution different pricing

]]> 2019-07-27 13:27:00 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372442308 REVAMPED public healthcare system eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372442309 West
Central
East

Each cluster has their own hospital, community hospital, polyclinics, specialist center, medical school partner.

]]> 2019-07-27 13:27:00 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372442309 Slow Medicine and Fast Medicine eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372442310 - Slow Medicine
Longer time to recover 
Treatment take a long time to heal for example, high blood pressure, diabetes 
Maintain the diseases by going for treatment
An elderly fall feel better but still not stable to walk, go to community hospital (rehab do leg exercise to improve mobility-  slow medicine)

-Fast Medicine
Treatment, medication, drugs
 

]]> 2019-07-27 13:27:00 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372442310 Insurance eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372442311 Insurance can be that company buy the insurance for individual or individual would buy.

Two types of health insurance
Catastrophic Medical insurance
o   Cover major illness where the associated medical cost is substantial
o   Example: Medishield Life
Long term care insurance
o   Fix monthly amount for long term nursing treatment 
o   Cannot do 3 of ADL, can approach insurance company and activate it
o   Example hypertension and get stroke, paralyzed. 

]]> 2019-07-27 13:27:00 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372442311 Limitations of Insurance eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372442312 Coordination of Benefits clause
o   To prevent clients to make profit from insurance companies
o   Company would check health bill to check 
o   Claim processing rules requires submission of original bills only 

]]> 2019-07-27 13:27:00 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372442312 eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372442314 DEDUCTIBLE
- Initial amount an insured member needs to pay for the claims made in a policy year before any pay out from Medishield Life
-Renew every year
-If paid fully for that year, sessions in the year do not need to pay but still need pay coinsurance.
-To avoid first-dollar coverage and help Medisheild target only large bills

COINSURANCE
-The percentage of the claim that an insured member needs to pay for claims made in a policy year before any pay out from Medishield Life
-To guard against over consumption

CLAIM LIMITS
-The maximum amount you can claim from an insurance policy for each type of expenses
-Example: Daily ward limit, policy year limit, lifetime limit: To address excessive claims

EXAMPLE OF A CASE
If the claimable amount from an inpatient bill is $3,000 and the insurance policy has a deductible amount of $2,000 with a co-insurance of 10%. What is the insurance coverage?

$3000 - $2000 = $1000
$1000 x 90% = $900 


]]> 2019-07-27 13:27:00 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372442314 Employee Medical Insurance eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372442315 -Advantage:Employed Singaporeans have medical insurance coverage provided by their employers
-Disadvantages: Pre-existing illness or medical conditions 
]]> 2019-07-27 13:27:00 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372442315 eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372442316 -Set up in April 1993
-A safety net is for patients facing financial difficulties with their remaining bills after government subsidies. 
·        One specially for elderly.  (Medifund Silver)
·        One specially for needy Singaporeans children age 18 years old and below      (Medifund Junior)
to provide more targeted assistance to two vulnerable groups
]]> 2019-07-27 13:27:00 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372442316 Key Principles of Medifund Assistance eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372442317 Personal responsibility
o   Patient expected to co-pay according to ability
Medical Necessity
o   Basic 
o   Based on necessity, hence exclude non-essential choices
o   No class ward A or cosmetic surgery
Family responsibility
o   Family resources
o   10 medisave can use, use that first
Many helping hands
o   Can rely on charity
o   Charity available use the charity but after charity still not enough than able to use medifund

]]> 2019-07-27 13:27:00 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372442317 Medifund eligibility criteria eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372442318 Medifund general scheme:
-Medifund assistance:
-Is a Singapore citizen;
-Is a subsidised patient;
-Has received treatment from a Medifund-approved institution
- Patient and family have financial difficulties paying for his healthcare bills despite receiving
- Government subsidies and drawing on other means of payments including MediShield Life/Integrated Plans, Medisave and cash. 
]]> 2019-07-27 13:27:00 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372442318 eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372442319 Needy patients who has problem paying their medical bills can approach Medical Social Workers of Medifund-approved restricted hospitals and institutions for assistance.

Local Medifund committees at the approved hospitals and institutions will decide on the appropriate level of assistance fir the applications

]]> 2019-07-27 13:27:00 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372442319 Medifund Silver eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372442320 -Singaporeans age 65 and above
-Medifund Silver introduce in 2007 to provide more targeted assistance
2008 Medifund silver was rolled out
-Subsidised patient
-And has taken and absorb all the medisave from the family

Medifund Silver targets at needy elderly as they generally have higher medical bills and are financially more dependent on their family members upon retirement

]]> 2019-07-27 13:27:00 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372442320 Medifund Junior eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372442321 -Singaporean 18 years old and below
-Low income family 
-Medifund don’t help middle income but Medifund junior helps
-Medifund Junior is based on the hospital bill is high and household income, status of family
-Medifund amount of assistance: Different principles
-Household income per capita
ONLY C class patient can enjoy 100% Medifund assistance

]]> 2019-07-27 13:27:00 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372442321 Medifund Level 1 to 3 eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372442322 Level 1- Public Assistance
-Pre Qualified Cases
-Medical fee exemption card
-IMH
-Public Assistance Card

Level 2-Straight Forward Applications
-When recommended  % based on household income are eligible (same or lower)
Approved by medical social worker

Level 3- Non straight forward application
-When % is greater than eligible % based on Household income
-Approves by medifund committee

]]> 2019-07-27 13:27:00 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372442322 Medication Assistance Fund (MAF) eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372442323 -To help lower income patient on medication (drugs)
-Max subsidy 75%
-Per capita income $1,500 and below
-Drugs must be listed under the MAF form
]]> 2019-07-27 13:27:00 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372442323 Criteria of MAF eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372442324 Clinical evaluation
Evidence of efficacy
Favorable safety profile
Ethical consideration

]]> 2019-07-27 13:27:00 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372442324 MAF Plus eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372442325 -To cover non standard and non formulary
-·Drugs must be listed under MAF plus form


]]> 2019-07-27 13:27:00 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372442325 Criteria for MAF Plus eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372442326 Audit and checks for MAF Plus

-Data will be submitted to MOH
-Clinical Audits
-All applications go through CMB
(Pharmacist, doctor, CMB must sign)

]]> 2019-07-27 13:27:00 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372442326 Why do we need financial counselling? eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372442327 -Mandatory under the Private Hospitals and Medical Clinics regulation to go through financial counselling. 
-To help/save patients and families from financial burden.  

]]> 2019-07-27 13:27:00 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372442327 When is it performed? eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372442328 -It is to perform before pre-admission testing
-Before and after admission
-Emergency
-If medical condition change within 48 hours, in need to do of another financial counselling under the PHMC actSubsequent changes to hospital bills due to length of stay, medication, complications, more treatment or drugs.

]]> 2019-07-27 13:27:00 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372442328 What is Financial Couselling eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372442329 - Estimate bill size must be communicates
(If there is a wrong communication wrong bill size, hospital can be sued.)


Patient must be informed to enable decision such as
-Choice of class, primary, private, sub
-To proceed or not to proceed with treatment
-Seek alternative options at other institutions
-Standard or nonstandard options

]]> 2019-07-27 13:27:00 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372442329 General rules and regulations eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372442330 Upgrading
o   Will switch the remaining charges to A class

Downgrading
o   Must do a means test (household meanest). To check every family household income 
o   Normally only need to give personal income (mean test) to go in but if want to downgrade, household mean test is required.

Downgrading/Upgrading
o    Subject to availability. If no slots, remain put.
·        Follow up at specialist outpatient clinic after discharge
o   Class A/B1 charge at private rate
o   Class B2/C charge at subsidized rate
o   Patient classified under industrial accident charge at private rate (injure during worktime by law company needs to pay) 
o   All other citizenship will be charge at private rate

Social over-stayer 
o   NOT applicable for Class A1
o   Overstay with no medical reason
o   For patients that doctor say can be discharge but want to still stay in the hospital
o   Charge different rate

]]> 2019-07-27 13:27:00 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372442330 Application of means test eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372442331 -Individual means testing
o   Inpatient admission
For employed: average monthly income for past 12 months
For self-employed:  monthly income within last two years
For unemployed or no income, received full subsidy (65% Class B 80% Class C)
BUT property with an annual value more than $11,000 they are given subsidies of 50% and 65% respectively for B2 and C wards.
 
-Household means testing
o   Inpatient downgrading
o   SOC enhanced subsidy
o   ILTC subsidy
o   Medifund application
o   Community health assist scheme (CHAS) applications
- Gross income (no deduction of CPF) of person needing care all spouse and immediate family members.
- Annual value of place residence for household with no income



]]> 2019-07-27 13:27:00 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372442331 Process eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372442332 - Consent Form 
-Payslip/Bank statement
-Means- Test declaration form
-Cinsent to release Medisave/ Medishield Information
-Acknowledgement that FC is performed by  patient signing
-Blll
-Medisave authorization form]]> 2019-07-27 13:27:00 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372442332 HEALTHCARE FINANCING eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372442333 P01-P12]]> 2019-07-27 13:27:00 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372442333 CHAS eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372442334 The Community Health Assist Scheme (CHAS) is a scheme by the Ministry of Health (MOH) that enables Singapore citizens from lower- to middle-income households to receive subsidies for medical and dental care at participating General Practitioner (GP) and dental clinics near their homes.

]]> 2019-07-27 13:27:00 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372442334 Benefits that patients can get from CHAS eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372442335 - Subsidies for 20 chronic conditions under  the Chronic Disease Management Programme (AT GENERAL PRACTITIONERS):

Subsidies available for CHAS Card Holders (from 1 Nov 2019) at Specialist Outpatient Clinics: 

CHAS Blue Card:  (for HHMI below $1,100 and AV of home $13,000 and below)

- Common Illness - Up to $18.50 subsidy per visit
- Simple Chronic Conditions - Up to $80 subsidy per visit (capped at $320 per year)
- Complex Chronic Conditions - Up to $125 subsidy per visit (capped at $500 per year)
- Dental Procedures - Up to $11 to $256.50 subsidy per procedure (dependent on procedure)
- Subsidy at SOC for services: 70%
- Subsidy at SOC for drugs: 75%

CHAS Orange Card: (for HHMI between $1,101 to $1,800 and AV of home between $13,001 to $21,000 and below) 

- Common Illness - Up to $10 subsidy per visit 
- Simple Chronic Conditions - Up to $50 subsidy per visit (capped at $200 per year) 
- Complex Chronic Conditions - Up to $80 subsidy per visit (capped at $320 per year) 
- Dental Procedures - Up to $50 to $170.50 subsidy per procedure (denture, crown and root canal treatment)
- Subsidy at SOC for services: 60% 
- Subsidy at SOC for drugs: 75%

CHAS Green Card (for HHMI of more than $1,800 and AV of home more than $21,000)

- Common Illness - Not Applicable  
- Simple Chronic Conditions - Up to $28 subsidy per visit (capped at $112 per year)  
- Complex Chronic Conditions - Up to $40 subsidy per visit (capped at $160 per year)  
- Dental Procedures - Not applicable
- Subsidy at SOC for services: 50% 
- Subsidy at SOC for drugs: 50%]]> 2019-07-27 13:27:00 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372442335 Types of Subvention eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372442336 Lump sum subvention
-Operating funds given to healthcare institution based on budgetary forecast

Piece rate subvention
-Funds awarded based on total number of patients days and volume of outpatient.
-Funding based in usage

Casemix subvention
-Funds based on DRG
-Depends on complexity of treatment

Global budget subvention
-Funds based on lum sump, piece rate and casemix funding principles ]]> 2019-07-27 13:27:00 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372442336 Subvention eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372442337 -Providing public hospitals subvention funds
-Block funding for patients using subsidized services (Class B2 and C)

-To cover resources such as manpower and consumable supplies]]> 2019-07-27 13:27:00 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372442337 What is Medisave? eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372442338 -A portion of your CPF savings account to pay personal or immediate family medical bills
-Medisave can be used for spouse, parents and children medical bill
-Medisave to pay insurance premiums for many shield and integrated shield plans
- Medisave withdrawal limit has been increased to $500 per year]]> 2019-07-27 13:27:00 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372442338 How can i use Medisave? eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372442339 Charges covered by Medisave  
 Inpatient ward charges ($450 per hospitalisation day) 
 Approved day surgeries (up to $300 for each day surgery episode) 
 For surgery (Claims from $250 to $7550 based on the TOSP) 
 
Outpatient charges:   
Chronic diseases treatment (20 chronic diseases under CDMP) - similar to CHAS CDMP scheme  
*15% co-payment  
 Cancer treatment  
Renal dialysis - $450 per month per patient 
 Health screenings (mammograms and screening for new born) 
 Selected vaccinations such as Pneumococcal vaccine for children, Hepatitis B vaccine, HPV vaccines for females (9 to 26 years) 
  Medisave Maternity Package (for pregnant women) - claim up to $3000 for Natural Delivery and $4850 for Caesarean Delivery. 
 $300 per year patient per scans needed to diagnose or treat your medical scans (for CT or MI scans ONLY) 
 For Old Age: $200 per year per patient under Flexi Medisave (aged 60 years and above) 

]]> 2019-07-27 13:27:00 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372442339 Charges covered by Medisave eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372442340 -Inpatient ward charges, 
-Approved day surgeries

Outpatient charges
-Chronic diseases treatment
-Cancer treatment
-Renal dialysis
-Health screening and selected vaccinations 
-Community hospital and hospice]]> 2019-07-27 13:27:00 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372442340 P07 eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372443599 Documentation & Inflight Management]]> 2019-07-27 14:07:45 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372443599 Documents Required during Registration eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372443718 1. Patient details:               
- Patient unique identification number 
- Name 
- Date of birth 
- Address
 
2. Other necessary information: 
- Contact number  
- 3rd party payers  
- Next Of Kin (NOK) information  
- Allergy information  
- Referral source]]> 2019-07-27 14:10:49 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372443718 Medical Claims Proration System eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372444009
MCPS is a secure web based medical benefits and  claims processing/ proration system that helps  Singapore Civil Service to centrally manage and  process employee healthcare benefits. 

The system, which is integrated with healthcare  providers, insurance companies and various  government agencies, has significantly streamlined  medical claims processes, ultimately enabling public  service employees to enjoy medical benefits at clinics  and hospitals.]]> 2019-07-27 14:18:59 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372444009 Credit Assessment eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372470566 2019-07-28 06:32:22 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372470566 Credit Assessment (con't) eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372470679 2019-07-28 06:36:40 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372470679 Credit Follow Up eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372470855 2019-07-28 06:41:32 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372470855 Credit Follow Up (Con't) eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372471032 2019-07-28 06:45:14 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372471032 Credit Follow Up (Con't) eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372471278 2019-07-28 06:51:27 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372471278 Ward Centric vs Patient Centric Collection eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372471649 Ward Centric: PSA or ward clerks are tasked with
monitoring the debt of patients.

Patient Centric: A team of PSA is located in a central location away from patient. They have access to patient financial data and review the debt situation remotely.]]> 2019-07-28 07:03:42 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372471649 Specific Bad Dept Provision eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372471822 Patients with “F” credit ratings must be submitted to finance for bad debt provision. The bad debt amount must be communicated to the Finance Dept.

Techniques for collection in the ward

- Placing documents in the ward]]> 2019-07-28 07:10:45 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372471822 Purpose of Discharge Summary and Interim Bill eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372472018 Discharge Summary
Upon discharge, the summary provides
details of the patient medical condition.
It is given to patient in the event that the
Employer or Insurer needs the medical
information for processing of medical bills

Interim Bill

An interim bill is given for the following
reason:

- To collect any cash outstanding before
patient leaves the hospital

- To ensure patient is aware of his medical
bill upon discharge as a final copy will not
be presented immediately due to CCPS
processing.]]> 2019-07-28 07:17:45 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372472018 P08 eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372472208 Charging (Charge Capture Process)]]> 2019-07-28 07:23:47 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372472208 Charge Form eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372472471 - A charge form is a document used by nurses to record the services rendered for a patient.
- Data entry of services will then be performed by billing staff reading from the charge form.
- Services entered into the bill must be reconciled with the charge form
- Charges reviewed regularly to ensure that prices and services are updated.]]> 2019-07-28 07:28:08 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372472471 Centralized Revenue Management Approach vs Decentralized Revenue Management Approach eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372472720 2019-07-28 07:34:30 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372472720 Direct Entry vs Batch Interface eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372472965 - Two modes of service codes input:

1. Direct entry of services into billing system by
billing staff (use of charge forms).
You usually use a batch interface to collect transactions
over a period of time and then process all of the
transactions at once

2. Batch or Online interface of services from
ancillary medical system to billing system.
(entry of service items by the various service
stations)
For an online interface system, transactions are processed as and when they are entered]]> 2019-07-28 07:41:50 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372472965 Benefits of Batch Interface eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372473527 Batch processing has these benefits:

- It can shift the time of job processing to when the computing resources are less busy.

- It avoids idling the computing resources with minute by minute manual intervention and supervision.

- By keeping high overall rate of utilization, it amortizes the IT System

- It allows the system to use different priorities for batch and interactive work.

- It allows effective use of manpower, key entries only once]]> 2019-07-28 07:58:27 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372473527 Key Concerns for Batch/Online Interface eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372473735 1. Quantity cannot be zero
2. Services must be performed within Length of
Stay.
3. Zero priced items are allowed
4. In the event, service codes are not available.
Miscellaneous codes may be used.]]> 2019-07-28 08:05:53 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372473735 Disadvantages of manual entry of services eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372473795 Human dependent and prone to error, subject to availability of staff to perform the work as opposed to automated entry by system]]> 2019-07-28 08:07:40 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372473795 Consumables & Implant Charging eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372473931 Mark up table is used, in the event the medical item used is new and service code has not been created. Miscellaneous charge code is employed, with price determined by a mark up table.]]> 2019-07-28 08:12:25 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372473931 Key Definitions eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372474003 Charge entry is a service that has been
performed and is pending data entry.
Order entry is a service that has not been
performed but “ordered”.
Closure of bill refers to instruction issued to the billing system to stop accepting service entries / charge code entries for an account.
A service entered after a bill has been closed is
termed a late charge.
Late Charge: For hospital billing, the bill has to be opened or cancelled if it has already been closed or billed, before any late charge can be entered. Debit or credit note are not raised to manage late charges with regard to hospital billing. Subvention and CCPS submission of claims will be compromised by the issuance of debit or credit notes.
Exploding/Battery Code: The input of a single code, similar to a macro,
that will automatically expands into multiple services. The primary purpose is to save time and effort in entering multiple keystrokes for
data entry staff. Unlike package, exploding/battery code does
not have discounted price.]]> 2019-07-28 08:15:06 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372474003 Packages eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372474094 1. Item based package

A package defined by a list of items and quantity .
(Similar to Macdonald set meal) or A&E charges in hospital

2. Dollar based package

A package defined by a price tag to treat a specific medical condition . It is usually further defined by list of exclusion. (Similar to a buffet]]> 2019-07-28 08:19:54 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372474094 Deviation from Normal Pricing eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372474247 Regardless of the mechanism, there is a need for
charging system to execute the following effect:

- Discount Service codes , a service code that trigger a discount effect on the entire bill

- Surcharge Service codes , a service code that trigger a surcharge effect on the entire bill

- Conditional codes , a code that imposes a surcharge on certain services only . This code may be entered in the form a service code, payer code or a specially designated code.]]> 2019-07-28 08:25:01 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372474247 Ward and Daily Treatment Fee eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372474515 - Ward charges typically relates to the
accommodation, nursing, linen and meals

- Daily Treatment fee relates to services rendered by the consultants or medical officers during ward rounds

- Ideally, this charge is imposed during a nightly batch job after midnight census is completed]]> 2019-07-28 08:32:23 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372474515 Charging for early discharge and late discharge eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372474591 To illustrate:

Before 1pm, no charge is imposed.
After 1pm, a quarter day ward charge is imposed.
After 6pm, a full day ward charge is imposed.
A penalty may discourage discharge, patient
rather discharge prior to 6pm since they had paid
the penalty.
Furthermore, a prorated ward charge does not
attract Medisave withdrawal.]]> 2019-07-28 08:34:50 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372474591 P09 eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372474992          Billing]]> 2019-07-28 08:46:41 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372474992 What is Billing eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372475087 It is defined as the generation of an invoice for the purpose of payment collection from a customer]]> 2019-07-28 08:48:52 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372475087 Components of a typical healthcare bill eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372475202
  • Patient information
  • Description of service rendered
  • Amount of the service
  • Total payable amount by 3rd party (if any)
  • Total payable amount by patient
    • ]]>     2019-07-28 08:50:54 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372475202     Fee Cap (Inpatient) eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372481395
  • Fee cap were introduced in 1984 for Class B2 and C patients
  • Purpose is to ensure that subsidised patients would not be put to excessive difficulty in meeting the revised hospital charges due to unnecessary tests/investigations
  • Currently, fee caps are applied on surgical operations, laboratory tests and specialised investigations, X rays,
    rehabilitative services and standard medications
    • ]]>     2019-07-28 12:25:29 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372481395     Fee Cap Approach eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372481472 1. Traditional Method or 3 Individual Fee Caps (old
    practice)
    i. Laboratory tests : $80
    ii. Specialized investigations: $80
    iii. X rays : $80

    2. Modern Approach or One Major Fee Cap/3 in 1
    (new practice)

    (i . Laboratory tests) + (ii. Specialized investigations) +
    (iii. X rays) = $180    ]]>     2019-07-28 12:27:46 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372481472     Subsidy Cap for Implant eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372481565
  • Subsidy caps were introduced in 1993 for implants and prostheses
  • All Class B2/C patients are given a 50 subsidy for these items up to a maximum subsidy of 500 as long as the consultant in charge certifies that there is no other cheaper alternative suitable for the patient, irrespective of whether the implant/prosthesis is “or “non standard”, except for cardiac devices
  • This is meant to help subsidized patients as previously they would need to pay full cost for non standard implants and prostheses
    • ]]>     2019-07-28 12:31:05 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372481565     GST Impact for Subsidized Cases eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372481632 - The Goods and Services Tax (GST)  was introduced on 1
    Apr 1994
    - Subsidised patients are not required to pay the GST for
    their bill These include inpatients (Class B2+/B2/ day
    surgery,  and outpatients (SOC and polyclinic)
    - The funding of GST absorbed by the government
    healthcare institutions for these subsidized patients is
    provided by MOH. ]]>     2019-07-28 12:33:11 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372481632     Types of Bills in a RESTRUCTURED hospital eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372481790
  • The Unbilled or Interim Bill stage refers to the period when the bill or invoice is open to addition of new charges. (OPEN BILL)
  • The Provisional Bill stage refers to the period when the bill or invoice is closed to addition of new charges but it is not yet ready for generation.  In the Singapore context, the bill or invoice is submitted via CCPS or Central Claim Processing System for claiming against Medisave, Medishield Life and Private Medical Insurance. (CLOSED BILL)
  • The Final Bill is when all services rendered has been keyed in the system When the bill returns from CPF board and is ready for generation
    • Once the bill is finalised , an original bill will be printed and given to patient. In the event that patient request for extra copies of the bill, it will be duplicate copies. Bill stamped with “Certified true copy” and acknowledge by the staff will be treated as original copy.   
    • The cancelled bill stage refers to the period when the bill or invoice is re opened for addition of new charge. If patient has received a copy of the first bill, they must be advised of the re bill via verbal or written means The rebilled will be considered as a new bill to the patient as there are changes to the charges in the bill
    • An original invoice will be given for rebilling

    ]]>     2019-07-28 12:37:41 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372481790     Civil Service Medical Benefits eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372482204 There are 3 medical benefit schemes: 

    Comprehensive Co-Payment Scheme (CCS) 
    - For Civil Servants appointed BEFORE 1 Jan 1994

    Medisave-cum-Subsidised Outpatient Scheme (MSO)
    - - For Civil Servants appointed FROM 1 Jan 2994

    Co-Payament on Ward Charges Scheme]]>     2019-07-28 12:54:13 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372482204     Careshield Life eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372482353 To provide more support to the ageing population, CareShield Life will replace Eldershield in 2020, 
    CareShield Life will feature higher payouts that  increase over time with no cap on payout duration, to provide better protection against the uncertainty of long term care costs if you become severely disabled]]>     2019-07-28 12:58:17 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372482353     eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372482395 CareShield Life will provide better protection and assurance in 4 ways: 

    1  Lifetime cash payouts - For as long as you are severely disabled 

    2  Payouts increase over time 

    Starting at $600 per month in 2020 
    Payouts increase until age 67, or when you make 
    claims, whichever is earlier 

    3 Government Subsidies to make it affordable - No one will lose coverage if they cannot pay the 
    premiums. 

    4 Premiums can be fully payable by MediSave]]>     2019-07-28 12:59:29 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372482395     Cancelled & Rebill eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372482896 The cancelled bill stage refers to the period when the
    bill or invoice is re opened for addition of new charges

    If patient has received a copy of the first bill, they must
    be advised of the re bill via verbal or written means

    The rebilled will be considered as a new bill to the
    patient as there are changes to the charges in the bill
    An original invoice will be given for rebilling]]>     2019-07-28 13:19:32 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372482896     Billing Category vs Bill Summary Code eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372483509
  • A Billing Category is a categorization code used to group service code in a pricing catalogue.
  • A Bill Summary Code is a code that is used for purpose of presentation on a Summary Bill. A summary bill does not display the individual items consumed for a particular episode. The items must be grouped within a bill summary code.
    • ]]>     2019-07-28 13:41:47 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372483509     Service Code eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372483559
  • A Service Code is a unique code that describes the services or item with a price.
  • Billing staff enters a service into the billing system to post a charge.
    • Example of a service code
    • Service Code: CXR002L
    • Description: Chest X Ray Left Side
    • Full Price: $45
    • B1 Price: $40
    • B2 Price: $24
    • C Price : $15
    ]]>     2019-07-28 13:43:48 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372483559     Bill Cum Receipt (Invoice) eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372483746 A Bill cum Receipt displays the services consumed and the payment details as well. A typical hospital bill usually display both the billing and payment details on the same page.]]> 2019-07-28 13:50:44 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372483746 Information that can be found on the receipt portion of the bill eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372483821
  • The receipt component includes:
    • 1. Payer Name
    2. Bill amount
    3. Payment amount
    4. Adjustment amount
    5. Amount due

    It is important to display the information in one document for the purpose of medical employment benefits and insurance claim.
    ]]>     2019-07-28 13:54:02 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372483821     A&E/Emergency Dept Bill eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372483992 A&E facilities are meant for patients with emergency conditions
    Subsidies are accorded to all emergency patients regardless of their citizenship and/or residential status of the patient
    The subsidy rate is set at 50%  of the norm cost of treating an emergency case
    The other 50% are to be recovered from patient’s charges

    A&E fee is a single flat fee system applying to
    both emergency and non emergency patients
    The cost of treating an emergency case is far
    higher than that of a non emergency case
    Since the amount to pay is much higher, a
    patient with a minor ailment should be deterred from clogging up A&E departments This is applicable only to cash paying customers    ]]>     2019-07-28 13:59:34 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372483992     P10 eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372525110 Counter Collection]]> 2019-07-29 02:28:16 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372525110 Non Patient Billing Approach eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372525172 A non patient is a customer referred by an
    external doctor to consume medical service
    offered by the healthcare institution
    For example, a polyclinic doctor may refer a
    patient to a hospital for MRI or CT Scan as the
    polyclinic has no MRI or CT Scan machines
    Patient is referred to the diagnostic imaging dept of the hospital and not the specialist of the hospital The results are interpreted and sent to the referring polyclinic doctors

    All services must be billed at Full rate since no
    subsidy is granted
    If patient is subsidized at the referring institution, he or she will just have to pay the amount less subsidy The subsidy amount must be billed to the referring institution that is subvented by MOH
    If patient is a private class, he or she will have to pay the full rate]]>     2019-07-29 02:29:02 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372525172     Introduction to Counter Collection eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372531995 - Work involved in ensuring all collections (via means of cash, cheques, Network for Electronic Transfers , Credit Card, EzLink etc ) transacted at the counters are accounted for.
    - All collections are deposited in the designated bank accounts
    of the healthcare institutions
    - To ensure reconciliation and timely detection of discrepancies cashier or collection staff must ensure that Close Counter is performed after the day’s shift and the total collections received reconcile to the amounts in the Close Counter Statements]]>     2019-07-29 03:29:44 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372531995     Payment Modes for Counter Collection eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372532192 - Cash
    - NETS
    - Cash card Cheque
    - Credit cards (e.g. Visa/ Master card, Diners Card,
    Amex Card, JCB Card)
    - Ez link Card 
    = GrabPay
    - PayNow 
    - Alipay
    - WeChat Pay]]>     2019-07-29 03:31:52 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/372532192     Alternative Approach to downtime bill eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/373064476 - An option is to permit patients to depart from the clinic without billing patient
    - A bill will be generated when the billing system is returned to
    normalcy
    - While downtime billing may ensure payment is collected, the
    manual process will extend payment and queue time.  For
    subsidized patients the GST must be absorbed, hence billing
    staff must ensure the right prices is selected for computation
    - Pricing catalogue must indicate both GST inclusive and exclusive prices for ease of computation
    Downtime billing is only applicable for outpatient setting and collection in advance and deposits]]>     2019-08-02 14:14:46 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/373064476     Differences between Shortages vs Excess eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/373111947 Shortages
    = Counter collection procedure is important as it ensures every cent collected is banked in to the hospital account.
    - Fraud or negligence could be detected with counter collection mode.
    - A shortage happens when the actual collection in terms of cash and other modes is less than the amount stated in the system.
    - Where a shortage is recorded, the shortage is to be topped up on the same day and banked in together with the current day’s collection.
    - Any topping up of cash shortages for amounts
    highlighted by Business Office should be separated
    from current day’s collection
    - The cash top up must be handed over to Business
    Office staff for bank in
    - For material shortages exceeding a high amount
    (e g 100 00 the Cashier/Collection staff may
    request to pay by installment, Manager in charge
    should seek approval from the Business Office
    Manager or Executive]]>     2019-08-03 05:25:19 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/373111947     Excess eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/373112062 - Any excess cash collection should be banked in together with the current day’s collection

    - Cashier/Collection staff should indicate on the Counter Discrepancies Form the excess collection amount and an explanation resulting in the excess collection]]>     2019-08-03 05:30:05 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/373112062     Credit Card & NETS Collection eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/373112331 2019-08-03 05:40:53 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/373112331 Credit Card Collection eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/373112358 • For credit card transactions, Cashier/Collection staff is required to print the Detailed and Batch
    Settlement Reports from the credit card terminals
    • Supervisor/Leader has to ensure that the sales slips
    are duly signed by cardholder and are collated
    according to the Detailed Report
    • The total count and amount of approved sales slips
    must tally to both the Detailed and Batch Settlement
    Report
    • Void sales slips must be submitted to Business
    Office
    • In the event of missing credit card slips,
    Supervisor/Leader must identify the patient’s bill
    details and make an indication on the Close Counter
    Statement]]>     2019-08-03 05:42:22 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/373112358     NETS Collection eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/373112493 • For NETS transactions, Cashier/Collection staff is required to print the Batch Settlement Report from the NETS terminals
    • Supervisor/Leader has to ensure that the NETS slips are collated according to the Batch Settlement Report
    • The total count and amount of NETS slips must tally with the Batch Settlement Report Void NETS slips must be submitted to Business Office
    • In the event of missing NETS slips, Supervisor/Leader must identify the patient’s bill details and make an indication on the
    Close Counter Statement]]>     2019-08-03 05:47:08 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/373112493     Cancellation of Receipts eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/373112651 - Any cancellation of receipt must be properly
    recorded in the Cancellation of Receipt Form to be attached to the Close Counter Statement

    - Clinic/Location Manager will then verify before submitting to the Business Office.]]>     2019-08-03 05:53:13 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/373112651     Refund eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/373115771 Front End Refund

    -     In the event where there is over charging or collection more than bill amount (excess) and a refund is due, Cashier/Collection staff may process an upfront cash refund if the customer requires the refund immediately

    - A correct invoice and SAP refund form is required to be printed out for the patient to acknowledge the cash refund by signing on the SAP refund form.

    - The SAP refund document is to be enclosed with the daily Close Counter Statement and send to Clinic/Location Manager for verification and submission to the Business Office.]]>     2019-08-03 07:58:54 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/373115771     eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/373115834 Back End Refund

    - For refunds arising from over charging of patient at the counters after the customer has left the vicinity of the healthcare institution, the refund is initiated through the Refund Request Form

    - Supervisor/Executive/ Manager in charge at the
    respective department must complete and sign the form before submitting to Business Office .    ]]>     2019-08-03 08:01:38 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/373115834     Cash Float eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/373118964 • Cash float is the cash given to cashier at the beginning of the day or session to provide change to be given to
    customers
    • Cash float is kept in the cashier till or drawer throughout the transaction or cashier work session
    • Different amount in different denomination must be distributed to each cashier at the start of the session
    • The cash float may be handed over to the cashier working the next shift after a proper handover process
    • However, for ease of management, each staff should be given their personal float to administer The amount may range from 100 to
    800 sporadic spot check must be conducted to ensure the float is intact
    • At the end of the day or cashier session, the department cash float should be deposited into a different safe from the counter cash
    collections safe]]>     2019-08-03 09:53:48 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/373118964     Walk off eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/373119289 • There are occasions where patients will leave the
    healthcare institutions after receiving the services or
    medications without payment This is known as a “walk off”
    • These should not be confused with “No Shows” which refers to patients which have been scheduled for consultation but did not come
    • Where possible, the workflow will make the patient pay for the services medication first E g Polyclinic makes the patients pay for medications before they can get a referral to the hospital specialist clinic, TTSH SOC clinics collect payment for medication at the clinic before the patient is sent to collect the medication at the pharmacy
    • It is made worse that patients may visit different
    departments before their journey ends, e g go to
    Diagnostic Radiology Department to take X Ray before going back to the clinic to see the doctor If the patients leaves after taking the X Ray without paying for it, resources would have been used without receiving payment
    • It would be more difficult and will cost more resources to collect payment after the services, product, medication is provided to the patient
    • Special attention is therefor paid to reduce prevent
    “walk offs” because they represent uncollected debts
    which can potentially result in bad debts and loss to the organization]]>     2019-08-03 10:07:58 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/373119289     Bank Reconciliation eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/373153239 2019-08-04 04:08:25 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/373153239 P11 eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/373153370 Claims Processing]]> 2019-08-04 04:11:48 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/373153370 Common types of claims eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/373153554 1. ‘First party claim’ from patient directly
    2. Third party claim Patients may pay their medical bills through other agencies other than by themselves common third party payors
    a) Civil Service payment for employee medical benefits (Government officers, pensioners and their dependants)
    b) Private organizations/employers/insurance companies of the patients (Letter Of Guarantee)
    c) CPF Patients’ own
    i. Medisave for hospital bills or for Chronic Disease Management Programme (CDMP)
    ii. Medishield Life
    iii. Integrated Shield Plan]]>     2019-08-04 04:16:26 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/373153554     Third party claims system eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/373155134 a) Civil Service payment for employee medical benefits
    i. Medical Claims Proration System (MCPS) -
    Government restructured hospitals, SOCs and
    Polyclinics
    ii. Medical Billing System or MBS@Gov - GPs and Dialysis Centres
    b) Private organizations/employers/insurance companies of the patients (Letter Of Guarantee - Manual claim)
    c) CPF Board Central Claim Processing System
    (CCPS) / Mediclaim System
    i. Medisave
    ii. Medishield Life
    iii. Intergrated Shield Plan (IP)]]>     2019-08-04 05:06:00 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/373155134     Claims Processing eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/373155199 Patients bills are sent to the respective agencies for payment
    • Usually such claims are sent electronically via respective
    healthcare institution’s IT systems. (LOGs are claimed
    manually)
    • Not all claims can be process successfully due to various
    reasons
    • Healthcare institutions will rectify and resubmit if error due to data entry If due to patient’s error (not covered by the specific 3rd party payer), the healthcare institution will charge to patient for payment
    ]]>     2019-08-04 05:08:39 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/373155199     Flowchart of claim process eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/373156301 2019-08-04 05:43:44 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/373156301 Bill Amendment eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/373156432 • In the event when the bill needs to be amended, the staff ( nursing and other departments) will raise a bill
    amendment form to the business office
    • Amendment form needs to be approved by the relevant parties
    • Supervisor in charge
    • Business office in charge
    • Higher authority if amount exceeds a certain limit

    • Once approved by the relevant authorities, staff may proceed to make the necessary adjustments
    • Re generate the bill and submit the claim]]>     2019-08-04 05:50:10 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/373156432     When is it required? eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/373161885 -  Bill amendment is required when
    • There are changes to the visit information of a billed visit Example wrong source of referral (Polyclinic instead of GP), wrong 3rd party payer
    • There are changes to the services billed
    Example Over or under billed of services]]>     2019-08-04 08:32:45 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/373161885     Bill Amendment Flow eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/373161959 2019-08-04 08:36:33 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/373161959 Claim Messages eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/373161993 • Claim message is send via the internet to the respective claim parties using HL7 messages
    • Health Level Seven (HL7) is a standard for exchanging information between medical applications
    • A HL7 message is generated with the necessary information once the patients is being billed
    • Depending on the institution’s requirement, these
    message are processed real time or by batches]]>     2019-08-04 08:38:04 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/373161993     Denied vs Rejected Claims eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/373259079 - A denied claim refers to a claim that has been
    processed and the insurer has found it to be not
    payable
    = A rejected claim refers to a claim that has not been
    processed by the insurer due to a fatal error in the
    information provided

    ]]>     2019-08-05 10:47:49 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/373259079     Unsuccessful Claims Examples eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/373259261 1.  Insufficient Information Sent 
    2. Wrong information sent 
    3. Non claimable item sent
    4. Missing out on charging certain items
    5. Bill exceeded claimable amount 
    6. Patients no longer eligible for 3rd party ]]>     2019-08-05 10:51:02 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/373259261     P12 eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/373259459 Off site payment, refunds and outstanding payment ]]> 2019-08-05 10:54:46 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/373259459 Account Types eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/373259710 • AR Accounts Receivable
    - Money owed by patients (individuals or corporations) to another entity in exchange for goods or services that have been delivered or used, but not yet paid for

    AP Accounts Payable

    - Debts that must be paid off to another entity (for example vendors, medical equipment suppliers or pharmaceutical companies) within a given period of time in order to avoid default At the corporate level, AP refers to short term debt
    payments to suppliers and banks

    GL General Ledger.
    • A general ledger is a complete record of financial transactions over the life of a company . The ledger holds account information that is needed to prepare financial statements, and includes accounts for assets, liabilities, owners' equity, revenues and expenses

    • P&L Profit & Loss
    • A financial statement that summarizes the revenues, costs and expenses incurred during a specific period of time usually a fiscal quarter or year. These records provide information that shows the ability of a company to generate profit by increasing revenue and reducing costs.]]>     2019-08-05 10:58:55 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/373259710     eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/373260227 2019-08-05 11:10:51 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/373260227 Other payment modes that patient can use eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/373260308 • AXS
    • SAM
    • Singpost Payment Counter
    • Cheers Payment Counter
    • Online
    • Internet payment]]>     2019-08-05 11:13:22 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/373260308     NETS eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/373260409 Network for Electronic Transfers (NETS)  Pte Ltd or NETS was founded in 1985 and is owned by DBS Bank, OCBC Bank and UOB Bank It is designated by the Monetary Authority of Singapore to be Singapore’s national PIN Debit payment system. 

    NETS is the scheme operator, processor and acquirer
    of the services

    The NETS EFTPOS (Electronic Funds Transfer at
    Point of Sale) catapulted Singapore into the age of
    electronic payment It enabled bank customers to
    make purchases through point of sales payment
    using their ATM cards

    CashCard is a stored value smart card used widely
    in the motoring market in Singapore

    FlashPay Card which is used for public transport
    payments and at NETS acceptance points in
    Singapore

    eNETS online payment through online and mobile
    merchants]]>     2019-08-05 11:15:41 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/373260409     Refund eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/373265341 There must be a credit balance in the Accounts
    Receivables in order for refund to be made

    - There are various scenario where a refund is required
    - Return of medications  (some institutions do not allow return of medications)
    - Service paid but not performed
    - Lapse in service provided ..(e g wrong diagnosis or wrong result)
    - Over charge of service rendered
    - Deposit balance from surgery
    - Duplicate payments ..(e g patient paid twice or 3rd party and patient paid for same service]]>     2019-08-05 12:23:26 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/373265341     Refund process eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/373265608 There are various documents and processes
    required prior to processing a refund to a patient

    - Investigation on whether a genuine refund is required
    - Supporting documents
    • Refund voucher Stating the reason for refund ..(e g duplicate charges, using patient bill as supporting
    documents)
    • Medication refund note from the pharmacy
    • Approval from supervisors and finance department
    • Return the money (front end refund) or issue a cheque bank transfer (back end refund)
    • Attach all supporting documents]]>     2019-08-05 12:26:06 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/373265608     Bank Reconciliation eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/373265736 • When the amount in the Handover Confirmation Report tallies to the amount credited to the bank, Business Office Assistant will perform clearing to the Main Bank account on a regular basis
    • Business Office Assistant will prepare the Bank
    Reconciliation monthly to be reviewed by the Supervisor and Executive
    • A copy of the Bank Reconciliation will be forwarded to the Finance Department for their retention]]>     2019-08-05 12:27:34 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/373265736     Outsourcing eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/373265856 • Institutions may choose to outsource some of their business functions to another party For public healthcare like NHG and SingHealth certain business functions are consolidated to Finance Shared Services (FSS) which processes for institutions under the same cluster For example
    • Bank reconciliation (depends on institution)
    • Refund can be processed directly from the bank
    • Payment posting outsourced to other financing companies
    • Debt recovery
    • 3 rd Party Billing billing of other organisations]]>     2019-08-05 12:29:10 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/373265856     Issues related to outsourcing eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/373266014 • External parties may not have proper understandings
    of the business process of the institution
    • Any rectification required by the institution may take
    longer time
    • Decision to outsource may come from cluster and not
    necessary cost effective for all the institutions involved ..(e g NHG and SingHealth cluster consolidate some of the financial and human resource services)]]>     2019-08-05 12:30:55 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/373266014     Accounts Recievable eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/373266162 - AR or accounts receivable is the money owed to a
    healthcare institution by any 3 rd party payor and
    patients After a service is rendered to a patient, a bill
    is sent to the respective 3 rd party payer or patient
    requesting payment This outstanding bill is
    accounts receivable

    - If these outstanding bills are not paid within a specific
    period, they will be term as bad debts]]>     2019-08-05 12:32:32 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/373266162     AR Report eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/373266230 Accounts Receivable Report is a report that shows
    services that is rendered and payment not collected
    • From a management perspective, the AR reports will
    identify problems with your receivables management
    process
    • From an operational perspective, the AR reports
    identify accounts that require collection action]]>     2019-08-05 12:33:26 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/373266230     Working on AR eugene_seah https://padlet.com/eugene_seah/hde3vta7wm0v/wish/373266373 • The most common use of the AR report is for collecting overdue balances from both 3rd party payers and patients.
    • The report should be stratified by:
    - The payer (by patient balance vs. insurance balance vs Medisave vs. Other Third Parties),
    • age of the outstanding amount (e.g ., patient balances
    over 30, 60, 90 and 120 days),
    • balance amount (e.g., within a category, list accounts in descending order of balance owed).
    • Staff should work on the largest accounts first when making the collection effort to patients]]>     2019-08-05 12:35:11 UTC https://padlet.com/eugene_seah/hde3vta7wm0v/wish/373266373