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Elements and Performance Criteria

1. Elements define the essential outcomes
2. Implement and monitor billing system
   • Integrate regulatory and legislative requirements into billing systems
   • Evaluate payment options and equipment requirementsto optimise ease of payment and client accessibility
   • Identify possible payment barriers that may prevent client access to practice services and develop billing strategies to best address barriers
   • Identify payment requirements to meet the viability and cash flow needs of the practice
   • Identify and respond to the accountability and reporting requirements for supported and special payment schemes
   • Evaluate, select and implement systems and procedures that will support the billing and payment system
3. Develop and implement client debt recovery strategy
   • Determine debt tolerance of the practice based on evaluation of business information
   • Evaluate strategies to reduce likelihood of client debt load given client population
   • Select and develop ethical debt recovery strategies
   • Monitor debt and adjust debt recovery policy and practices accordingly
4. Manage information and data required to maintain subsidy payments
   • Interpret and evaluate the information and data requirements to maintain subsidy payments
   • Develop systems to collect data with minimal interruption to practice functions
   • Manage information and data requirements to meet quality and timeframe requirements
   • Develop necessary reports and data in the prescribed manner

Performance Evidence

The candidate must show evidence of the ability to complete tasks outlined in elements and performance criteria of this unit, manage tasks and manage contingencies in the context of the job role. There must be evidence that the candidate has:

managed a billing and accounting system that meets regulatory requirements for a least 1 health practice

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Knowledge Evidence

The candidate must be able to demonstrate essential knowledge required to effectively complete tasks outlined in elements and performance criteria of this unit, manage tasks and manage contingencies in the context of the work role. This includes knowledge of:

legal and ethical considerations for health practice billing, including:

codes of practice

policy frameworks

privacy, confidentiality and disclosure

records management, including:

reporting (for supported and special payment schemes )

information and data requirements for subsidy payments

types of billing options available to health practices and the requirements to implement these:

bulk billing

direct debit of health insurance components

cash payment

credit card payment

features of products, systems and initiatives that support health billing systems:

software

staff training and support

systems support

client payment issues and considerations for health practices:

barriers to prompt or complete payment

barriers that may prevent access to health services

strategies to reduce likelihood of client debt load

payment options for clients and suppliers

debt recovery systems and practices

cash flow needs of the practice and associated payment requirements to ensure viability of the practice

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