Unit of Competency Mapping – Information for Teachers/Assessors – Information for Learners

HLTADM004 Mapping and Delivery Guide
Manage health billing and accounting system

Version 1.0
Issue Date: March 2024


Qualification -
Unit of Competency HLTADM004 - Manage health billing and accounting system
Description
Employability Skills
Learning Outcomes and Application This unit describes the skills and knowledge required to implement and monitor a billing and accounting system in a health practice, with consideration of client accessibility, practice viability and regulatory and legislative requirements.This unit applies to health practice administrators working in a coordination or management role.The skills in this unit must be applied in accordance with Commonwealth and State/Territory legislation, Australian/New Zealand standards and industry codes of practice.
Duration and Setting X weeks, nominally xx hours, delivered in a classroom/online/blended learning setting.

Skills must have been demonstrated in the workplace or in a simulated environment that reflects workplace conditions. The following conditions must be met for this unit:

use of suitable facilities, equipment and resources, including:

computerised billing system

client records

regulatory requirements

modelling of industry operating conditions

Assessors must satisfy the Standards for Registered Training Organisations (RTOs) 2015/AQTF mandatory competency requirements for assessors.

Prerequisites/co-requisites
Competency Field
Development and validation strategy and guide for assessors and learners Student Learning Resources Handouts
Activities
Slides
PPT
Assessment 1 Assessment 2 Assessment 3 Assessment 4
Elements of Competency Performance Criteria              
Element: Elements define the essential outcomes
       
Element: 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
       
Element: 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
       
Element: 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
       


Evidence Required

List the assessment methods to be used and the context and resources required for assessment. Copy and paste the relevant sections from the evidence guide below and then re-write these in plain English.

ELEMENT

PERFORMANCE CRITERIA

Elements define the essential outcomes

Performance criteria describe the performance needed to demonstrate achievement of the element.

1. Implement and monitor billing system

1.1 Integrate regulatory and legislative requirements into billing systems

1.2 Evaluate payment options and equipment requirementsto optimise ease of payment and client accessibility

1.3 Identify possible payment barriers that may prevent client access to practice services and develop billing strategies to best address barriers

1.4 Identify payment requirements to meet the viability and cash flow needs of the practice

1.5 Identify and respond to the accountability and reporting requirements for supported and special payment schemes

1.6 Evaluate, select and implement systems and procedures that will support the billing and payment system

2. Develop and implement client debt recovery strategy

2.1 Determine debt tolerance of the practice based on evaluation of business information

2.2 Evaluate strategies to reduce likelihood of client debt load given client population

2.3 Select and develop ethical debt recovery strategies

2.4 Monitor debt and adjust debt recovery policy and practices accordingly

3. Manage information and data required to maintain subsidy payments

3.1 Interpret and evaluate the information and data requirements to maintain subsidy payments

3.2 Develop systems to collect data with minimal interruption to practice functions

3.3 Manage information and data requirements to meet quality and timeframe requirements

3.4 Develop necessary reports and data in the prescribed manner

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

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


Submission Requirements

List each assessment task's title, type (eg project, observation/demonstration, essay, assignment, checklist) and due date here

Assessment task 1: [title]      Due date:

(add new lines for each of the assessment tasks)


Assessment Tasks

Copy and paste from the following data to produce each assessment task. Write these in plain English and spell out how, when and where the task is to be carried out, under what conditions, and what resources are needed. Include guidelines about how well the candidate has to perform a task for it to be judged satisfactory.

ELEMENT

PERFORMANCE CRITERIA

Elements define the essential outcomes

Performance criteria describe the performance needed to demonstrate achievement of the element.

1. Implement and monitor billing system

1.1 Integrate regulatory and legislative requirements into billing systems

1.2 Evaluate payment options and equipment requirementsto optimise ease of payment and client accessibility

1.3 Identify possible payment barriers that may prevent client access to practice services and develop billing strategies to best address barriers

1.4 Identify payment requirements to meet the viability and cash flow needs of the practice

1.5 Identify and respond to the accountability and reporting requirements for supported and special payment schemes

1.6 Evaluate, select and implement systems and procedures that will support the billing and payment system

2. Develop and implement client debt recovery strategy

2.1 Determine debt tolerance of the practice based on evaluation of business information

2.2 Evaluate strategies to reduce likelihood of client debt load given client population

2.3 Select and develop ethical debt recovery strategies

2.4 Monitor debt and adjust debt recovery policy and practices accordingly

3. Manage information and data required to maintain subsidy payments

3.1 Interpret and evaluate the information and data requirements to maintain subsidy payments

3.2 Develop systems to collect data with minimal interruption to practice functions

3.3 Manage information and data requirements to meet quality and timeframe requirements

3.4 Develop necessary reports and data in the prescribed manner

Copy and paste from the following performance criteria to create an observation checklist for each task. When you have finished writing your assessment tool every one of these must have been addressed, preferably several times in a variety of contexts. To ensure this occurs download the assessment matrix for the unit; enter each assessment task as a column header and place check marks against each performance criteria that task addresses.

Observation Checklist

Tasks to be observed according to workplace/college/TAFE policy and procedures, relevant legislation and Codes of Practice Yes No Comments/feedback
 
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 
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 
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 

Forms

Assessment Cover Sheet

HLTADM004 - Manage health billing and accounting system
Assessment task 1: [title]

Student name:

Student ID:

I declare that the assessment tasks submitted for this unit are my own work.

Student signature:

Result: Competent Not yet competent

Feedback to student

 

 

 

 

 

 

 

 

Assessor name:

Signature:

Date:


Assessment Record Sheet

HLTADM004 - Manage health billing and accounting system

Student name:

Student ID:

Assessment task 1: [title] Result: Competent Not yet competent

(add lines for each task)

Feedback to student:

 

 

 

 

 

 

 

 

Overall assessment result: Competent Not yet competent

Assessor name:

Signature:

Date:

Student signature:

Date: