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.
Elements and Performance Criteria
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 requirements 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 |
Evidence of Performance
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
Evidence of Knowledge
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
Assessment Conditions
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.
Foundation Skills
The Foundation Skills describe those required skills (language, literacy, numeracy and employment skills) that are essential to performance. |
Foundation skills essential to performance are explicit in the performance criteria of this unit of competency. |