Healthcare Collection Policies and Procedures

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Table of Contents

Introduction
Variety of Healthcare Collection Policies and Procedures
Mechanism of Writing a Collection Policy and Procedure
The Policy and Procedure in Revenue Cycle Management
Conclusion
References

Introduction

Preparing healthcare collection policies and procedures is a responsible task that involves different stakeholders. To receive competent and timely medical care, the relevant principles of payment for healthcare services are determined, and the responsible employees draw up appropriate protocols for receiving payments from the population. The importance of these procedures is also due to the fact that, in addition to the financial aspects of revenue cycle management, it is important to comply with existing fiscal regulations. This work is aimed at evaluating the mechanisms for compiling such policies and procedures, the principles of their communication to patients and staff, and the methods of choosing responsible parties to write corresponding programs.

Variety of Healthcare Collection Policies and Procedures

Depending on different criteria, such as the type of care provided, resources involved, preadmission diagnosis, and other factors, appropriate collection policies and procedures are compiled. A common aspect that brings together all such programs is the need to adhere to official regulations, for instance, the Internal Revenue Code Section 50 I(r), which requires specific reporting (Policies and procedures, 2020). Concomitant factors to consider relate to payment scheduling rules, setting discounts for services in accordance with national affordable healthcare programs, and some other criteria (Health Resources & Services Administration, 2022). These nuances are significant because they are clearly regulated by the relevant legislation.

Different policies and procedures are drawn up on the basis of the course of work that a particular healthcare institution pursues. For instance, under the program proposed by the Methodist Health System, third-party agencies are engaged to help with the task of generating key pricing policies and reporting (Policies and procedures, 2017). The collection project proposed by Cone Health also involves such agencies, but their task includes patient alerts, which indicates the delegation of a number of executive functions (Policies and procedures, 2020). As a target healthcare institution for which collection policies and procedures will be developed, a general healthcare facility is engaged with basic services, which does not specialize in the provision of non-traditional or alternative therapies. To compile an appropriate program, the project presented by Flagler Hospital is the most convenient (Billing, collections policy & procedure, 2022). The principles of financial activities and work with patients assume the accompanying interaction with insurance services, which is consistent with the policy of the selected healthcare institution.

Mechanism of Writing a Collection Policy and Procedure

One of the critical stages of writing the necessary collection policy is selecting responsible employees. According to Ray (n.d.), departments heads are the main facilitators who oversee coders who complete the necessary insurance paperwork. Control practices directly affect the hospitals profits because insurance reimbursements can be lower than expected in the case of incompetent coding. Employees working in the accounting department must be aware of the principles of patient appeals regarding insurance claims and promptly identify any inconsistencies. In addition, involving a credible collection company is a valuable solution to ensure the safety of any planning procedures, and through interviews, partners can be selected (Ray, n.d.). Thus, following the Flagler Hospital program, departments heads and a collection company will define key service delivery practices based on specific insurance commitments, excluding any financial bills to patients if they are insured.

To communicate the policy to target customers, calls and notifications sent via popular messengers are convenient ways of interaction. When contacted by customers, responsible employees must disclose all price contingencies and obligations timely, either immediately or after additional contact with insurance services (Billing, collections policy & procedure, 2022). This will help retain patients and ensure high-quality communication modes. In relation to the clinic staff, at the general meeting, the conditions of work in accordance with the programs conditions must be communicated. It is essential to consider related factors, for instance, payments for follow-up procedures, to protect the clinic from unreasonable claims from patients (Billing, collections policy & procedure, 2022). As Ray (n.d.) argues, it is important for employees to understand that individual decisions must be kept to a minimum, and any steps are to be taken in accordance with the policy rules. This will allow for establishing a sustainable algorithm for providing assistance in accordance with all the declared standards.

The collection policy for the hospital in question should be located both on the official website and in each of the departments. To access its terms and conditions, patients may contact the staff or departments heads. In addition, by following the hospitals promotional program, relevant terms and conditions of billing for patients can be posted on official accounts on popular media platforms. According to Ray (n.d.), in addition to providing financial oversight, healthcare professionals should also communicate directly with target patients and keep them informed about the current collection policy. This is a convenient practice to avoid disagreements and notify the public timely of any changes in the financial program.

The Policy and Procedure in Revenue Cycle Management

When managing profits, the management of the hospital should take into account any sources of budget replenishment. The considered collection policy and procedure are the crucial elements of the funding system. As Makori and Sile (2017) state, collection policies applied by organizations affect such an important criterion as return on investments (ROI). When building its revenue cycle management system, the healthcare institutions leadership should remember that any revenues to the budget serve as sources of strengthening the resource base and allow for optimizing the hospitals infrastructure. As a result, the role of the proposed policy and procedure is significant as one of the essential components of ensuring a stable growth algorithm and patient recognition.

Another factor that adds value to a well-designed collection policy in the context of revenue cycle management is the effectiveness of reporting procedures. Makori and Sile (2017) draw attention to tax contingencies and debt obligations and note that through sustainable payment programs, organizations build robust accounting strategies. For the hospital in question, this prospect is significant, especially in light of a large number of patients admitted for treatment under insurance programs. Therefore, in the revenue cycle management system, such a policy is a significant component that simplifies all financial procedures.

Conclusion

By using the example of a specific healthcare facility, the collection policy and procedures have been compiled, and the key aspects of this process have been presented. The appointment of responsible participants is an important process to ensure the sustainability of the payment system. Communicating the programs conventions to patients and staff is a crucial factor in ensuring a smooth and conflict-free practice. The details of the policy should be posted in all departments of the hospital, on its official website, as well as online. The proposed program is an essential attribute of the revenue cycle management system because it allows for controlling the budget and maintaining effective reporting.

References

Billing, collections policy & procedure. (2022). Flagler Health. Web.

Health Resources & Services Administration. (2022). Billing and collections. Web.

Makori, G. O., & Sile, I. (2017). Effects of debt collection practices and credit risk governance on profitability of deposit taking SACCOs in Nairobi County. Journal of Finance and Accounting, 1(1), 42-57.

Ray, L. (n.d.). How to write a collection policy for a medical office. Chron. Web.

Policies and procedures. (2017). Methodist Health System. Web.

Policies and procedures. (2020). Cone Health. Web.

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Healthcare Collection Policies and Procedures

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