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Copay Collection and Reconciliation - Managers Responsibilities Summary _Current_

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					                                                      Copay Collection & Reconciliation - The Manager's Responsibilities
 Key Findings
#Responsibilities                                                       What This Means                                                                     References
 All Managers must attend the Time of Service and Copay                                                                                                     * See TOS Policy - Page 12, Addendum E, item g
                                                                        Ensuring that the copay reconciliation process is managed smoothly and
 Reconciliation classes
                                                                        accurately benefits the Medical Center and our patients. It is important that       * Ambulatory Training Role Reference Sheet
                                                                        Managers attend this training to fully understand and manage this process.
                                                                                                                                                            * See the attached reference sheet for the link to the
                                                                        Even if direct responsibility for daily reconciliation is delegated, the practice
                                                                                                                                                            Ambulatory Education & Systems training schedule
                                                                        manager must maintain oversight to ensure the integrity of the process.             and TRAININGAMB email box.


 Ensure that front desk staff have the required tools and               These tools and resources include:
 resources                                                              * Time of Service Policy and Procedures at front desk                               * See TOS Policy - Page 1, policy 13,

                                                                        * Provide Copay Grid - documents when a copay may not be required                   * See TOS Policy - Page 9, Addendum D, item b
                                                                        * Individual Cash Bags                                                              * See TOS Policy - Page 5, Addendum C, item b
                                                                        * $50 cash for each collector to make change with                                   * See TOS Policy - Page 5, Addendum C, item b
                                                                        * Manual Ledger/Receipts                                                            * See TOS Policy - Page 5, Addendum C, item b
                                                                                                                                                            * See TOS Policy - Page 5, Addendum C, items a,b
                                                                        * Signage, Managed Care Letter, BIDMC Rubber Stamps
                                                                                                                                                            &c
                                                                        * Credit Card Machine - Working order                                               * See TOS Policy - Page 6, Addendum C, item g

 Ensure that all staff receive the appropriate training                 Staff training requirements include:
                                                                                                                                                            * See the attached reference sheet for the link to the
                                                                         * All check-in staff must attend Time of Service class and score 70% or
                                                                                                                                                            Ambulatory Education & Systems training schedule
                                                                        greater on the class competency exam.                                               and TRAININGAMB email box.
                                                                         * Staff designated to reconcile all payments for the practice (if this is not
                                                                        performed by the manager) must attend Copay Reconciliation and Tracking             * See TOS Policy - Page 12, Addendum E, item g
                                                                        class
S
Oversee the daily copay reconciliation process, including:
e                                                                       This "handoff" check ensures that all cash bags have been reconciled daily
Ensure that staff individual cash bag/CO11 report reconciliation is
                                                                        and are prepared for the next day - with $50 beginning balance. Ideally this        * See TOS Policy - Page 12, Addendum E, item a
checked by a manager or designee
                                                                        is done same day to catch/resolve any errors.
 A Practice Manager/Coordinator (someone other than the person
                                                                        At no time can the person completing the reconciliation also approve the
 who completed the initial reconciliation/deposit) must always verify                                                                                       * See TOS Policy - Page 12, Addendum E, item e
                                                                        deposit.
 the deposit and initial the CO1 and variance reports
 The Practice manager is responsible to ensure that all variances
 occurring during the payment reconciliation process (including         At no time can the person completing the reconciliation also approve the
                                                                                                                                                            * See TOS Policy - Page 12, Addendum E, item e
 those on the CO11, CO1, CO6, CO4 and CO7 reports) are                  deposit.
 documented and explained

L
Ensure that cash is secured at all times
a
Cash bags should be in locked drawers during business hours and
 in the department safe or a locked drawer in a locked room             Protects funds from theft or from being misplaced
 overnight
 Deposit should be stored in the safe overnight or in a locked
                                                                        Protects funds from theft or from being misplaced                                   * See TOS Policy - Page 19, Addendum F, item h
 drawer or cabinet in a locked room
 Deposits should be transported to the cashier in a locked cash bag     Protects funds from theft or from being misplaced                                   * See TOS Policy - Page 18, Addendum F, item d
Staff carrying large deposits to the cashier should be accompanied
                                                                      Protects funds from theft or from being misplaced
by another staff member or security
Adhere to "Lost/Stolen" procedure when applicable                     When an amount over $50 is missing, this policy must be invoked                         * See TOS Policy - Page 22, Addendum G
                                                                      Steps for off-site practices are different - the Practice manager must be
Adhere to Off Site deposit procedures (for off-sites)                                                                                                         * See TOS Policy - Pages 24-25, Addendum H
                                                                      familiar with these differences
Monitor the compliance with the following Copay
Reconciliation Policies and Procedures:
Each employee collecting payments must have their own cash bag        Collectors will not share cash bank or cash bags                                        * See TOS Policy - Page 1, policy 8

C                                                                     Each collector has $50 cash for the purpose of making change. Managers
a
Each cash bag should contain $50 at the beginning and end of the      are responsible to ensure that there is a process to verify that the starting
                                                                                                                                                              * See TOS Policy - Page 1, policy 8
s
shift                                                                 and ending balance is always $50, and that any discrepancies are reviewed
h                                                                     and documented.
b
                                                                      Practice Manager must complete unannounced spot checks of PA cash
Complete unannounced spot audits of cash bags                         bags every four to six weeks and document this on the CO11 which should                 * See TOS Policy - Page 13, Addendum E, item i
                                                                      be reviewed for this purpose. This documentation must be maintained.
Other                                                                                                                                                         * See TOS Policy - Page 12, Addendum E, item h
                                                                      Ensure the Daily Report is run and reviewed each night and the Batch
Oversee credit card end of day procedures                                                                                                                     * See BIDMC Copay/Other Payment Reconciliation
                                                                      Report shows the previous days collections passed to the bank successfully
                                                                                                                                                              and Tracking Manual, page 15-19


Review and storage of reports
Daily:                                                                The Manager must run this report daily to ensure proper oversight of edits              * See TOS Policy - Page 30, Addendum K, item a
Monitor the CO6 report                                                to payments entered in CCC. Any changes should be reviewed with staff
                                                                      who made a change to an initial entry to n/a or a lower amount and signed               * See BIDMC Copay/Other Payment Reconciliation
                                                                      off by the staff member and the Practice Manager.                                       and Tracking Manual, page 21

CO N/A report                                                         The Manager must run this report daily to monitor usage of N/A in the
                                                                                                                                                              * See BIDMC Copay/Other Payment Reconciliation
                                                                      Copay Amount field. Inappropriate use of N/A should be reviewed with each               and Tracking Manual, page 23
                                                                      staff member.
Weekly:                                                                                                                                                       * See TOS Policy - Page 30, Addendum K, item c
CO2U report                                                           This report must be run weekly to monitor individual collections and
                                                                      determine if additional training is needed                                              * See BIDMC Copay/Other Payment Reconciliation
                                                                                                                                                              and Tracking Manual, page 35
Bi-Weekly:                                                            The CO4 and/or CO7 reports must be run monthly (twice a month                           * See TOS Policy - Page 30, Addendum K, items b
Monitor CO4/CO7 Report                                                recommended). Practice Manager should use this tool to: 1-Ensure that                   (CO4) and d (CO7)
                                                                      funds made it to the cashier. 2-Identify lag time in delivery from the practice         * See BIDMC Copay/Other Payment Reconciliation
                                                                      to cashier. 3. Identify discrepancies that may not have been caught if the              and Tracking Manual, page 28 (CO4) and page 30
                                                                      manager does not perform the daily reconciliation.                                      (CO7)

Monthly:                                                                                                                                                      * See TOS Policy - Page 30, Addendum K, item c
L
Monitor CO2 Copay Collection Rates                                    The CO2/CO2C or CO2M report must be run and reviewed on a monthly
                                                                      basis to monitor practice collection rates                                              * See BIDMC Copay/Other Payment Reconciliation
                                                                                                                                                              and Tracking Manual, page 33
Other Documentation:
                                                                      The CCC generated receipts and the credit card daily report and batch
These documents must be stored along with all the above reports:
                                                                      report are generated daily. In split bill clinics, credit card slips for the hospital   * See BIDMC Copay/Other Payment Reconciliation
Variance report, credit card daily and batch reports, HMFP credit                                                                                             and Tracking Manual, page 39
                                                                      go to the cashier while HMFP slips stay in the clinic. Variance reports and
card slips, CCC generated receipts and security reports for lost or
                                                                      security reports are created only when necessary.
stolen deposits
                                                                      All documents related to payment collection should be stored in department              * See TOS Policy - Addendums E,F and K.
Ensure documenation is maintained according to policy                 files for a period of one year for audit purposes. This includes the daily              * See BIDMC Copay/Other Payment Reconciliation
                                                                      CO11 and CO1 reports as well as those reports listed above.                             and Tracking Manual, page 25
Copay Collection & Reconciliation - Manager's Resources


Listed below are the contents of the attached packet of Manager's Resources. These documents and reference tools
provide comprehensive information on the Ambulatory policies, procedures, training information and staff competencies
related to Time Of Service/Payment Collection and Reconciliation. It also includes reference to on-line tools and
resources for additional questions as they arise.



    1) Copay Collection & Reconciliation - The Manager’s Responsibilities Summary Sheet

    2) Ambulatory Time Of Service Policies and Procedures

    3) Ambulatory Training Role Reference Sheet

    4) Ambulatory Education and Systems Team Training Policy/Schedule

    5) Training Confirmation Email with Directions

    6) Training Manual - Time Of Service/Copay Collection

    7) Training Manual - Copay Reconciliation and Tracking

    8) Time Of Service/Copay Collection Competency and Answer Sheet

    9) Copay Reconciliation Competency and Answer Sheet

  10) Instructions for Accessing Ambulatory Education and Systems Team Web Page
s and reference tools
and staff competencies
 n-line tools and

				
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