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Unit of competency details

HLTADM004 - Manage health billing and accounting system (Release 1)

Summary

Usage recommendation:
Superseded
Mapping:
MappingNotesDate
Is superseded by HLTADM011 - Manage health billing and accounting systemNon Equivalent. Unit Code updated. Changes to Elements, Performance Criteria and Performance Evidence to reflect updated job role requirements. 24/Nov/2022
Supersedes HLTPM502B - Manage health billing and accounting systemThis version was released in HLT Health Training Package release 2.0 and meets the requirements of the 2012 Standards for Training Packages. Minimal changes to the elements and performance criteria. New evidence requirements for assessment, including volume and frequency. 05/Aug/2015

Releases:
ReleaseRelease date
1 1 (this release) 06/Aug/2015

Companion volumes:
Unit of competency Assessment requirements

Delivery:
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Training packages that include this unit

Qualifications that include this unit

Classifications

SchemeCodeClassification value
ASCED Module/Unit of Competency Field of Education Identifier 080301 Business Management  

Classification history

SchemeCodeClassification valueStart dateEnd date
ASCED Module/Unit of Competency Field of Education Identifier 080301 Business Management  02/Nov/2015 
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Unit of competency

Modification History

Release 

Comments 

Release 1

This version was released in HLT Health Training Package release 2.0 and meets the requirements of the 2012 Standards for Training Packages.

Minimal changes to the elements and performance criteria. New evidence requirements for assessment, including volume and frequency.

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 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

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.

Unit Mapping Information

No equivalent unit.

Links

Companion Volume implementation guides are found in VETNet - https://vetnet.gov.au/Pages/TrainingDocs.aspx?q=ced1390f-48d9-4ab0-bd50-b015e5485705

 

Assessment requirements

Modification History

Release 

Comments 

Release 1

This version was released in HLT Health Training Package release 2.0 and meets the requirements of the 2012 Standards for Training Packages.

Minimal changes to the elements and performance criteria. New evidence requirements for assessment, including volume and frequency.

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

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

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.

Links

Companion Volume implementation guides are found in VETNet - https://vetnet.gov.au/Pages/TrainingDocs.aspx?q=ced1390f-48d9-4ab0-bd50-b015e5485705

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