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Unit of competency details

HLTADM011 - Manage health billing and accounting system (Release 1)

Summary

Usage recommendation:
Current
Mapping:
MappingNotesDate
Supersedes HLTADM004 - 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

Release Status:
Current
Releases:
ReleaseRelease date
1 1 (this release) 25/Nov/2022


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  08/Feb/2023 
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Unit of competency

Modification History

Not applicable.

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 or Territory legislation, Australian standards and industry codes of practice.

No occupational licensing, certification or specific legislative requirements apply to this unit at the time of publication.

Pre-requisite Unit

Nil

Competency Field

Health Administration

Unit Sector

Health

Elements and Performance Criteria

ELEMENTS 

PERFORMANCE CRITERIA 

Elements describe 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 to 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 to support the billing and payment system.

2. Develop procedures for actioning outstanding accounts.

2.1. Identify outstanding accounts of the practice according to organisational policies and procedures.

2.3. Select and utilise strategies for ethical recovery of outstanding accounts.

2.4. Monitor and adjust outstanding accounts according to organisational policies and procedures.

2.5. Document adjustments to accounts and report to the supervisor according to organisational policies and procedures.

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. Generate reports and data according to organisational policies and procedures.

Foundation Skills

Foundation skills essential to performance are explicit in the performance criteria of this unit of competency.

Unit Mapping Information

Supersedes and is not equivalent to HLTADM004 Manage health billing and accounting system.

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

Not applicable.

Performance Evidence

Evidence of the ability to complete tasks outlined in elements and performance criteria of this unit in the context of the job role, and:

  • manage an accounting system that meets regulatory requirements for at least one health practice for three billing cycles.

Knowledge Evidence

Demonstrated knowledge required to complete the tasks outlined in elements and performance criteria of this unit:

  • legal and ethical considerations for health practice billing:
  • codes of practice
  • policy frameworks
  • privacy, confidentiality and disclosure
  • records management:
  • 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 and 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 be demonstrated in the workplace or in a simulated environment that reflects workplace conditions.

Assessment must ensure access to:

  • 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’ 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