Presentation is loading. Please wait.

Presentation is loading. Please wait.

Platte County Memorial Hospital Healthcare Basics.

Published byAlicia Fleming Modified over 9 years ago

Similar presentations

Presentation on theme: "Platte County Memorial Hospital Healthcare Basics."— Presentation transcript:

1

2 Platte County Memorial Hospital Healthcare Basics

3 Learning Objectives How is healthcare funded Revenue Cycle What do we spend What can I do

4 Healthcare Funding Medicare Medicaid Private Insurance Other Govt Self pay

5 Medicare Reasonable Cost Reimbursement Cost report Costs related to patient care PPS – Prospective payment system CAH- Criteria Less than 25 beds (can be used for swing beds) Avg Length of stay less than 4 days Licensed by the state as a CAH

6 Medicaid State run programs Federal Matching Dollars Wyoming current program Level of care reimbursement Maternity/surgical$6,826 Maternity/Medical $3,749 Newborn Nursery$ 740 Rountine care$5,380 Outpatient reimbursement cost based via an intergovernmental transfer calculation

7 Commercial Wyoming is very unique % of charges and our actual reimbursement runs from 88% - 97% of charges. Other parts of the country are on fixed payments or risk sharing. Moving to population based health reimbursement (capitation and risk)

8 Charity and Bad Debt PCMH average collection for self pay patients is 12 cents on the dollar All hospitals owned or operated by Banner Health, including the one(s) where you received your care, offer a Basic and an Enhanced Financial Assistance Program to uninsured patients. An uninsured patient is someone who does not have any health coverage at all, whether through insurance or any government program, and who does not have any right to be reimbursed by anyone else for their healthcare expenses. PCMH Charity care in 2013 - $1,072,000 Bad Debt $1,442,000

9 Let’s Make it Real

10 Revenue Cycle Physician Order – Including a Dx Documentation of completion of the order Charges (manual or from systems) Discharge Coding Billing Collections

11 Care Manager WFA MedSeries 4 Cerner LawsonPayroll General Ledger APMaterials SDSM/Eclipsys(TSI) Impac Medilinks Kronos System Flow

12 Charge Master File Daily Transactions PHRR560 Report DateGL AccountGL Account DescAcctChgChg DescQTYDateBatchAmountPatient Name 6/26/201426300.4201AMBULATORY CARE - HOSP 419790302601375INF IV THRPY FIRST HR6/25/201467543-343.00Sample 1 6/26/201426300.4201AMBULATORY CARE - HOSP 419790302601383INF IV THRPY ADDL HR6/25/201467543-149.30Sample 1 6/26/201426300.4201AMBULATORY CARE - HOSP 20236700172601375INF IV THRPY FIRST HR6/25/201467500-343.00Sample 2 6/26/201426300.4201AMBULATORY CARE - HOSP 20236700172601383INF IV THRPY ADDL HR6/25/201467500-149.30Sample 2 6/26/201426300.4201AMBULATORY CARE - HOSP 20236700172601383INF IV THRPY ADDL HR6/25/201467500-149.30Sample 2 6/26/201426300.4201AMBULATORY CARE - HOSP 20236700172601375INF IV THRPY FIRST HR6/26/201467504-343.00Sample 2 6/26/201426300.4201AMBULATORY CARE - HOSP 20236700172601383INF IV THRPY ADDL HR6/26/201467504-149.30Sample 2 6/26/201426300.4201AMBULATORY CARE - HOSP 20236700172601375INF IV THRPY FIRST HR6/24/201467543-343.00Sample 2 6/26/201426300.4201AMBULATORY CARE - HOSP 20236700172601383INF IV THRPY ADDL HR6/24/201467543-149.30Sample 2 6/26/201426300.4201AMBULATORY CARE - HOSP 20236700172601375INF IV THRPY FIRST HR6/25/201467543-343.00Sample 2 6/26/201426300.4201AMBULATORY CARE - HOSP 20236700172601383INF IV THRPY ADDL HR6/25/201467543-149.30Sample 2 6/26/201426300.4201AMBULATORY CARE - HOSP 20236700172601383INF IV THRPY ADDL HR6/25/201467543-149.30Sample 2 6/26/201426300.4201AMBULATORY CARE - HOSP 20236200122601375INF IV THRPY FIRST HR6/25/201467500-343.00Sample 3 6/26/201426300.4201AMBULATORY CARE - HOSP 20236200122601375INF IV THRPY FIRST HR6/26/201467504-343.00Sample 3 6/26/201426300.4201AMBULATORY CARE - HOSP 20236200122601375INF IV THRPY FIRST HR6/25/201467543-343.00Sample 3 6/26/201426300.4201AMBULATORY CARE - HOSP 20236200122601375INF IV THRPY FIRST HR6/24/201467543-343.00Sample 3 6/26/201426300.4201AMBULATORY CARE - HOSP 20236400102601375INF IV THRPY FIRST HR6/25/201467543-343.00Sample 4 6/26/201426300.4201AMBULATORY CARE - HOSP 20236400102601383INF IV THRPY ADDL HR6/25/201467543-149.30Sample 4 6/26/201426300.4201AMBULATORY CARE - HOSP 20236400107616725VISIT ESTABLISHED LEVEL 1 6/25/201467543-134.20Sample 4 Daily Transaction Report

13 Responsibilities https://www.youtube.com/watch ?v=AGt5f70K02Q PFS Error Worksheet Chart Audits Daily Stat Report Revenue and Usage Report R2W reports

14 That leaves us with 4¢, which we can use to reinvest in ourselves by hiring more people, providing pay increases, purchasing new equipment and building new facilities.That leaves us with 4¢, which we can use to reinvest in ourselves by hiring more people, providing pay increases, purchasing new equipment and building new facilities..06 Depreciation.03 Interest.04 Operating profit.16 Supplies.20 Operating Expenses.51 Compensation and Benefits

15 Again Let’s Make it Real

16 Questions? Did this meet your expectations? What did you like about this Education? What would you change?

Download ppt "Platte County Memorial Hospital Healthcare Basics."

Similar presentations

COLLECTIONS TIPS FOR COLLECTIONS Collect within 1 st 30 days. Designate a time to review accounts weekly. Follow up on past due accounts. Restate the.

COLLECTIONS TIPS FOR COLLECTIONS Collect within 1 st 30 days. Designate a time to review accounts weekly. Follow up on past due accounts. Restate the.
Sustaining a Financially Vibrant Healthcare Organization

Sustaining a Financially Vibrant Healthcare Organization
Revenue Cycle Management: Dealing with Denials Fred J. Pane, B.S.Pharm. Sr. Director of Pharmacy Affairs Premier Inc. Linda Pearson, R.N., M.B.A.,CCM,

Revenue Cycle Management: Dealing with Denials Fred J. Pane, B.S.Pharm. Sr. Director of Pharmacy Affairs Premier Inc. Linda Pearson, R.N., M.B.A.,CCM,
Rebecca M. Johnson, MNPL Mark Meye, CPA

Rebecca M. Johnson, MNPL Mark Meye, CPA
What the CAHFIR can do for you ORHP Grantee Partnership Meeting, September 1 2009 CAH Financial Indicators Report Team North Carolina Rural Health Research.

What the CAHFIR can do for you ORHP Grantee Partnership Meeting, September CAH Financial Indicators Report Team North Carolina Rural Health Research.
Medicare-Medigap-Medicaid Gabriella Hayes  Chantel Ochoa ^_^ Kelle Marshall :D Annysia Hoffman (:

Medicare-Medigap-Medicaid Gabriella Hayes  Chantel Ochoa ^_^ Kelle Marshall :D Annysia Hoffman (:
13. Healthcare Sector Costs Payments and revenue received by physicians and healthcare entities represent the cost of business for the government, insurance.

13. Healthcare Sector Costs Payments and revenue received by physicians and healthcare entities represent the cost of business for the government, insurance.
Overview of Medicare Policies Keith Williams & Associates, Inc.

Overview of Medicare Policies Keith Williams & Associates, Inc.
Platte County Memorial Hospital Healthcare Basics Level 2.

Platte County Memorial Hospital Healthcare Basics Level 2.
© 2009 by The McGraw-Hill Companies, Inc. All rights reserved. McGraw-Hill Career Education Computers in the Medical Office Chapter 1: The Medical Office.

© 2009 by The McGraw-Hill Companies, Inc. All rights reserved. McGraw-Hill Career Education Computers in the Medical Office Chapter 1: The Medical Office.
Code Blue Introduction to Terms Reimbursement and Managed Care Chapters One through Seven Accounting Version.

Code Blue Introduction to Terms Reimbursement and Managed Care Chapters One through Seven Accounting Version.
May 10, 2012.  Committee charter  Understand waiver funds flow  IGT fundamentals  UC pool payments  DSRIP pool payments  Timeframes  Begin work.

May 10,  Committee charter  Understand waiver funds flow  IGT fundamentals  UC pool payments  DSRIP pool payments  Timeframes  Begin work.
Hospital Indigent Care Pool Technical Advisory Committee Summary NYS Department of Health June 13, 2007.

Hospital Indigent Care Pool Technical Advisory Committee Summary NYS Department of Health June 13, 2007.
5/11/20151 ALL YOU EVER WANTED TO KNOW ABOUT BILLING & REIMBURSEMENT BUT WERE AFRAID TO ASK Presented by: Evelyn Alwine, RHIA CHDA Director Revenue Cycle.

5/11/20151 ALL YOU EVER WANTED TO KNOW ABOUT BILLING & REIMBURSEMENT BUT WERE AFRAID TO ASK Presented by: Evelyn Alwine, RHIA CHDA Director Revenue Cycle.
Understanding Charity Care/Bad Debt for Hospitals in South Dakota Dave Hewett, President/CEO South Dakota Association of Healthcare Organizations Medicaid.

Understanding Charity Care/Bad Debt for Hospitals in South Dakota Dave Hewett, President/CEO South Dakota Association of Healthcare Organizations Medicaid.
Budget and Finance Concepts for the CNL Susan J. Penner, RN, MN, MPA, DrPH, CNL.

Budget and Finance Concepts for the CNL Susan J. Penner, RN, MN, MPA, DrPH, CNL.
CHAPTER © 2013 The McGraw-Hill Companies, Inc. All rights reserved. 7 Creating Claims.

CHAPTER © 2013 The McGraw-Hill Companies, Inc. All rights reserved. 7 Creating Claims.
Component 1: Introduction to Health Care and Public Health in the U.S. 1.5: Unit 5: Financing Health Care (Part 2) 1.5b: Reimbursement Methodologies and.

Component 1: Introduction to Health Care and Public Health in the U.S. 1.5: Unit 5: Financing Health Care (Part 2) 1.5b: Reimbursement Methodologies and.
© Center for Tax and Budget Accountability 2009 The Role of Charity Care in Illinois’ Health Care Safety-Net Prepared by: Heather O’Donnell Policy Director.

© Center for Tax and Budget Accountability 2009 The Role of Charity Care in Illinois’ Health Care Safety-Net Prepared by: Heather O’Donnell Policy Director.
Reforming and Restructuring the Hospital Indigent Care Pool Methodology New York State Department of Health Commissioner Richard F. Daines, M.D. November.

Reforming and Restructuring the Hospital Indigent Care Pool Methodology New York State Department of Health Commissioner Richard F. Daines, M.D. November.

Similar presentations

Ads by Google