Job Description

Overall Supervision and functioning of the department to deal with billing clarifications with respect to Cash, TPA, corporate. Ensure staff training in billing & Billing audit Policy. Improve processes to achieve quick and error free billing. Ensure all the services provided in hospital are mapped in HIS with their Tarif as per bed category and payer category . Ensure that the admission deposit is collected as per policy at the time of admission Ensure that the surgeries are proceeded only after collection of OT clearance amount Ensure that the services provided to patients are posted in HIS on regular basis The respective stakeholders are informed regarding pending service posting and ensure the same is completed within 12 hours of informing Ensure the OT billing is closed within 4 hours of surgery completion. In case of items where GRN is pending, ensure that the OT billing is closed within 24 hours of surgery completion Ensure that all the patients leaves the hospital only after paying complete bill and bill closure in HIS and discharge clearance is issued to all the patients In case the service is not available in HIS and has been posted as "Unlisted services", the new service request is created as per Service Code creation SOPs. The billing manager has to ensure that no service is posted under Open billing without their approval Keep track of Open bills of discharged patients and get them closed within 24 hours In case of credit/corporate patients, the bill must be closed after receiving Final authorization from the TPA/insurance company and clearing the patient payable amount from the patient Ensure that the required Document are sent as soon as possible and any query is resolved within 24 hours Ensure the staff, clinicians and their next of kin are given discounts as per policy Authorize the discounts as per policy for cash patients and ensure that the discount remarks are entered properly in HIS Ensure the discount approvals are taken in designated forms and authorization is taken from respective authorities as per policy. The scanned copies of forms are uploaded in HIS for future reference. Authorize the bill cancellations due to billing error, admission cancellation or any other reasons. Document the same in HIS under reason for cancellation Ensure the refund is processed within 24 hours of bill cancellation Ensure that the Daily monitoring of bill status and collection of outstanding is done without failure Ensure that 100% of the bills are audited before closing the bills. In case the interim bill of patient goes beyond the estimate, ensure the staff informs the financial counsellor for re-counselling of the patient Monitor conversion against estimate provided to patients Ensure that recounselling is done to the patients whose interim bill exceeds the counselled amount and who has any deviation in treatment plan Check reasons for gap between estimates and final bill and address the issue to keep it under check as per HCG policy Increase the number of planned admissions by effectively putting in place the planning process & by identifying and rectifying the reasons for unplanned admissions Monitor the daily planned & Unplanned admission ratio & beds booked. Authorizes & Monitor upgradation/down gradation and shifting back of patients to requested category. Ensure provision of Bed & counseling upon admission in timely manner Monitor planned and unplanned discharges, adherence to discharge planning. Monitor TAT for patient discharges (Payor type wise) Improve discharges planned a day prior, Ensure non clinical discharge activities are completed on the day of planning. Ensure The responsibility includes proper Registration of the patients, capturing all the necessary details, collecting details for the admission of the patients, taking consents, overseeing patient rooms in terms of proper services and provision of services to the relatives as determined by the Organization from time to time, managing patient transfers as requested by the Clinical team and discharging the patient as per the Discharge Process.