Patient Accounting Application
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A patient accounting application tracks the accounting transactions related to patient services.
All charges incurred because of the patient visit need to be tracked and added to the patient’s financial record. This can include inpatient fees if the patient is hospitalized, healthcare provider (e.g., physicians and nurse practitioners) and medication fees associated with the treatment, and procedure costs, including surgeries, radiology, and whatever else is necessary for the care of the patient. The procedural and diagnostic codes also become part of the patient billing record in order to complete the information necessary for the insurance payer to submit payment for the claim. Without critical information such as charges and coding, the claim process is delayed, resulting in reduced cash flow for the healthcare organization.
The collection process can begin at the time of the visit. This statement implies that the patient can receive services without paying anything up front. This is the reality in emergencies. Because of the Emergency Medical Treatment and Active Labor Act (EMTALA), patients must be treated in the case of emergency regardless of their ability to pay. This can lead to hundreds of thousands of dollars outstanding that the healthcare facility will try to collect after the service has been performed. Therefore the collection process in healthcare is much different from the process in a traditional business that requires payment before the product or service is provided. The FIS also needs to be able to track outstanding balances and assist in tracking these for the patient accounts personnel who will be attempting to collect the balances. The older the balances are, the more difficult they are to collect. The FIS needs to be able to differentiate the balances based on several factors, including, but not limited to, amount, payer, age of the account, and so forth. The features needed in FISs are now much more complex than in the past. For example, managers now may need to track the revenue generated by staff as a measure of productivity.