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Today’s healthcare provides face intense regulatory, economic and competitive pressures. To thrive organizations must increase the quality of care and services they deliver to patients while lowering their operating costs, maintain privacy and comply with regulatory compliance standards (Spring CM, 2011).
The review of related literature focuses on discussion of both local and foreign literature, the collection of facts and principles of the present study that is related to subject matter.
In Lawley (2008), develop a sequential scheduling model with exponential service times and multiple patient no-show probabilities. The objective maximizes the expected revenue for patients seen minus costs for patient waiting and staff overtime. The expected profit of a schedule is non-decreasing with the number of patients until some critical number scheduled and then decreases monotonically as more patients are added. This provides an optimal stopping rule, after which patients are rejected for that particular schedule and can be considered for the schedules of other days. The work presented in this paper generalizes this approach by allowing arbitrary service time distributions, which requires that we include variables capturing time spent in service.
The traditional billing system involves lots of paper work and manual documentation. Since the documentation is done manually it has a high rate of errors and subsequently higher percentage of rejections by the insurance companies. In addition, reimbursement for performed services can take months if using this billing system. Electronic medical billing on the other hand, has eliminated many disadvantages of the traditional billing system and enabled the healthcare providers to save both their time and money which is why more private practices as well as hospitals and clinics have switched to electronic billing system.
Electronic medical billing system has revolutionized the process of reimbursement and has several advantages over traditional billing system. Firstly, the electronic billing software eliminates the paper work and subsequently potential human errors which are the number one cause of relatively high rate of rejections by the insurance companies in the traditional billing system. In case an error in the claim does occur, it is reported in a matter of minutes enabling prompt corrections. Secondly, this software significantly reduces the paper costs because the claim is filed via electronic means but what is even more important is the fact that fast, accurate and easy to use electronic billing system reduces the need for administration personnel enabling healthcare practitioners and facilities to increase their profit and subsequently improve the quality of their services to patients (Wickman, 2011).
Transforming a clinical service into income requires managing tens of thousands of transactions with hundreds of thousands of data elements. In order to make the difference between mediocre and outstanding billing service and collection performance, an effective and efficient billing process is required. The billing services process has to be locked at from two perspectives how do you get a specific claim paid in the right amount at the right time, and how do you monitor the entire process to assure that all of your claims are being paid in the right amount at the right time. The former requires accurate information and anticipation and review of the payment. The latter requires systems of evaluation and review of workflow and business processes to assure expected performing (Rosenberg, n.d).
Many firms do not bill by the hour for all tasks, instead using fixed-fee arrangements, value pricing or combination of methods. Regardless of a firm’s billing strategy, tracking time is widely considered to be an important practice for measuring costs and profitability for specific clients and engagements. In recent years, invoicing has evolved in time and billing systems to give firms extensive customization options for the layout, text and colors of invoices. By taking advantage of these features with a little creativity, invoices can be used as a branding and advertising mechanism instead of just a collection tool. Many of the leading time and billing software packages provide multiple delivery methods, including PDF attachments to e-mails and a medium by which to pay by credit card or PayPal, satisfying many of the growing younger generation of clients who prefer to pay electronically.
With web-based programs, accountants can even enter time and produce invoices while clients’ offices, increasing the likelihood of being paid in world record-breaking time. Capturing and disseminating accurate and detailed information in time and billing software is essential for effective reporting. Management can make more informed decisions with real-time data showing the profitability of services, clients and staff (Benjamin, n.d). As appropriate appointments schedule systems is essential to any medical practice is the ambulatory care setting. Each clinic has unique needs in its physical facility and for its staff. The physical arrangement of the scheduler, including the various combinations of the time allotments, must be determined.
Some have major headings for hours with minor spaces for 15 minutes intervals, others have 10-minute intervals, and still others only hour intervals. An appointment sheet is necessary for both legal risk management and quality management purposes. Copies of the daily appointment sheet are made available to the doctors, medical assistants, and any other staff members. Using the daily appointment sheet, it is easy to check in patients as they arrive and indicate no-shows and cancellation. Indicating the check-in and checkout times can be useful for quality management purposes. More importantly, the daily appointment sheet enables all staff members to see the total scheme of the day’s patient low.
If a provider works between two clinics or a hospital and office, it is helpful to have this appointment schedule transferred to a handheld computer device for immediate referral. If a hand-held computer is not used by the provider, reduce the dimensions of the appointment schedule sheet to pocket size for the provider’s easy access. Generally, if the provider makes hospital visits before coming to the office in the morning, this schedule is printed the previous evening before closing. These daily appointment sheets can also be used to include other provider commitments such as meetings and visits from pharmaceutical representatives. Such a complete record of time ensures that no patient appointments will be booked when, in fact, the provider is not available (Lewis, 2007).
A computerized reservation and scheduling system is provided which alternately allows patients to select from pre-scheduled consultation services provided by the secretary or consultation provides or to negotiate and contract with consultation providers who have available unscheduled consultation or admission space. The system comprises a central computerized data base. Consultation providers and consumers alike access the computer via a plurality of terminal units. The central computerized data base comprises a “maybe” file for storing information regarding available unscheduled consultation space which may be offered by a provider for service if a suitable consumer demand exists and for storing information regarding unscheduled transportation space which is needed by consumers.
The “maybe” file facilitates negotiating and contracting between the parties (EmMhayDoRe, 2011). Bailey (1952) already announced that an appointment system is a trade-off between doctors’ and patients’ waiting times. Although the Erasmus MC outpatient clinic’s average internal waiting times are long, doctors frequently have idle time. Patients who do not show up or who are late for their appointments cause idle time for doctors, leading to temporary underutilization of the outpatient clinic’s capacity. Gaps in the appointment schedules also cause underutilization of the doctor’s time. Appointment system can be a source of dissatisfaction, both for the patients and for the providers. Patients are impacted by the lack of availability of timely and convenient appointment slots, especially when their need is urgent.
Clinicians are impacted by the uncertainly is the number of patient appointments from day to day, and the mix of appointments on any given day. These factors can affect clinicians’ earnings as well as their job satisfaction levels. In many instances, clinicians can handle high priority demands and variations in case mix, only by stretching their schedules to absorb demand variation–i e, by shrinking lunch time, pushing back dinner and double booking ( working faster). (The soft nature of provider capacity is one of the factors that differentiate health care delivery systems from manufacturing, transportation and logistics systems). Even with such strategies in place, it is sometimes necessary to reschedule certain booked appointments for non-urgent services in order to take care of urgent demand.
Moreover, significant direct waiting time is not uncommon in environments that deal with life-threatening urgent cases. Frequent involuntary changes in appointments and long direct waits can cause dissatisfaction among patients who book in advance (DENTON, 2007) Regarding the literature related to the study manual scheduling and billing of Sanchez clinic can be aided with the use and help of the booming technologies. Providing a written receipt to than patients as the customers of the clinic tends to consume more time unlike in making the process in an automated system. The automated billing system scopes the generation of the receipt with the description of the service treated to the patient. Automation in noting schedules of patient can be seen and managed in a fast time with no hassle because the user can just select a date and view the list of the patients scheduled for that specific date.
Billing System for Castro Maternity and General Hospital (2007), the system is a major leap forward in computing. It makes computation easier and more fun to use with many user interface and performance enhancement. It will get more work in less time. Professionals in every field are discovering knowledge to meet these changes. To complete effectively in world market, every individual is making effort to explore in their respective firms.
A “LAN-based Patients Record and Billing System” (August 2007), stated that every establishment started from nothing, so as this hospital that we are designing a system. It was conceived by a group of pioneering physicians who envisioned a modern hospital with all the advance technologies and amities that can service affordable to patient from the common mass and can direct the billing process be easy.
Arriola, et. Al. 2010, a designed system entitled “Computerized Billing System of Pangasinan Provincial Hospital” that provides a billing and collection mechanism for a patients billing process. The system aimed to prove and shorten the time consumed in different transactions and reports generation of the said organization. The system is capable of performing regular service billing that provide better services such as faster and efficient way of processing information by the billing personnel to the patients.
Mentis Soft Solutions, a leading health care and education software products provider, distributes and supports medinous HMS, worldwide. The team developed a Hospital Billing System that handles all types of billing for long term care. The patient Billing Module facilities cashier and billing operations for different categories of patients like outpatient, inpatient and referral. It provides automatic posting of charges related to different services like bed charges, lab test conducted, medicines issued, consultants fee, food, beverage and telephone charges etc. The Billing Module is extensively flexible by which each of your billing plans can be configured to automatically accept or deny. The system is turned to capture room and bed charges along with ancillary changes based on the sponsorship category.
Furthermore the changes for various services rendered can be recorded through service module and this can be lose for billing purposes. Payment Monitoring System of CIGA covers the entire committee like the study constructed by Basilio et. al (March 2008). Payment Monitoring System at Pangasinan State University – Bayambang Campus. It can help the Information & Communication Technology Department in having a fully organized accurate and efficient record of payment. With the help of the system, the budgetary deficiency of the Information & Communication Technology Department can be minimized since it is able to identify the amount which will be spent for every semester. The system helped track and monitor monthly payments and to prepare financial reports. The system can also provide the department an accurate reliable and faster way of tracking students amount and information
Contributions of the Reviewed Related Studies to the Present Study Through the stated system in the Related System the developers understand some features of the previous information and billing system that have been developed. Analysis of thesis features can lead to a new possibility that can be researched upon in the current project. Thus review of the system is an important part of one’s research. It also helped the developers to identify problem that may occur with the current project with the problem encountered with the previous one. It also gives an idea on how to develop designed the project and understand the flow of the billing process.
The Maglonzo and Cruzon Billing System, signifies the proper build the world of billing. In this case of understanding, the proponents are more inspired by means of expand the knowledge especially on the part of billing process. By this studying of other research paper about billing, the proponents are more trained of developing the billing system in AWD.
The Patients and Billing system of San Lorenzo Hospital of Galon (August 2007) showed the proponents acquired some way of techniques and knowledge on how the billing process is. The system of San Lorenzo gives the proponents the right vital of environment in billing. In this way of acquiring knowledge, the proponents are more eager to build a billing system that can more efficient in the users.
The Computerized Billing System of Pangasinan Provincial Hospital (Ariola et. al. 2010) enlightened the developers in using the Process Model in showing the flow of information through the processing performed by the system.
The Billing and Information of Nazareth General Hospital by Perez et. al, (1997) gives the proponents an idea on how to develop the environment of billing. The Information of Nazareth General Hospital had shown the interface of the system.
With the development of Medinous Hospital Management System made by the Team Mentisoft (Mentisoft Solutions, 2012), it gave the developer an idea in terms of the features included with the project they developed additional capabilities that likely lead to higher efficiency.
The Payment Monitoring System of CIGA helped the ICT Department to track and monitor the payment transaction of ICT. The Payment Monitoring System of CIGA made the ICT Department payment systematized and manageable. With the modified system of CIGA the proponents provided a useful, understandable and efficient.