Unit Overview
Unit Title
BSBMED302 – Prepare and process medical accounts
Unit Purpose
This unit describes the skills and knowledge required to provide advice to patients regarding fee structures and process referrals, as well as prepare and process medical accounts for a range of patients.
Prerequisites
There are no pre-requisites for this unit.
Content
- Section 1: Introduction to Healthcare Fee Structures
- Section 2: Preparing Medical Accounts for Patients
- Section 3: Processing Accounts
Resources/Readings
Readings A – E are located in the associated BSBMED302 Readings.
Suggested Hours
Although everyone will work at their own pace, we suggest you allow approximately 60 hours to complete this unit competently, including seminars, tutorials, assignments and practical activities.
Timeframe
The recommended time frame for this unit is 4 weeks.
Assessment
This unit will be assessed by completing the BSBMED302 Assessment.
How to Use This Module
This module and associated readings contain all of the information that you need to complete the assessment tasks associated with this unit. You must read through all of the information provided (both the module and associated readings) before attempting the assessment tasks.
Tip
This is used to indicate the presence of tips or additional instructions that may assist you as you work through this module. They are designed to help you expand your knowledge and skills and deepen your understanding of how concepts and practices are applied in workplaces.Read
You will find these throughout the module. They indicate that a particular Reading contains additional information on the topic that is being discussed at that point.Reflect
This indicates a self-reflection question. You are not required to submit answers to these questions. They are designed to get you thinking more about the topic and to consider key points in order to aid your understanding.Upon completion of this unit, you should be able to:
| Element | Performance Criteria |
|---|---|
| 1. Provide advice to patients about fee structure | 1.1. Identify and advise patients of fee schedule for different services 1.2. Advise patients regarding entitlements and rebates 1.3. Schedule medical appointments using appropriate booking and account systems |
| 2. Process referrals to specialist practitioners | 2.1. Check referrals to ensure validity 2.2. Follow correct procedures for referral 2.3. File referral letters according to legislation and workplace policies and procedures |
| 3. Prepare medical accounts for bulk billed and private patients | Accurately follow procedures for billing based on account type 3.2 Identify and cost procedures which are not eligible for Medicate rebate 3.3 Select and complete appropriate account and billing documentation according to workplace and legislative requirements 3.4 Follow procedures for preparing Veterans’ Affairs, workers’ compensation and motor vehicle third party accounts accurately 3.5 Forward medical account to designated person or organisation according to legislation and account processing procedures |
| 4. Process accounts | 4.1 Receive and document payments 4.2 Prepare and issue receipts to person or authority according to legislation and workplace policies and procedures 4.3 Reconcile Medicare payments with claims made by the medical practice 4.4 Follow up overdue accounts 4.5 Provide and store financial records and data in accordance with policies and procedures of the workplace |
Knowledge Evidence
The candidate must be able to demonstrate essential knowledge required to effectively do the task outlined in elements and performance criteria of this unit, manage the task and manage contingencies in the context of the work role. This includes knowledge of:
- Outline Medicare entitlements
- Outline public and private health insurance systems
- Discuss key aspects of relevant legislation, regulations, standards and codes of practice that affect workplace operations
- Describe the differences between workers’ compensation, TAC and Veterans’ Affairs claims
- Explain procedures for patients without a Medicare card or number.
Performance Evidence
The candidate must show evidence of the ability to complete tasks outlined in elements and performance criteria of this unit, manage tasks and manage contingencies in the context of the job role. There must be evidence that the candidate has:
- provide accurate and clear advice to patients about a range of entitlements and benefits
- use an appointment system to schedule medical appointments
- process referrals according to legislative and organisational requirements
- prepare, process and store medical accounts and payment records according to legislative and organisational requirements
- follow up unpaid accounts.
This unit is designed to introduce you to the skills and knowledge required to provide advice to patients regarding fee structures and process referrals, as well as prepare and process medical accounts for a range of patients.
Overview of Sections
Section 1: Introduction to Healthcare Fee Structures
In this section, you will be introduced to the fee structure in Australia’s healthcare system: the public and private health insurance system as well as the fee schedule for different services. We will also look at the procedure of how to process referrals.
Section 2: Preparing Medical Accounts for Patients
In this section, you will learn about the preparation of medical accounts for both bulk billed and private patients. We will first briefly look at the differences between two account types and look at the general procedures for each account type. We will also explore the procedures to prepare for Veterans’ Affairs, workers’ compensation, and motor vehicle third party accounts.
Section 3: Processing Accounts
In this section of the Study Guide, we will look at how you could process accounts. Specifically, we will look at how to receive and document payments made by patients, Medicare, and other relevant organisations. We will then look at the process of reconciling Medicare payments and how to follow up on overdue accounts. We will also briefly look at how to provide and store patient’s financial information.
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