Hospital Organizational Structure
Hospital Organisational Structure
Name
Affiliation
Date
Introduction
A hospital is a regulated organisation that is made of different departments. It is important that a hospital has a well-defined organisation structure which helps with its operations where the model will also define the line of duty, operation framework, and roles of communication and allocation of resources (RevCycleIntelligence, 2019). The following organisations structure looks at the financial billing department in the organisation structure on accountability, efficient financial management and interaction between various dockets. The roles and responsibilities for each section is also clearly defined allowing for the team in the management to establish equilibrium.
Financial Service in Organisation structure
The financial service department in the hospital will continue to fulfil the general duties of book keeping that will include purchasing of orders for supplies and other equipment, finalizing the provision of service, maintain receipts for purchases or procurement and the management of payment by the healthcare organisation (RevCycleIntelligence, 2019). The finance department is also very instrumental when it comes to contract negotiations with contractors and service providers, they will be responsible for running the staff payroll, managing the cash reserves for planned or unexpected expenses and issuance of receipt for medical and pharmacological services provided.
ALSO READ: Nursing Dissertation Writing Service
Interaction of Financial services with other departments
The financial department is supposed to cater for the different activities involved in the financial management of healthcare organisations, among which includes long term investment decisions, evaluation and planning, financing decisions, contract management, working capital management and financial risk management. The financial department is also mandated to ensure that moneys for expenditure is raised so that services in the hospital can keep in operation. Financing entails following up with payments of hospital bills, record keeping, debt collection and ensuring that all the insurance compensations have been fulfilled. Other areas for financing will include grants, fundraising, loans and the use of internal funds(Malmmose & Fouladi, 2019). The financial department is also going to look at the cost and benefit of various investments including the types of debt that the hospital incurs in the process. It is the work of the senior financial manager to also make a call for hospital financing; for example, in development of a new maternity ward, the financial department team is going to bring a financial consultant that will determine the amount the construction activities is going to cost and the time that this is going to take. Decisions about using internal or external funds are made at this point so long as the financial department meets the revenue needs of the hospital.
Financial services will also focus on the issue of billing claims which is very important and can affect the clinical services, where resources that are solely dedicated to the cycle of revenue is often lacking. Hospitals that succeed when it comes to billing are required to address how each of the components can fit on the cycle of the revenue thus reduce pre-service or pre-authorization, the costs related to care process, process of integrity in medical practice ( like compliance in coding, charge master and clinical documentation) (Malmmose & Fouladi, 2019). The financial department also needs to look at how the billing services support the customer needs, collection of funds and follow up. Financial administration services will also look at the fee schedules, contract management, debt collection, denial management and care contracts.
To ensure that financial department functions fully and smoothly including management of billing claims and reimbursements, it is important that leaders from different healthcare departments establish clear communication system. The need to have frequent meetings regarding financial services more than others meetings. For example, the hospital can have a meeting with the financial advisor, office administrator and authorized team on a weekly basis to review trends in patient billing claims, receipt of payments, expenditures and collection of debts. It is important that the hospital manager, the office insurance management staff and accountants meet also in a weekly basis to discuss factors related to cash balancing, underpayment, among other concerns related to billing (RevCycleIntelligence, 2019). The key stakeholders in processing of claims are supposed to be organized in a much more standardized manner.
One of the best models to be used in financial department is a centralized billing model where the majority of the billing functions are going to be completed in a central office. This ensures the establishment of economies of scale, dedicated expertise, consistency, standardized monitoring and reporting and opportunities to use enhanced IT systems or resources (RevCycleIntelligence, 2019). The only challenge is where there is increase physician billing leading to delay in response and treatment, there are also higher costs related to billing requirements and coordination between different management departments can be disturbed.
In conclusion, to have an effective billing process and billing claims in the financial department, the hospital needs to have a coordinated practical financial management system, there should be dedicated well trained staff that support professional fee billing, shared accountability between front and back end, well documented, consistent, communicated policies and procedures related to financial performance.
References
Malmmose, M., & Fouladi, N. (2019). Accounting facilitating sociopolitical aims: The case of Maryland hospitals. Financial Accountability & Management, 35(4), 413-429. https://doi.org/10.1111/faam.12220
RevCycleIntelligence. (2019, December 18). Exploring the fundamentals of medical billing and coding. https://revcycleintelligence.com/features/exploring-the-fundamentals-of-medical-billing-and-coding
