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HomeMy WebLinkAboutMINUTES - 06171986 - 1.18 it '• r +. 1 i.e ` POSITION ADJUSTMENT REQUEST No. Date: May 13, 1986 Dept. No./ -- - - Copers Department Health Svc/Finance Budget Unit No. 0540 Org. Nq. Agency No. 54 _ .i'. ; „b lti� Action Requested: Reallocate Clerk - Experienced Level position #54-1687 n c�Lnt Mprk Beginning Level. C!\!I ,- - Proposed Effective Date: 6/18/86 Explain why adjustment i-, needed: Tn prmeriv claccifv tha ,nr•,mhant (j Lopez) -_n the Inpatient Transfer Unit of the Pati ent Acrrnnni-i ng rlf f i'rc Classification Questionnaire -nttached: Yes No Estimated cost of adjustment: $ 0 (same sa Cost is within department's budget: Yes [3 No E] eve If not within budget., use reverse side to explain how costs are to be funded. Department must initiate necessary appropriation adjustment. Web Beadle, I� Use additional sheets for further explanations or comments, IXP=tmentparyonzaQr r epar men ead Personnel Department Recommendation Date: Reallocate Clerk - Experienced Level position #54-1687, Salary Level C5 1023 (1264-1536) to Account Clerk - Beginning Level , Salary Level C5 1023 (1264-1536) . Amend Resolution 71/17 establishing positions and resolutions allocating classes to the Basic/Exempt Salary Schedule, as described above. Effective: day following Board action. Date for Director o rsonnel County Administrator Recommendation Date: �•-/0 -�lo )(- Approve Recommendation of Director of Personnel Disapprove Recommendation of Director of Personnel Other: for) County Administrator Board of Supervisors Action JUN 17 1986 Phil Batchelor, Clerk of the Board of Adjustment APPROVED/i)-P •ED on Supervisors and County Administrator Date: JUN 17 1986 By: 1paAVL� APPROVAL OF THIS ADJUSTMENT CONSTITUTES A PERSONNEL/SALARY RESOLUTION AMENDMENT. M 5 r COMMENTS OF IMMEDIATE SUPERVISOR Do you concur or disagree with the statements of the employee? If you disagree, be specific as to why. Yes, I concur with the statement she has made. Her desk is a revenue generating desk for Health Services and coda-ins a great number of complexities. What parts of this job do you check or review closely and why? Jeanette Lopez is well trained anddoes not need close reviewing. Spot checking is done to see if the Inpatient transfer folders are moving to the billing area on a timely basis. Regulation changes, office procedure changes are dicussed at meetings or announced in memo form. (Signature � �� -�-- C�-''��.e, (Date) NZ'" COMMENTS OF DEPARTMENT HEAD / DESIGNEE Comment on the statements of the employee and supervisor. If you disagree with the employee and/or supervisor, be specific. �� ,u,�.[.r..t, .T-GL' .•a_.74i._Y�-�.,f�O` .��Lc.� .� /G'-/'-'�- �- e.G�I.Z''�. '`_'`-'/ b�'L' ztti,zv�r�, (Signature) (Date) JEANETTE LOPEZ ' EMPLOYEE NAME 1 . What is the function of your work unit? WE GATHER ALL NECESSARY BILLING INFORMATION FOR MEDI-CAL, MEDICARE, PRIVATE PAY, INTERDEPARTMENTAL A14D HEALTH PLAN FOR ALL INPATIENTS SEEN AT CONTRA COSTA COUNTY MEDICAL FACILITY. 2. For whom or for what group are you providing accounting clerical support? CONTRA COSTA COUNTY HEALTH SERVICES DEPARTMENT-PATIENT ACCOUNTING DEPARTMENT- INPATIENT TRANSFER UNIT 3. Designate the name and title of the person who supervises your position. How is your work reviewed? BARBARA BOUCHET - SUPERVISING ACCOUNT CLERK, MY WORK IS REVIEWED BY COMPLETING A WEEKLY LOG WITH TOTALS OF ALL CLAIMS HELD ON MY DESK. 4. Where is your supervisor located in proximity to your desk? APPROXIMATELY 30 FEET FROM MY DESK. THE TRANSFER UNIT IS 2N THE BACK AREA OF THE BUILDING. MY SUPERVISOR IS LOCATED IN THE BILLING UNIT, LOCATED IN THE MIDDLE OF THE BUILDING. 5. What are the most important assignments you perform and why? I NEED KNOWLEDGE OF VARIOUS STATE, COUNTY AND FEDERAL PROGRAMS AND OBTAIN ALL BILLING INFORMATION NEEDED SPECIFIED BY THESE RULES AND REGULATIONS. I MUST KEEP UP ON ALL THE CONSTANT CHANGES IN BILLING PROCEDURES OF ALL THE DIFFERENT PROGRAMS. I MUST BE AWARE OF WHAT IS SITTING ON MY DESK AT ALL TIMES AND MUST PROCESS AS QUICKLY AS POSSIBLE IN ORDER TO MEET DEADLINES. I REVIEF ALL CHARGES AND REQUEST CREDITS OR NEW CHARGES. I DO COMBINATIONS ON ACCOUNTS. I CALL ELIGIBILITY WORKERS FOR MEDI-CAL ELIGIBILITY. I COMPLETE. SHARE. OF COST FORMS. 6. What is the most difficult or complex work you perform and why? BEINr AWARE: OF THE RULES AND REGULATIONS AND CONSTANT CHANGES IN ALL THE VARIOUS COUNTY, STATE AND FEDERAL PROGRAMS. OBTAINING ALL NECESSARY BILLING INFORMATION FROM SOCIAL SERVICES AND OTHER DEPARTMENTS IN THE HOSPITAL. I HAVE TO MAKE SURE WE ARE BILLING THE RIGHT SOURCE AS MANY OF OUR PATIENTS MEDICAL COVERAGE CHANGES FREQUENTLY, I MUST SEE THAT ALL BILLING DEADLINES ARE MET. GIVING LEAD DIRECTION FOR ANY FINANCIAL CLASS CHANGES, WRITE OFFS OR ANY ADJUSTMENTS NEEDED ON AN INPATIENT ACCOUNT, VERIFYING MEDICARE ELIGIBILITY. 7. What parts of your job involve the greatest responsibility and why? NOTIFYING, DEPART- MENTS IN THE HOSPITAL OF INSURANCE INFORMATION CHANGES WHICH REQUIRE A FINANCIAL CLASS CHANGE AND REQUESTING THE NECESSARY BILLING FORMS TO GO WITH THE CHANGE. I MUST BE AWARE AT AL.L'TIMES OF ALL THE ACCOUNTS SITTING ON MY DESK. I MUST ALSO BE AWARE OF EXACTLY WHAT INFORMATION IS NEEDED TO COMPLETE THE INPATIENT FOLDER AND HOW TO OBTAIN THE MISSING INFORMATION AND FORMS IN ORDER TO MAKE ANY NECESSARY ADJUSTMENTS. I MUST GET THE COMPLETED FOLDER TO AN ACCOUNT CLERK III TO BILL BEFORE THE DEADLINE. I MUST DIRECT THE ACCOUNT CLERK III TO COMPLETE ANY COMBINATIONS OR ADJUSTMENTS. 8. List the name and job titles of employees to whom you are assigned to provide lead direction. ( PROVIDE INSTRUCTION BUT NOT SUPERVISION ON A DAY TO DAY BASIS.) FINANCIAL COUNSELING DEPARTMENT CAROL RAINOS - ACCOUNT CLERK III UTILIZATION REVIEW DEPARTMENT SHARON GOLDSMITH - ACCOUNT .CL.ERK III MEDICAL RECORDS DEPARTMENT SOCIAL SERVICES - REGARDING ERRORS ON FISCHE OR MC177 9. Do you .deal with extraordinarily difficult, angry or potentially explosive persons? Provide an example and indicate the frequency of these contacts and what your respons- ibility is in these situations. I AM CONTACTED BY PATIENTS BY PHONE CALLS AND BY MAIL. MANY PATIENTS ARE IRATE AND COMPLAINING ABOUT THEIR BILLS OR ABOUT INSURANCE COVERAGE THAT HAD NOT BEEN BILLED. I TRY TO EXPLAIN OUR VARIOUS PROGRAMS AND BILLING PROCEDURES TO THEM AND DIRECT THEM TO THE DEPARTMENT THAT CAN HELP THEM. IF INSURANCE INFORMATION IS INVOLVED, I REQUEST THE PATIENT TO SEND THE, INFORMATION TO ME AND I CAN TAKE CARE 10. Cffo b67W7JVdu been in your current position? Years Months 11 . Where were you assigned before this position? Desk, Department, Location, Assignment. ARK - EXPERIENCED LEVEL PATIENT ACCOUNTING 606 FERRY STREET PRESORT UNIT 7 (Signature) ,, (Date) I 1 ' CONTRA COSTA COUNTY CLASSIFICATION QUESTIONNAIRE , NAME DEPARTMENT DIVISION OFFICIAL JOB CLASSIFICATION WORKING JOB TITLE PICLV o! Work anc A►►:pneo Mojfs Tam* R9puarsd D&scnpt,on of %...k: Financial classes are changed after the final billing on the computer. When I receive new billing information for Medicare, Medi-Cal or Insurance after �" D the bill has final billed on the computer, the financial class must be changed. Revenue must be moved and a rebill requested and necessary documentation requested from Medical Records or Utilization Review. If the previous financial class was one that automatically wrote off, I reinstate the Patcom on AR, request write off reinstated and follow the above procedures to get an accurate bill. Sometimes the new billing information is incomplete and we must spend time verifying the information with the various resources at our disposal. I I F i I AK 7S CONTRA COSTA COUNTY CLASSIFICATION QUESTIONNAI RE , I i NAME DEPARTMENT DIVISION OFFICIAL JOB CLASSIFICATION WORKING JOB TITLE Plc.. o: Wo(k one Ass:pn.c Mo.r_ i i Tam• Requared D.acnpl,un of Wo,k: I also must call a patient's worker when I have received conflicting information from the patient's folder, the CDS fische or Cal Meds. . When I notice that a patient has a odd aid code 'in his or her Medi-Cal number I know that I must have a share of cost form (MC177) . This form should be in the patient's folder upon receipt by the Transfer Unit If it is not in the folder, a phone call is made to the patient requesti that they send the form to us. If patient states that the form is lost, I check worker's name and call Social Service Department for patient's amount of share of cost. I check to see if patient's total bill exceeds the share of cost. If the share of cost is not met, the patient is responsible for the bill. If the share of cost is met, I notify the Social Service Department with an MC177 manually completed,by me, requesting labels. I should receive the labels within 4 to 6 weeks. The statement is checked for correct charges. Any surgical procedures need an RVS code for billing purposes. I find the codes from a code book and write them on the statement for the biller to see. Any other necessary forms need to be requested at this time. If a male baby has been circumcised, the parents must receive a bill for the costs of circumcision. A financial class change must be done by me at this time for data mailer purposes. If a folder has the needed Medi-Cal label, the statement, the TAR and all information is correct - I then give it to the Account Clerk III with the direction to bill, combine or make any other necessary adjustmei If any necessary fbrm is missing, I keep the folder until complete. Insurance - In order for the biller to bill insurance a signed face sheet or a Consent for Disclosure of Information is needed. If the Consent was not signed by the patient at the hospital, I send the form r; to the patient requesting signature. The name and address of the insurance company involved must be correct. I call insurance companies to verify conflicting information. I check the statement and if all necessary information is in the folder and all charges are correct I give it to the Account Clerk III with directions to bill. If it is incomplete, I hold it. Health Plan - Interdepartmental - The charges must be checked on the statement. I check the CRT to verify that the amaunt has been written 3 E✓ off. If not written off I determine the amount tD be written off and direct the Account Clerk III to do write off. I also direct the origina copies •of the statements to the correct departments. The folder is then filed. Private Pay - Contract - These two financial clay-:es were set up for people who have no medical insurance. In each ca;)Ie the patient is sent �6 a copy of the bill and requested by me to begin piyments. A contract person already has scheduled payments set with a person in the collections department. I also attend two meetings a month with Financial!Counselors. At these meetings we discuss current problems with present;.3rocedures used in 1�0 preparing the inpatient data for billers. I help to develop new procedures to efficiently gather accurate financial information for current billing. Ai: 7 5 . i - CONTRA COSTA COUNTY CLASSIFICATION QUESTIONNAIRE Jeanette Lopez ` Health Rprmirjact Patient A.r•rrnnnti NAME DEPARTMENT OIVI 10'N r'nw OFFICIAL JOB CLASSIFICATION WORKING JOB TITLE place of War► ono Assigner Mo.:ri Time RsQuired Description of Work: I receive 'Inpatient folders from the hospital generally 3 to 30 days after the date of discharge. The folders are checked off on a report sheet and E ;D divided alphabetically. Once .the folders are checked in I begin checking tit for accuracy of financial classes assigned patient's by Financial Counselors. ' Any folder marked referred to Hayt, Hayt and Landau is verified by the referral inside and set aside for HH&L to work on. I receive Inpatient statements on a daily basis with the itemization of the services and supplies rendered to the patient. All statements are matched with the folders sent from the hospital. At this time the financial classes on the statements are checked with the financial classes in the folders. Not t(1 all information given to me in the folder by the Financial Counselors is accurate or consistent and I check on the CRT, CDS fische and other resources to get corrected information and notify Utilization Review Department by a phone call and in writing of financial class change. If I have an Inpatient folder with necessary documentation and a statement is not received within 3 to 5 days, I use the CRT to investigate what is holding up the statements If only insurance verification is needed, I then verify the insurance information and a statement should drop from the system within days. The various types of financial classes that I work with are: 7 Mental Health - Medi-Cal - I check the folder for current label. If there is no label, check outpatient folders, make phone call to patient requesting labels or an AB1305 can be filled out and sent to Social Service Department requesting labels. The CRT needs to be used to see if current charges have been written off. File folder in purged. Mental Health - Short Doyle - I check for active date of Short Doyle and for patient's annual liability if any. Change financial class so patient may receive- data mailer for liability. I then check the CRT to verify that all but the patient's liability has been written off. If it has not been written off, I write the amount of write off on a write sheet and direct the Account Clerk III to do the necessary procedure. The folder is filed. M - Medicare with all other secondary financial classes - Ecample: MO - Medicare Only - MI - Medicare and Insurance - I check to verify Medicare eligibility, I also check for a DRG which lists a diagnosis 1 and procedures performed. I must have Medi-Cal labels where necessary, G a signed face sheet or a Consent for Disclosure of Information signed by the patient with correct name and address of insurance coapa:iy involve If any surgery was performed on the patient, I need to call Surgery Dept. for exact anesthesia time and write it on the statement. Any surgical procedure:performed must have an RVS code for the procedure pe�,_formed. I check that procedures listed on the DRG are charged. If all itecessary information is in the folder, I then direct the Account Clerk III to bill T - Medi-Cal - The first item I check, is if it is mother and hab Mothe and baby inpatient stays do not require a Treatment Authorizatior Request if the stay is 3 days or less. I also must check to see if it wa! an ABC delivery or a normal delivery, also if the baby was scale or fe.nale. Anything over 3 days requires a TAR. After checking for a TAR I m st have a Medi-Cal label. If no label is in the folder, I check the l. �tient outpatient folders, .call the patient and request a label for date o. service, check the CDS fische to make sure patient was eligible to Medi-Cal, call the Social Service Department and speak to patients Mn rker (worker number obtained from CDS fische) or complete an AB 1305 requesting labels from Social Service Department. AX 7 5