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HomeMy WebLinkAboutMINUTES - 05201986 - 1.34 1-034 , _._.._ POSITION ADJUSTMENT REQUEST No. Date: 4/23/86 Dept. No./ a-,�. Copers Department Health Services/Finance Budget Unit No. ;t 05 g ;g.���lo. 6569 Agency No. 54 Action Requested: Reallocate Clerk — Experienced Leel 2 �t�ion''#�54-0067 to Account Clerk Beginning Level. Proposed Effective Date: 5/21/86 Explain why adjustment is needed: To properly classify the incumbent (S. Olsson) according to the duties she performs in the Billing Unit of our Patient Accounting Office. Classification Questionnaire attached: Yes ® No [� Estimated cost of adjustment: Cost is within department's budget: Yes ® No If not within budget, use reverse side to explain how costs are to be funded. Department must initiate necessary appropriation adjustment. Web Beadle, Use additional sheets for further explanations or comments. Dept. Personnel Officer for Department Head Personnel Department Recommendation Date: Reallocate Clerk-Experienced Level position #67, 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: JKI day following Board action. C1 Date for Director at7ersonnel County Administrator Recommendation Date: d Approve Recommendation of Director of Personnel D Disapprove Recommendation of Director of Personnel 6 Other: or County Administrator Board of Supervisors Action MAY2 0 1986 Phil Batchelor, Clerk of the Board of Adjustment APPROVED/Ds "�S °.°-°.� 4ED on S4pervisors and CoL-niAdmini trator Date: MAY 2 p 1986 By: APPROVAL OF THIS ADJUSTMENT CONSTITUTES A PERSONNEL/SALARY RESOLUTION AMENDMENT. i P300 M147 6/P2 T �• �,'. ACCOUNT CLERK DEEP CLASS CLASSIFICATION QUESTIONNAIRE q 1 l4f PATRICIA ARRD i ame -Department Division Work unit ✓ � � �� B.LEVEL CLERK � PATIENT ACCOUNTING 724 ESCOBAR• ST. MARTINEZ CA Job Classification or Location ress pit«t' VAA* Percent of Denription of Work: Time Required - 80s I work for Patient Accounting which is part of Health Services, a revenue producing agency. I process and bill medical.-claims for private insurance company's on any patients seen in X11 CCMS facility's. I receive .the insurance billing runs weekly in alpha order. Below are examples of insurance accounts I work with. I, FINAL BILLING ACCOUNTS e Final billing_accounts should have statement of charges, a UB-82 claim form and a face sheet. I check the Financial class status on the �. statement. I then check the face sheet for the patients or their representatives signature.. If I have no signature on the face .sheet or no face sheet I send a copy of the billing statement and an A-81 form requesting insurance information and patients "or their representatives signature. I then put in a financial class change request. When the A-81 form is returned I readjust the F/C status of the patient back to the original F/C and 'I bill the insurance company. The reason for the F/C changes are to move the money to the correct payor source. . In processing the billing claim I keep one copy for restating in case . the insurance company doesn't pay within 60 days. I send one copy to central collections so they can return to me with payment.-information when payment is received. ti II. FINAL BILLING ACCOUNTS FOR INDUSTRIAL'S and WORKMANS Compensation 3ndiibtriai- and Vorkmans-Sompensation billing are basically the same as final billing accounts except a Dr's first report is necessary. The Dr's first report and the UB-82 claim form must have the same diagnosis. A^code of 8* and date of original injury must be added to the claim . before processing. III. REBILL ACCOUNTS Rebill accounts deal mainly with financial class changes. EXAMPLE: A = patient shows an original F/C of PO - private pay but I have insurance information on this individual. I have to put in a FIC of IO-insurance and bill the insurance co. F/C changes and revenue adjustments are done often to keep the money moving to the correct payment source. If the date of a rebill account exceeds 6 months then I have to manually type a7UB-82 claim form. Each claim can take as much as 30 minutes to complete. Alot of research goes into a manually typed claim. Pt's name, clinic number, patcom number, address, all billing codes from the transaction master files that pertain to the date of service, allprice listings by codes, total price'of services received, diagnosis and ICD codes, payor source, suscriber of the policy, Social security number of suscriber, group numbers and coverage codes, address of insurance company, address of insured, ETC. Most of e%diagnoses are not given. I then have to call the facilityAtKe patient was seen and-ask ":-., for additional information or I put in a medical records request for information needed for a-particular date of service. IV. REBILLS FOR LATE CHARGES After a claim is processed but before it is *nailed to the insurance company the computer is checked for late charges that might not have been included on the original claim. I take the codes from the ' computer match the codes with the transaction master get RVS codes and prices Iand type all codes and prices on the original claim. Total price is changed and processed for payment. January 1985 ACCOUNT CLERK CLASSIFICATION QUESTIONNAIRE (Continued) Percent Of Description of Work,:, Time Required V. 'CYCLE BILLING ACCOUNTS Cycle billing accounts are continuous charges with a balance forwarding and new charges occuring continuously keeping.the same patcom numbers. These accounts -are mental health accounts and prenatal accounts. After researching mental health accounts and -I find that their insurance does not Boer mental health services. billing adjustments and write offs must be made. -On prenatal accounts+ I must put in a * 07 a to the facility seeing the patient asking them to discharge patcom number from the system. 5% USE OF CRT FOR VARIOUS INFORMATION I must know what screens to go into on the CRT depending on what I am trying to verify: I check for financial class status of the patient, social security numbers of patients px patients representative, and address changes must be changed in the computer daily to insure speedy payment from the patient after insurance has paid. 5% INCOMING MAIL . I have to keep up on incoming mail that is received from different a:f*rent-departments. I must know what ail fprms I am receiving are forwso I know where to put them on my desk. My desk must be organized in such a way so that all other billers would know where to go if they are trying to find a certain piece of information. ' 5% RESEARCHING I use the phone to call employees, employers, or patients for any additional information I might need. I use the ICDM code book,for diagnosis and codes, medical dictionary, PDR, and Transaction waste, 5% I keep a statistical accounting of how many claims I do a day. I use an adding machine at the enL of every day to total each claim I am sending out. I put my total of all claims on the stat-report. I . it a copy of each billing statement to the patient. This rodedure is done daily. C l • EMPLOYEE NAME 1 . What is the function of.your.work unit? = C ? HC nITAOR ITS OLLY1')ILLI:' :ERIC-L S E �r, CZI^ZCS. 2. For whom or for what group are you providing accounting clerical support? 3. Designate the name and title of the person who supervises your position. How is your work reviewed? ,����nw ,�TTC T"T'�c*m '�,:rL �v• r..�+.�+ �.T 4. Where is your supervisor located in proximity to your desk? 5. What are the most important assignments your perform and why? 3ILT i"17- 'i I'�w , 7;.� --1 � .i•�IC� T-- Ai M, �:M'=` L �1i1 s. �T_ .�•��1.7T�, . �.n�.-T- r;-�-i m.7•-. 6. What is the most difficult or complex work you perform and why? n- 7., -,T. _ TL� T7'. . ci' .Tf7T'•._ �:".'vim -' 'InLF "I"- I. ..r,.. :�:Tin.. 0T' "�., 71.1:7LTJ T!' m .�! 1-?^ ..1T -�, •.�-+ r n 3-7`77 ^ C `.�1 [? 7'.^TT7^ '"S� ,?:; �LT,7`7r'?�, A� 77,T-=; C. 3-T`7 7. 7T TOSS J I i'L •J 7. What parts of your job involve the greatest responsibility and why? TT.' , .T. T,•�7TTT/�. T^.I 'r T„T •T^ wn!y^ '.,'T�- ^?7T' PT• �^ 'Tr- Ly'' r^r' T�:7 - S t ') ") ._ T S .TLC ,�., 1. _ rIT)';a. r-.TCS. 'T7)I.^n77 N'M �.7-,TI-7\r r'r nom+.,. M CU-J•.T ?n ',V;-r Si,-; 7171 *T?? =77CT. t�^^, •T'^IC.'1L LA? L 70 nr ';-)A7r- 'r Cr A7% MA'M- A',TY AT.TJs371771 ; \T`.?-_�1�r.n}r �•-� tI o,.T;,'�`L T, r�..,Z-179 TNI 07)7-3 To 1.117^'(!4.? ?7017T^7C IG' 1*7P.C 1JI 7 "17r T0LT 'T �,, s 177,717-7) �-N n Q r I s� � � ,,Lr., 3� sT. Lf0 , or 7 r:. 8. List the name and job titles of employees to whom you are assigned to provide lead direction. 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- ibilityv�is in these situations. \T!� DI7 "^ r.�•.i-r+7�C'n T.S �^'_* T'J� `j'!�.7^?.�t�r•..J T nTJ?�D 7y err.^ 4r.7I+'* 10. How Tong have you been in your current position? (Years) Months 11 . Where were you assigned before this position? Desk, Department, Location, Assignment. Tr7 mtfry nn92 *r,7N, 7m7,C17T.T c�.TrJ'jL � �n (Signature) (Date) %, r' POSITION ADJUSTMENT REQUEST No. Date: 4/22/86 Dept. No./ i Copers Department $ealth_-Sr_,/Fl nnce Budget Unit No. 0540 Org. t g Agency No. 54 L Action Requested: Reallocate four (4) Clerk— Experienced l �} s� 164, 1688, 2013, and 132 to Acoount Clerk — Beginning Level. Proposed Effective Date: 5/21/86 Explain why adjustment is needed: To pr=erly classify the indumbents (Arruda, Lagarejos, Dryer, and Mathis) according to the duties thev perform. Classification Questionnaire attached: Yes [x] No [] Estimated cost of adjustment: $ Cost is within department's budget: Yes [xj No (] If not within budget, use reverse side to explain how costs are to be funded. Department must initiate necessary appropriation adjustment. Web Beadle, Use additional sheets for further explanations or comments. Dept. Personnel officer for Department Head Personnel Department Recommendation Date: —ffr'o Reallocate four Clerk-Experienced Level positions #164, 1688, 2013 and 132, 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 ersonnel :ounty Administrator Recommendation Date: p Approve Recommendation of Director of Personnel D Disapprove Recommendation of Director of Personnel L3 Other: r County Administrator yard of Supervisors Action MAX 2 0 1986 Phil Batchelor, Verk of the Board of ljustment APPROVED/b!5APPKOf€D on Supe visors ar,uCountytidministrator to: ' MAY 2 0 1986 --By: PROVAL OF THI_S ADJUSTMENT CONSTITUTES A PERSONNFIicnlASV wr. - - - - - ACCOUNT CLERK DEEP CLASS C L A S S I F I C A T I O N Q U E S T I O N N A I R E 44(PATRICIA ARRUDA � PATIFNT Arr0TTMrr , BILLII11G �+ ' Name Department Division work Unit B. LEVEL CLERK I PATIENT ACCOUNTING 724 ESCOBAR• ST. MARTINEZ CA Job Classification L Work Location AdUress 6J1141 Vwk Percent of Description of Work: r Time Required I 80% I work .for Patient Accounting which is part of Health Services, a revenue ,producing agency. I process and bill medical ..claims for private insurance company's on any patients seen in All CCMS facility's. I receive the insurance billing runs weekly in alpha order. Below are examples of insurance accounts I work with. I. FINAL BILLING ACCOUNTS Final billing_accounts should have statement of charges, a UB-82 claim form and a face sheet. I check the Financial class status on the statement. I then check the face sheet for the patients or their representatives signature.. If I have no signature on the face sheet or no face sheet I send a copy of the billing statement and an A-81 form requesting insurance information and patients or their representatives signature. I then put in a financial class change request. When the A-81 form is returned I readjust the F/C status of the patient back to the original F/C and I bill the insurance company. The reason for the F/C changes are to move the money to the correct.payor source. . In processing the billing claim I keep one copy for restating- in case the insurance company doesn't pay within 60 days. I send one copy to central collections so they can return to me with payment information I when payment is received., II. FINAL BILLING ACCOUNTS FOR INDUSTRIAL'S and WORKMANS Compensation s 3ndustriaifand glorkmans*.Vompensation billing are basically the same as f final billing accounts except a Dr's first report is necessary. The Dr's first report and the UB-82 claim form must have the same diagnosis. A^code of 8* and date of original .injury* must be added to the claim before processing. III. REBILL ACCOUNTS Rebill accounts deal mainly with financial class changes. EXAMPLE: A patient shows an original F/C of PO. - private pay but I have insurance information on this individual. I have to put in a F/C of IO-insurance and bill the insurance co. F/C changes and revenue adjustments are done often to keep the money moving to the correct payment source. If the date of a rebill account exceeds 6 months then I have to manually type a7UB-82 claim form. Each claim can take as much as 30 minutes to complete. Alot of research goes into a manually typed claim. Pt's .name, clinic number, patcom number, address, all billing codes from the transaction master files that pertain to the date of servics, all. price listings by codes, total price'of services received, diagnosis and ICD J codes, payor source, .suscriber of the policy, Social security number of suscriber, group numbers and coverage codes, address of insurance j : company, address of insured, ETC. Most often diagnoses are not given. I then have to call the facility^ tge patient was seen and-ask for additional information or I put in a medical records request for information needed for a.-•particular date of service. IV. REBILLS FOR LATE CHARGES After a claim is processed but before it is mailed to the insurance company the computer is checked for late charges that might not have been included on the original claim. I take the codes from the computer match the codes with the transaction master get RVS codes and prices and type all codes and prices on the original claim. Total price is changed and processed for payment. Januar.v 1985 s k ACCOUNT CLERK CLASSIFICATION QUESTIONNAIRE (Continued) " r r ! Percent Of Description of Work: Time Required "i V. ' CYCLE BILLING ACCOUNTS Cycle billing accounts are continuous charges with a balance forwarding and new charges occuring continuously keeping. the same patcom numbers. These accounts are mental health accounts and prenatal accounts. After researching mental health accounts and I find that their insurance does not gvVtrmental health services billing adjustments and write offs must be made. . "On prenatal accountst I must put in a wx u L to the facility seeing the patient asking them to discharge patcom number from the systema 5% USE OF CRT FOR VARIOUS INFORMATION I must know what screens to go into on the CRT depending on what 1A I am trying to verify. I check for financial class status of the patient, social security numbers of patients pr patients representative and address changes must be changed in the computer daily to insure speedy payment from the patient after insurance has paid. 4 ;i 5% INCOMING MAIL I have to keep up on incoming mail that is received from different -'__-departments. I must know what all forms I am receiving are for•so I know where to put them on my 'desk. My desk must be organized in such a way so that all other billers would know where to go if they are trying to find a certain piece of information. ' 5% RESEARCHING 4' I use the phone to call employees, employers, or patients for any additional information I might need. I use the ICDM .code book.for diagnosis and codes, medical dictionary, PDR,. and Transaction master., 5% I keep a statistical accounting of how many claims I do a day. I use an adding machine at the ent.of every day to total each claim I ' am sending out. I put my total of all claims on the 'statreport. I it a copy of each billing statement to the patient. This �. rodedure is done daily. • i • t 1 2 i PATPTUA ARRIMA • EMPLOYEE NAME 1 . What is the function of your work unit? I ',IQRK. FOR PATIENT ACCOUNTING WHICH IS PART OF HEALTH SERVICES, A REVENUE PRODUCIN5 AGE'1CY`. I PROCESS AND BILL MEDICAL•CLAI�IS FOR PRIVATE INSURANCE COMPANY'S ON ANY PATIENTS SEEN IN ALL CCMS FACI^LITY"S_ 2. For whom or for what group are you providing accounting clerical support? CONTRA COSTA COUNTY HEALTH SERVICES PT, ACCOUNTING. . 3. Designate the name and title of the person who supervises your position. How is your work reviewed? BARBARA BOUCHET SUPERVISING ACCOUNT CLERK. AFTER I PROCESS Mr CLA,T'.MS I RFCFIECK THEM TO MAKE SURE EVERYTHING IS COMPLETE BEFORE THEY` ARE SENT OUT, 4. Where is your supervisor located in proximity to your desk? I AM SE,�,TED RIGHT NEXT. TO MY SUPERVISOR, 5. What are the most important assignments you perform and why? USE OF THE CRT FOR BUCKETING ACCOUNTS. THE 001,1LEDGE I MUST HAVE FOR EACH I"ISURANCE COMPANY, !!HAT THEY '.JILL PAY FOR., REGULATIONS 11ANDADED BY INS�JRANCE PRIVATE AND FEDERAL, 6. What is the most difficult or complex work you perform and why? INPATIENT BILLING; THE' KNOWLEDGE I MUST HAVE, 1,4HAT RECORDS TO BE COPIED AND SENT TO THE INSURANCE COMPANY'S USE OF THE CRT FOR BUCKETING ACCOUNTS, COMUNATIONS OF ACCOUNTS DEBIT!" AND CREDITING OF ACCOUNTS. 7. What parts of your Job involve the greatest responsibility and why? I HAVE TO MAKE, SURE I' HAVE ALL OF THE LEGAL CONCENT FORMS TO BILL INSURANCE CO"1PANYS. WHICH 14ILL ALSO INSURE THAT PAY,f•IEyT IS MADE CORRECTLY` TO CONTRA COSTA CO!J!JTY MEDICAL SERVICES. 8. List the name and job titles of employees to whom you are assigned to provide lead direction. N/A 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. P•�(A 10. How long have you been in your current position? Years Months 11 . Where were you assigned before this position? Desk, Department, Location, Assignment. CORTRA COSTA COUNTY HEALTH: SERVICES 38TH & BI,SSELL RICHMONDz CALIF, 94506 , (Signature) (Date) 1�0� t 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 statements Pat Arruda has made. Her desk is a revenue generating desk for Health services and contains a great number of complexities. What parts of this job do you check or review closely and why? Pat Arruda is well trained and does not need close reviewing. Spot checking for routine claim processing is done, and regulation changes, office procedures are discussed in a memo or meeting. e (Signature (Dat 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. (Date) (Signature)