Best Practice Guidelines: Healthcare Practice Management & POPIA Compliance Framework

Best Practice Guidelines: Healthcare Practice Management

POPIA Compliance Framework




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16. Reports: Roles, Purpose, Dates & Terminology

Responsible Roles


Ensure all transactions are up to date before reports are generated and sent to management. Draw and check all reports and send them with notes (if needed) to the responsible manager(s). Implement management decisions to optimise operations.

 

Check the audit trail to ensure the correct stock were billed. In stock management, more reports will be used to ensure the correct details.


Check all reports, ensure all reports balance with each other and the information on the reports is correct. Send reports to the Auditors for the financial reports to be compiled and audited before submitted to SARS.


Purpose of Reports

Reports communicate information that has been compiled as a result of the analysis of data captured in the software. Reports convey information to assist Practitioners and/or business owners in business decision-making and planning as well as to comply with laws.


Dates in GoodX

To be able to draw the reports correctly and consistently, the user must take note of the following different dates used in drawing the reports:

Transaction date: the service date on which the consultation was conducted or treatment performed.

Capture date: the date on which the information was captured on the software system.

Period: the financial period in which a transaction is captured, eg 1 March to 31 March is period one for practices whose financial year is from 1 March to 28 February.

Take note:

  1. It is imperative to always work with one type of date. Depending on your type of practice, it is advisable that your reports are drawn per period.
  2. If reports are drawn with different data types, the reports will not balance with each other.
  3. If reports have been drawn eg for March according to capture date or period, but corrections are done in April for March and the same reports are drawn in April based on capture date or period, the reports will differ. It is therefore imperative that if transactions are reversed and redone, those updated reports are drawn for the month.


Reports terminology

Filters

Information can be excluded so that only selective information can be viewed in the report. There are three types of filters in GoodX:

  • The single selection filter per column by a dropdown menu;
  • The custom filter provides two options by which to filter information; and
  • The advanced filter provides unlimited filtering options.

Sorting

Information can be sorted alphabetically or numerically.

Grouping

Information can be grouped together by eg transaction type, practitioners, service centres, dates, amounts, billing codes, medical aids, ICD10 codes, referring and treating doctors and price lists.

Settings

Reports can be customised by choosing items in the settings of the report. The items are described in the user manuals so that senior reporting personnel can set up their own reports. If you set up your own reports, you will know what information is generated by the reports.

Parameters

Parameters are the filters used to limit the scope of a report. Parameters used in the GoodX reports are:

  • All amounts
  • < 0
  • > 0
  • = 0
  • Not equal to zero

If for example an age analysis is generated with a scope of amounts larger than zero on the debtor accounts, the report will not show the credits on debtors accounts.


The following Reports should be drawn regularly and will be discussed in the sub-chapters:

  1. Debtor Transaction Drilldown (Daybook)
  2. Age Analysis
  3. Assistant Audit Report
  4. Invoices Outstanding
  5. Debtor Statistics Report
  6. Turnover Report
  7. Turnover Report (Codes Billed)
  8. Practice Overview
  9. Doctor Overview
  10. Booking Status Report
  11. Booking Type Report






Web App Reports

It is vital for any Medical Practice that the Practice Manager ensures that the Critical Business processes are successfully completed. This will reduce the risk of all kinds of losses, eg Data loss and Financial losses.

The following diagram gives an overview of the Internal Controls that need to be performed on a regular basis. The Controls are performed by:

  1. Generating the relevant Reports available on the GoodX Software System;
  2. Analysing & Interpreting the information in the Reports; and
  3. Responding to the information, by eg making corrections on the system OR implementing Management decisions based on the information to make the Practice more profitable.
The GoodX Web App's reporting functionality can be extended with the reporting functionality in the GoodX Desktop App. The GoodX Desktop App is extremely customisable and we, therefore, urge you to go through the Desktop App Reports for your convenience.

In the Web App the following reports can be accessed:

All reports can be exported to excel. The reports will show graphs and the detail can also be viewed. 














Debtor drilldown (Daybook) Report

The Debtor Drilldown Report (Daybook Report) displays a complete list of all the transactions processed between specified dates.

The user is able to select the detail of each transaction type.

TAKE NOTE: Please know the differences between the types of dates:

  1. Capture date: the date on which the transaction is captured onto the system (is not necessarily the same as the transaction date).
  2. Transaction date: the treatment/service date.

The Debtor Transaction Drilldown Report is used to generate the following Reports:

  1. Debtor Control Ledger Report - Monthly
  2. Audit trail Report (Transactions) - Daily & Monthly
  3. Audit trail Report (Billing items) - Daily & Monthly
  4. Movement Summary Report - Monthly
  5. Code Statistics Report - Daily & Monthly
1. Ledger Report

The Ledger report groups all transactions into various sections. For example Debtors invoices, Credit notes, Deposits (Cash, Card, Electronic and ERA), and Journals. The Ledger report also contains the Debtors control account (CAS001).

The Ledger report has an opening balance from the previous period and a closing balance for the current period.

All transactions are summarised and the movement total of all the Debtors for a certain period is displayed.


2. Audit trail Report

The Audit trail report contains all debtor transactions for a specific period. Report detail is on invoice level. The report is used for fault finding and grouping information according to needs. Report columns are the same for all types of transactions but only the information applicable to that transaction will display in the column.

The following columns can be found on the report:

  • Transaction date, capture date and financial year
  • Batch number, document number and split number
  • Ledger account
  • Debtor account number, file number and case number
  • Debtor initials and surname
  • Credit note and journal description
  • Journal actions
  • Amount exclusive of VAT
  • VAT amount
  • Amount inclusive of VAT
  • The user that posted the transaction
  • The patient portion on the amount
  • Treating provider and referring provider
  • Service centre
  • Billing group and price list collection
  • An indication of the number of transactions per transaction type
  • The total amount per transaction type and grand total for all transactions 


3. Audit trail Invoice detail

The audit trail invoice detail displays all debtor transactions for a certain period, on item level. This report is similar to the audit trail but this report contains billed for all accounts, with more information where applicable. The report is used for fault finding, grouping information, or filtering on specific codes or stock items that were billed to patients. Report columns on the report are the same for all types of transactions but only the information applicable to a specific transaction will display in each column.

The following extra information is available on the report:

  • Patient ID
  • Medical aid name and medical aid number
  • Code (Stock code or Tariff code)
  • Description (Stock description or Tariff description)
  • ICD-10 code
  • The quantity that was billed as QTY
  • VAT percentage that was charged for each line
  • Cost of sales
  • Patient name and surname
  • Nappi code
  • Default billing group, posting billing group and price list
  • Modifier code
  • Authorisation number


4. Movement Summary Report

The Movement summary report is key to practice management. The report indicates turnover, cash flow and journals on debtors, and balances back to the age analysis showing outstanding accounts for a specific period. 

The report can be generated per practitioner indicating turnover per practitioner. Depending on practice needs, the report can be filtered or grouped to assist in getting the required information.

The report is divided into six sections:

  • A. Opening balance
  • B. Turnover
  • C. Cashflow
  • D. Journals
  • E. Posted after the period
  • X. Totals

The following columns are available on the report:

  • Ledger, description and the type of transaction
  • Amount excluding VAT
  • VAT amount
  • The total amount including VAT

The following information is displayed under the different sections:

A. Opening balance

The opening balance from the previous period

B. Turnover

Turnover is the income per patient treated and billed, and is also known as gross income, or as total income received. Turnover is grouped by various types of income (for example, procedure, material or medicine) with a positive amount. Under turnover, credit notes are displayed as negative. 

Turnover will be the amount from the invoices minus the amount from the credit notes for a specific period.  

C. Cashflow

Cashflow represent all cash, card or any other type of income payment. Cashflow forms an important part of any practice, facilitating day to day expense payments. Without healthy cash flow management, a practice can fall into financial difficulties which can lead to bankruptcy. 

The cashflow section is grouped by different types of deposits (receipts) and is displayed as negative amounts. Corrections (receipts written back) are displayed as positive amounts. The difference between the two displays the total cash flow for a specific period.

D. Journals

Journals are usually done for three main reasons, namely: bad debts, settlement discounts and small amounts written off. Under the journal section, transactions are grouped by different journals captured. Journals can reflect negative or positive amounts, depending on journal type. Journals don't correct or change turnover or cash flow.

E. Posted after the current period

Transactions displayed under this section are all the transactions that were posted in a future period, with transaction dates in the current period, or linked to transactions in the current period. These transactions need to be investigated by the practice. 

X. Totals

The total is calculation in the following manner:

Opening balance + Turnover - Cashflow + or - Journal + or - transactions posted after the period = Total = Age Analysis 

A + B - C +/- D +/- E = X

The total must always balance back to the age analysis total for the same period, which indicated good practice data integrity.

5. Code Statistics Report

The Code Statistics Report gives an objective description of all the Codes billed in the Practice, presented in a statistical table. The purpose of the Code Statistics Report is to provide the Doctor with Statistics on how many procedure codes, material codes, or consumable codes were billed in a specific time frame. It will also show the Turnover, Cashflow, VAT incl/excl, the total paid by Medical Aid and Private Patients per Code. It is meaningful to see how many patients were treated and what codes were billed the most and paid in full to know if the practice is growing. The Doctor can also determine from the code statistics report if some codes are not paid in full or rejected by Medical Aids to know if they should rather bill an alternative code in the future or switch the code over to a Private/Cash code.

The code report can be used by the practitioner to see which procedure, treatment and consultations were done. The code report will show which items were most often used. The report can assist in making decisions on which treatments or procedures to keep on doing or which should be stopped because of low-income benefit to the practice.

The following information can be viewed on the report:

  • Code (tariff or stock code)
  • Description or name
  • Units billed
  • Number of times billed
  • Total amount excluding VAT per code 
  • Total VAT amount per code 
  • The total amount including VAT per code 
  • Unit price
  • Total of all units billed for all codes
  • The total amount billed for all codes (VAT exclusive amount, VAT amount, and VAT inclusive amount)


Age Analysis Report

The Age Analysis Report displays all the Outstanding balances of the Debtors on the system and the Age of the outstanding balance as per the information selected from the Report set-up.

The Age Analysis Report indicates all the outstanding accounts for both Medical Aid and Private Patient outstanding accounts. 

The Age Analysis Report assists in following up with the Medical Aid or the Patient on outstanding amounts. It can also assist in limiting Bad Debts if the amounts are followed up and collected regularly before 60 days of Age. 

A debtor age analysis is divided into the following:

  • Total outstanding amount
  • Medical aid outstanding
  • Private patient outstanding
  • Current outstanding
  • 30 days outstanding
  • 60 days outstanding 
  • 90 days outstanding
  • 120 days outstanding
  • 150 days outstanding
  • 180 + days outstanding

The columns from current until and including 180 + will be added together to make up the total outstanding per line or per account. The totals at the bottom of each column indicate the sum for each column.

It is noteworthy that negative amounts (credit amounts) are deducted and will decrease the total.

Outstanding accounts

The best practice is to have no outstanding private patient accounts on 90 days and older, and to have no outstanding medical aid patient accounts on 60 days and older.

Use the age analysis to identify accounts that need to be followed up: a regular process should be put in place nominating which week to use for following up on outstanding accounts. For example, the first week of each month can be used to follow up on all 30 days outstanding accounts, the second week of the month to follow up on all 60 days outstanding account, etc. 

Remember to make notes in the notebook when following up on each account.

Credit accounts

Credit amounts on the age analysis mean that those accounts are in credit and that the practice owes money to those medical aids or patients.

When the credit amount is on the patient's part, a refund should be arranged with the patient.

When the credit amount is on the medical aid part, the credit should be kept until the medical aid pulls the amount back on the following payment from the medical aid.