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Scenario 5
As the Billing Manager I electronically submit claims to Medicare for payment. Medicare
has adjusted the format of the billing form which affects my billing process. The billing software
vendor will give me the new form with the changes by the deadline, with no time to test the new
format. Due to the lack of testing time there are many issues that could arise. The new form has
3 new fields and the field length has changed for 3 fields. Fields could be in the incorrect order
or they could be overlapping each other on the form. With that in mind billing could be delayed if
the new format coming from the billing software vendor is incorrect and needs to be revised.
The deadline for the new format is tight, not allowing for any testing time. The billing manager
can’t send incorrect forms to Medicare for payment. As the billing manager it’s important to
make sure patients receive proper billing. With the short turn around of this form it’s possible
billing issues will come up.
Communication is lacking in the hospital, it is unclear if the billing department will need
to update all of the computers to the new version of Internet Explorer. “Rumors” have been
spread that there might be a need to update the computers to the new version of Internet
Explorer to support existing applications, but nothing has been confirmed. Updating all of the
computers in the billing department will take time, and there is already a tight deadline with the
new form.
The billing manager has the responsibility to make sure that all of the bills get to
Medicare in a timely manner. With all of the new changes to the form and the tight deadline, it’s
unsure if the new form will be correct.
