Billing and Financials—Aged Care Software for a Changing Australian Market

17/05/2018

While the aged care system has become more of a consumer-driven market, further reform is required to offer greater consumer choice. This was the position made by the Aged Care Sector Committee in the Aged Care Roadmap.

The roadmap acknowledges that the aged care market has improved its ability to respond to a wide range of care needs by a diverse customer base. However, it is fair to assume that further reform will place even greater importance on the need for organisations to continually evolve and innovate. 

For a CFO, legislative changes can be a real burden, particularly if your software tools don’t keep up with your market’s evolving nature. If your organisation’s aged care software was not built as a senior living solution but instead catered for yourAged Care Billing and Financial Software for a Changing Australian Market industry as an afterthought, then you’ve probably experienced this frustration.

Keeping pace with the Australian legislative environment and Medicare’s online claiming system takes a significant commitment, one that I am proud to say that Epicor has made.

Epicor has been developing and continually updating our billing, funding and financial modules over the last 15 years to comply with legislative changes. The Epicor Senior Living Solution (SLS) supports the latest suite of requirements within the Living Longer Living Better reforms, such as tracking means tested care fees, applying annual lifetime caps, and the calculation of accommodation supplements based on supported resident ratios. 

As the Australian aged care industry is undergoing a period of significant change, harnessing the value of software purpose-built for this market brings with it a number of distinct advantages. To avoid speaking generally, I will outline below some of the relevant billing and financial tools available in the Epicor Senior Living Solution (SLS) so that you can consider potential areas of improvement of your aged care software in comparison with functionality available today.

Medicare online claims and third-party billing
The Epicor SLS system automatically processes and submits online claiming events to Medicare when you enter relevant records such as client entry, discharge, leave, and oxygen usage. Once the system receives event updates from Medicare, you can view the response result.

As the tool is purpose-built for Australian aged care, billing can be performed for funders such as Medicare, Department of Veterans' Affairs, insurance companies, and other third parties.

Billing management
The Epicor SLS system allows you to allocate different billing schedules (and change/add billing codes within that schedule) to a single client accommodation combination. You can also assign different billing requirements for independent living, aged care, and community care.

Billing of basic daily care fees, monthly service fees, rent, deferred management fee, and other charges are facilitated within the same system which automatically calculates subsidies for reimbursement from Medicare.

To cater for the varied nature of how aged care organisations coordinate billing periods, the Epicor SLS system allows for billing to be processed at the end of any period as defined by the user, whether fortnightly, monthly, or any other designated schedule.

Billing and funding reconciliation 
Australian aged care organisations often face discrepancies between expected and actual government funding. The Epicor SLS system uses resident event information, such as entry and departure events, Aged Care Funding Instrument, and leave events to calculate expected funding, and allows for any necessary reconciliations due to received funding discrepancies. In cases where a discrepancy is expected to be rectified in a future period, adjustments can be carried forward indefinitely.

Once payment details are imported via Medicare Online Claiming or from a worksheet, an auto-match process allows funding adjustments to be automatically created. Once you have completed the reconciliation, you can post the actual funding.

Financial management 
The accounting applications within the Epicor SLS system are built around a series of "global engines" that support effective financial management and control anywhere. To provide a high-level overview of some of the key features, I will briefly introduce the general ledger, accounts payable, and accounts receivable tools.  

  • General ledger (GL)
    A strong GL enables accounting controls and system security so that the integrity of your financial data is not compromised. 

    The GL sits at the heart of effective financial management, and through the Epicor SLS system you can enable flexible financial accounting representations through multiple book functionality and automate the allocation of funds across multiple accounts without manual entry. 

    The GL also allows you to post transactions to different accounts within different books simultaneously and post entries to any period in the current year, following year, or any subsequent year.

  • Accounts payable (AP) and accounts receivable (AR)
    Both the AP and AR functions in your business are critical for cash flow and stakeholder relationship management. However, they are also functions which can be effectively streamlined through the use of automation tools available within the Epicor SLS system as discussed here.

    The built-in AP functionality can generate payments for all invoices due, those for a particular supplier, or only for specific invoices. The system also has user-friendly functionality for dealing with purchasing variances.

    Evaluate and Select the Best Aged Care SoftwareFor aged care organisations, being able to set alternative bill-to contacts (i.e. son or daughter) and allowing the entry of multiple services on a single invoice (including miscellaneous services) can significantly improve AR productivity. This functionality is available in the Epicor SLS system.

Future growth
The Australian Government Aged Care Financing Authority’s Fifth Report on the Funding and Financing of the Aged Care Sector highlights that aged care is among the fastest growing sectors in Australia. With this rapid growth and a changing market, it is imperative you equip your organisation with the right software tools to ensure your company is fit for the growth you expect to achieve.

Posted by: Greg O'Loan, Regional VP, ANZ






 







 

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