1. Submission of 2nd and 3rd Party Billings
  • Definition: Financial operations team member submits 2nd and 3rd party billings accurately
  • Standard: 2nd and 3rd party billings submitted accurately by the 5th working day of the month
  • Source: Monthly figures balanced and given to Associate Director of Operations who signs and dates receipt
  • Compliance Rating: 95% of the time
  • Solution Plan: 2nd and 3rd party billing operations team member will meet with supervisor to determine factors that interfered with compliance within 7 days and a plan will be developed to meet compliance within the next report period.
  1. FINANCE:

Goals:

  1. Accurate billing statements will be generated and issued to consumers no longer than 20 business days after month end 100% of the time
  2. Based on the number of consumers billed, substantiated customer complaints will not exceed 2%
  3. Third party fees will be billed 100% of the time
  4. 100% of complete and accurate invoices will be paid within 30 days of receipt
  5. Financial reports will be generated and distributed to management staff within 15 business days of month end 90% of the time
  6. Consumer satisfaction survey rating for financial matters/charges will not fall below a score of 90%.

Monitor Focus at Local Board Level:

The Chief Financial Officer reports to the Executive Director semi annually regarding goals and their method of data collection.

Outcome:

A plan of correction is warranted if any of the goal areas are not in compliance.

  1. Gather financial intake data

a. Definition: A financial intake package (annual, updates, as status changes, or as required by program) will be completed on all individuals requesting services with the center.

b. Standard: Financial intake paperwork will be entered by support staff into CMHC/CIS prior to or on the date of clinical intake.

c. Source: Monthly audit of financial assessments.

d. Compliance Rating: 100% of these entries made prior to clinical intake =compliant. Less than 100% = non-compliant.

e. Solution Plan: Development note and retraining for first non-compliant rating. A Written Warning and retraining will be offered following the second consecutive non-compliant period and Separation from employment upon the third consecutive non-compliant period.

  1. Reimbursement for services

a. Definition: Reimbursement for all billable services provided by the center staff will be executed monthly.

b. Standard: Reimbursement staff will accurately bill for services no later than the 10th day of the following month in which the services were provided.

c.Source: Review of financial reports.

d. Compliance Rating: 98% or greater of these entries made by the 10th day of the following month =compliant. Less than 98% = non-compliant.

e. Solution Plan: Development note and retraining for first non-compliant rating. A Written Warning and retraining will be offered following the second consecutive non-compliant period and Separation from employment upon the third consecutive non-compliant period.

  1. Billing statements

a. Definition: Client statements will be accurate and issued to each individual via mail each month.

b. Standard: Client statements will be reviewed for accuracy and mailed out no later than the 20th day of each month.

c. Source: Client statement spreadsheet

d. Compliance Rating: 98% or higher of the statements are accurate and mailed = compliant. Less than 98% accuracy and distribution = non-compliant

e. Solution Plan: Development note and retraining for first non-compliant rating. A Written Warning and retraining will be offered following the second consecutive non-compliant period and separation from employment upon the third consecutive non-compliant period.

  1. Posting of payments

a. Definition: All payments to the center will be accurately posted to the appropriate accounts and CMHC.

b. Standard: All payments will be accurately posted to the appropriate accounts no later than the 15th day of the month following receipt.

c. Source: Monthly financial reports

d. Compliance Rating: 98% of the postings events are accurate and on time = compliant. Less than 98% accuracy and timeliness = non-compliant

e. Solution Plan: Development note and retraining for first non-compliant rating. A Written Warning and retraining will be offered following the second consecutive non-compliant period and separation from employment upon the third consecutive non-compliant period.