Elements and Performance Criteria

RANGE STATEMENT
The range statement relates to the unit of competency as a whole. It allows for different work environments and situations that may affect performance. Bold italicised wording, if used in the performance criteria, is detailed below. Essential operating conditions that may be present with training and assessment (depending on the work situation, needs of the candidate, accessibility of the item, and local industry and regional contexts) may also be included.
Fees may relate to:
advice to patients
AMA recommendations
Department of Veterans' Affairs
insurance medical reports
Medicare (hospital, medical)
other items sold to patients (e.g. immunisations, dressings)
other services provided by the clinic
provision of copies of medical files
provision of legal and other reports
provision of repeat prescriptions
refund only
scheduled fees
services provided to Divisions of General Practice
services with no fee structures
Transport Accident Commission
workers compensation
Entitlements and rebates may relate to:
Department of Veteran's Affairs
Medicare
private health funds (level of cover, restrictions)
Transport Accident Commission
workers compensation
Medical appointments may include:
block
limited block
sequential
Systems may include:
software-based accounting and appointment systems
print-based accounting and appointment systems
Procedures for referral may include:
checking for 'acceptable evidence' (e.g. name of referring doctor, address or service provider number of the referring doctor)
checking that the referral is valid (e.g. length of time stated in the referral has not been exceeded)
entering patient details into computer system
filing patient notes
maintaining patient information
recording information
word processing
Policies and procedures may include:
abiding by state/territory and federal legislation
accessing and updating files
bank reconciliations and preparing banking documentation
correspondence format
end of session, end of day, end of week, end of month and end of year procedures
following instructions
information specific to the enterprise
management of provider numbers for doctors
managing particular Medicare problems (e.g. lost cards, newborns, foreign national, new card numbers, patients separating from family cards)
office practice manual
RACGP Code of Practice for the Management of Health Information in General Practice
RACGP Entry Standards for General Practices
recording information
security, confidentiality and privacy procedures
Procedures for billing may include:
additional information
attachments
claims
dates and names
Department of Veteran's Affairs items of service
descriptions of services
explanatory notes
forms
Health Care cards
hospital
item numbers of services
levels of fees
medical certificates
Medicare item numbers
Medicare provider numbers
name of service provider
patient details
payment options
referrals
services that are consultation items, and those that are procedural items
treatment vouchers
vouchers
workers compensation
Account type may include
bulk billing
private
Appropriate account and billing documentation may include:
accounts
enterprise's templates (e.g. for accounts, accompanying reports)
forms
invoices
receipts
reports
statements
vouchers
Designated person or organisation may include:
Australian Medical Association
Department of Veteran's Affairs
guardian
Health Insurance Commission
patient
Transport Accident Commission
workers compensation organisations
Legislation may relate to:
consent
duty of care
equal opportunity
malpractice
negligence
occupational health and safety (OHS)
privacy
relevant state/territory and commonwealth Acts
workers compensation
Account processing procedures may relate to:
additional information
attachments
claims
dates and names
debt collection
descriptions of services
explanatory notes
forms
Health Care cards
item numbers of services
levels of fees
medical certificates
Medicare item numbers
Medicare provider numbers
name of hospital
name of service provider
overdue accounts
patient details
payment options
receipts
reconciliation of claims and payments
referrals
vouchers
workers compensation
Storing procedures may relate to:
date order
period of storage
storage conditions
Financial records may relate to:
computerised billing software
credits and debit amounts
daily/weekly summaries/reports
general ledger
Medclaims (electronic billing of Medicare)
overdue accounts
overdue debtors list/report
payment history
payments received
receipt book
statements
statistics
types of payments and related documentation/reports (e.g. credit card payments, EFTPOS)

EVIDENCE GUIDE
The Evidence Guide provides advice on assessment and must be read in conjunction with the performance criteria, required skills and knowledge, range statement and the Assessment Guidelines for the Training Package.

Overview of assessment

Critical aspects for assessment and evidence required to demonstrate competency in this unit
Evidence of the following is essential:
communicating information on a range of entitlements and benefits
using appointment and referral systems to ensure accuracy of billing records and processes
applying knowledge of the healthcare system and practice polices and procedures to ensure timely and accurate collection of accounts.
Context of and specific resources for assessment
Assessment must ensure:
access to an actual workplace or simulated environment
access to office equipment and resources
examples of documentation and resources.
Method of assessment
A range of assessment methods should be used to assess practical skills and knowledge. The following examples are appropriate for this unit:
direct questioning combined with review of portfolios of evidence and third party workplace reports of on-the-job performance by the candidate
review of authenticated documents from the workplace or training environment
analysis of responses to case studies and scenarios
demonstration of techniques
observation of presentations
oral or written questioning to assess knowledge of workplace emergencies, risks and hazards
observation of performance in role plays
assessment of documentation.
Guidance information for assessment
Holistic assessment with other units relevant to the industry sector, workplace and job role is recommended, for example:
BSBITU306ADesign and produce business documents.