BILLING SYSTEM OF BACNOTAN DISTRICT HOSPITAL

JEROME T. CARBONELL

DON MARIANO MARCOS MEMORIAL STATE UNIVERSITYMID LA UNION CAMPUSCOLLEGE OF INFORMATION TECHNOLOGYSAN FERNANDO, LA UNION

BACHELOR OF SCIENCE IN INFORMATION TECHNOLOGY

MARCH 2015

TABLE OF CONTENTS

Page

TITLE PAGE ....i

APPROVAL SHEET ....ii

ACKNOWLEDGMENTS iii

LIST OF TABLES iv

LIST OF FIGURES ......v

CHAPTER

1INTRODUCTION

Situation Analysis ............1

Framework of the Study ..6

Statement of the Problem .10

Definition of Terms .11

2METHODOLOGY

Research Design ..........12

Sources of Data ............13

Instrumentation and Data Collection ...............14

Analysis of Data ..........16

LITERATURE CITED.

17

APPENDICES

AChecklist to Determine the ICT Resources of Bacnotan District Hospital...

18

BSurvey Checklist to Determine the Level of Usability of Billing System of Bacnotan District Hospital

22

CURRICULUM VITAE25

LIST OF TABLES

Table No

Page

1Distribution of Respondents..13

LIST OF FIGURES

Figure No

Page

1

The Research Paradigm

9

2The Rapid Application Development Diagram

15

ACKNOWLEDGMENTSFirst and foremost, the researcher would like to express his sincere thanks to our Almighty God for the gift of life, wisdom and understanding He had given to him, a reason for his existence. And to his family for the love and support they had provided throughout his life.The researcher also thank Atty. Gilbert R. Hufana whom he regard as his mentor and supervisor, he thank him for the expertise and intelligence he has displayed while supervising this study. The researcher believe that this good work is a result of his good guidance and cooperation.Ms. Anne Girlie C. Dulay, for the kind approval for the study to be conducted and for allowing him to gather data and information. And to the staff of Bacnotan District Hospital who assisted him in getting the information he needed.The researcher cannot forget his friends in the College of Information Technology (DMMMSU-MLUC) for the company they have accorded to him; the researcher would always remember them as being good friends in a lifetime.May the good Lord bless them and keep them safe. I love you all.

JTC

Chapter 1INTRODUCTION

Situation AnalysisToday's society is different to the one that existed not so many years ago. Our society is constantly changing. The most important characteristics of our era may be the transformation, transmission and dominion of information. We live in an information society where the leading role has been given to new technologies, especially those devoted to information. Our society could not be imagined without new technologies and their role both in this society and in human life in general.Stair (2009) emphasized that the development of technology through the years have supported us to do more with less effort. From the orientation of the light bulb to the industrial revolution and beyond, we have continuously tried in a more efficient means of doing task.Computers has become a way of life in todays modern age, and it is evident that most of our countrys institutions and organizations still do not adapt the high tools and technology. One of them are hospitals, daily hospital transactions are still done on paper. According to Southern Nevada Billing and Management Services, Inc. (2014), the traditional billing system involves lots of paper work and manual documentation. Since the documentation is done manually it has a high rate of errors and subsequently higher percentage of rejections by the insurance companies. In addition, reimbursement for performed services can take months if using this billing system. Electronic medical billing, on the other hand, has eliminated many disadvantages of the traditional billing system and enabled the healthcare providers to save both their time and money which is why most private practices as well as hospitals and clinics have switched to electronic billing system.Electronic medical billing system has revolutionized the process of reimbursement and has several advantages over the traditional billing system. Firstly, the electronic billing software eliminates the paper work and subsequently potential human errors which are the number one cause of relatively high rate of rejections by the insurance companies in the traditional billing system. In case an error in the claim does occur, it is reported in a matter of minutes enabling prompt corrections. Secondly, this software significantly reduces the paper costs because the claim is filed via electronic means but what is even more important is the fact that fast, accurate and easy to use electronic billing system reduces the need for administration personnel enabling healthcare practitioners and facilities to increase their profit and subsequently improve the quality of their services to patients. Electronic medical billing offers numerous advantages over the traditional billing system and helps improve both productivity and cash flow of healthcare practices and facilities. Most electronic billing software systems are highly flexible which means that they can be easily adjusted to specific needs of medical practices.According to Harrell (2011), hospital billing brings together charges based upon patient stays or procedures performed at a hospital. Mott (2015), making the evolution from manual to computerized billing can transform the way a medical, dental or veterinary practice handles its procedures as well as its data. As added, handling patient billing digitally doesn't remove the need for all forms of paper records, but it does simplify the task of centralizing and standardizing the recordkeeping process. Also, it reduces the need of cabinet and shelves to store information, records, and data. Computerized billing system can keep your records and data securely from unauthorized access. One of the concerns of Local Community Hospitals nowadays is how to lessen the number paper works in having a transaction with the patient that could fasten the process of admission, discharging and billing of a patient. This greatly affects the profitability of the institution that makes the admission and billing of patients a long process.According to Wavomba (2012), computerized patient billing systems in the health care sector have many advantages and are preferable to manual patient billing system particularly in notifying you about your outstanding payments and the status of accounts. They also enable you to process your hospital bills, such as nursing, medications, lab testing and laundry, with ease. Automation of processes has brought about efficiency and speed. Speedy performance of tasks has saved human effort and time. Technologies provides foundation for driving efficiencies and powering modernization. Computerized patient billing systems (CPBS) are more efficient and effective for it allows effective management of the patients payment schedules, CPBS also performs generation of bill reports, reduced paperwork because the data that is needed in the payment record is entered in the computer instead of recording it on a sheet of paper which can then be filed and later various bills and reports can then be easily generated through the computer. Since the patients record of payments is stored in the database, the data cannot be easily destroyed. CPBS minimized errors and increase accuracy because they leave less room for errors. With the computer systems performing calculations regarding the patients bills, errors are minimized except perhaps when you make a mistake of keying in data wrongly, or you enter figures in the wrong fields. Today, computerization is a major advancement in technology that helps in many ways: it makes information storage easier and faster thus it can save a lot of time and manpower, and many tasks are done in a certain amount of time. Great amount of time is being consumed by information retrieval and the billing process of most Local Community Hospitals without computer generated system is slow. To be able to provide the medical needs of the rapidly growing population, Local Community Hospitals must be versatile to the current trends and innovation in today's changes in technology. Quinn (2013), Electronic Medical Billing (EMB) eliminates the need to manage large amount of data in hard copy format. EMB performs automatic process and eliminates redundancy of information. EMB is very cost effective as opposed to paper-based billing because the electronic records require fewer staff and less space as compared to paper-based management of data. Also, it can improve productivity because the need to manually search for medical history is no more present. EMB can change the face of healthcare. Electronic Medical Billing Systems reduces the cost added by printers and envelopes.According to Potter (2014), when you used Computerized Billing system patients information can be accessed or updated from any computer location in the hospital if the computer system is networked. Bills can be tracked to eliminate the possibility of forgotten charges. And information is protected. Also making adjustment to bills is easy, theseadjustments occur when a patient wasnt able to pay the bills so credits for the patients is given. A statement of account can also be made using a Computerized Billing System.According to the study of Reyes (2009) entitled Automated Centralized Billing System for Morong Doctors Local Community Hospitals, that a Centralized Billing System also registers patients automatically when they are admitted in the Local Community Hospital. Electronic record improves patient care by insuring that the correct information, such as the proper medication is retrievable.Bacnotan District Hospital (BDH), a local community hospital is located at the Municipality of Bacnotan in La Union. BDH is processing daily transactions manually. Their manual process processes causes delays on their transactions. The rapid change brought by technology in the society must be taken advantage by Bacnotan District Hospital to enhanced rendering its services to the people on the hospital. The vision of the hospital is Bacnotan District Hospital is to center of excellence in quality health care in the 1st District of La Union. And BDH objectives is to provide all patients the necessary and effective quality health care; to improve the facilities of the hospital by acquiring modern/high tech equipment; and to improve capabilities of manpower through seminars, conferences and trainings.The researcher aims to conduct a study entitled: Billing System of Bacnotan District Hospital. This is a computer-based system that is for the usage of selected employees of BDH. The main function of the system is the automated billing. The purpose of this study is focused on securing, updating, monitoring and reporting of patient bills. The computerized billing system is expected to help Bacnotan District Hospital because of its ability to automatically compute the patient's bills, generates reports and official receipt that surely fasten their transactions with the patients. From admitting a patient to discharging, laboratory procedures and other hospital procedures will be updated and presented in precision.Based from the abovementioned situations, the researcher emphasized the felt need to develop a computerized billing system for Bacnotan District Hospital to further enhance its operation and daily processes and transactions especially on processing bills.

Framework of the StudyThis study is conducted based on the following assumptions: That Bacnotan District Hospital will used the proposed system; and that the current billing process is manually done and now requires automation. To support Bacnotan District Hospital to be effective in carrying out daily hospital task in terms of hospital billing process, this study use three frameworks as basis and foundation in the development of this capstone project. This study is guided by the following ideas: Automated Hospital Billing, Patient Billing System, and Electronic Health Record.According to the study of Deerlittle (as cited in Florendo, Jocson, Madrid, Palisoc, 2009), the Local Community Hospital System, that computerization is a major advancement in technology that helps in many ways: it makes information storage easier and faster thus it can save a lot of time and manpower, and many tasks are done in a certain amount of time. Great amount of time is being consumed by information retrieval and the billing process of most Local Community. According to Tatum (2015), automated billing is an action in which in which invoicing for services occurs without the need to prepare the invoice by hand. Billing systems provides the ability to generate invoices to customers. The usage of automated billing software makes it possible to manage billing or invoicing process with greater efficiency, saving the organization both time and money.Hospitals without computer generated system is slow. Efficient billing management greatly affect areas of Local Community Hospitals such as on the billing policies and price rates. With the support of this proposed computerized system, effort will be lessen which will possibly lead to a faster and more accurate billing process which will lead to profitability of local community hospitals.Automated Billing System has many advantage in business according to Amansharma (2008). First the time consumed in updating the financial records is reduced. Secondly, some routine jobs like invoicing of cash collections, adding and deleting of information or transaction is speeded up. The rest of clerical errors while making calculations and transferring data between records is also reduced. Any up-to-date record on the financial dwelling is always available. Another idea that guided the researcher is the Patient Billing System because of the function of patient billing system that it stores patient information, prepares bills, print billing statements. According to Nelson (2013), an automatic payment posting can significantly reduce staff work. He also added that manual payment posting is an inefficient use of resources. According to Bonewit-West, Hunt, Applegate (2014), one of the most tasks required for the effective functioning of a medical office is to ensure prompt payment of patient bills. The function of the patient billing system is to prepare bills and print billing statements. When patient charges, payments, and adjustments are posted, this information is stored in the computer and is available when needed by the patient billing system. This system is responsible for searching the medical practice database to obtain the information necessary to generate bills for patient with outstanding balances.The third idea was the Electronic Health Record. According to Keen (2012), he said in his article Improved Hospital Billing and Operational Benefits with Electronic Health Record (EHR) Adoption that EHR implementation improves hospital billing process. The latest version of EHR software have, in fact, focused specifically on billing processes, that includes robust eligibility checking for preventing errors, updates Medicare as well as with other payer reimbursement rates. The implementation of EHR can also cut down on inefficient and time consuming paper works. Patient information, laboratory tests, diagnosis, prescriptions and treatment can be accessed with just a click. Other information of a patient can also be kept for easy retrieval.The previously mentioned ideas will be used by the researcher as guide in creating and developing a more effective procedures in terms of billing process and maintaining secured patients information. Based on the ideas, the research paradigm therefore is formulated. The research paradigm was through the Input-Process-Output (IPO) model as shown in Figure 1. It shows how the inputs will be processed to obtain the desired output.

INPUT PROCESS OUTPUT1. Determination of ICT Resources through:a. Interview Methodb. Documentary Analysisc. Ocular Inspection

2. System Development using the Rapid Application Model (RAD)

3. Evaluation of the Level of Usability of the developed system.

BILLING SYSTEM OF BACNOTAN DISTRICT HOSPITAL1. ICT Resources of Bacnotan District Hospital along:a. Hardwareb. Softwarec. Peoplewared. Network

2. Billing Policies and Procedures of Bacnotan District Hospital

FeedbackFigure 1. The Research Paradigm

Statement of the ProblemThis study is aimed at developing a reliable, efficient and more effective Billing System for Bacnotan District Hospital.Specifically, this study aims to answer the following:1. What are the available ICT resources of Bacnotan District Hospital in terms of:a. Hardwareb. Softwarec. Peoplewared. Network2. What system can be develop for Bacnotan District Hospital for their billing to be more effective?3. What is the level of usability of the proposed Billing System of Bacnotan District Hospital?This study will benefit future researchers who wish to have similar studies as they can get information from this study which will give them ideas to improve their research.

Definition of TermsInformation and Communication Technology (ICT) Resources. This refers to the resources (hardware, software, peopleware, and network) that are present in Bacnotan District HospitalHardware. These are objects referring to the physical part of the computer which can be touch. Software. Software are exists ideas, concepts, and anything that can be stored electronically. Peopleware. This refers to the people that operates and manage both the hardware and the software. Network. This refers to the interconnection of computer systems.Billing System of Bacnotan District Hospital. This is a computer-based system that allows the user to store information about the patient, post bills and prepare billing statement for the patient. It allow users to add, edit, save patients information.System Development. This is the process of developing Billing System of Bacnotan District Hospital (BS-BDH). It follows certain phases of a model (RAD Model) in able to come up with a functional system for a specific client.Rapid Application Development (RAD). This is the developmental model that the researcher will use in developing the Billing System of Bacnotan District Hospital.Level of Usability. This determines whether the developed system is Usable or Not Usable.

Chapter 2METHODOLOGY

Research DesignAccording to Robson (1993), research can be categorized into different types depending on the nature of the purpose or research problem. Saunders (2000) note that more than one purpose can be employed in a study. In this study, the researcher made use of the descriptive and developmental research. According to Penwarden (2014), descriptive research gathers quantifiable information that can be used for statistical inference on your target audience through data analysis. As a consequence this type of research takes the form of closed-ended questions, which limits its ability to provide unique insights. However, used properly it can help an organization better define and measure the significance of something about a group of respondents and the population they represent.According to Richey (1994) developmental research, as opposed to simple instructional development, has been defined as the systematic study of designing, developing, and evaluating instructional programs, processes, and products that must meet criteria of internal consistency and effectiveness. Developmental research is particularly important in the field of instructional technology. The most common types of developmental research involve situations in which the product-development process is analyzed and described, and the final product is evaluated.Sources of DataThis study will be conducted at Bacnotan District Hospital (BDH). In determining the ICT Resources of BDH, the researcher will choose one expert who is knowledgeable in Information and Communications Technology. The Administrative Officer IV and Administrative Aide II determine problems face by BDH and provide the information needed in the development of the system. For the determination of Level of usability of the developed system, the target users will evaluate the system through a checklist. The distribution of respondents is shown on Table 1.Table 1. Distribution of RespondentsRespondentsNumberAdministrative Officer IV 1Administrative Aide I 1Administrative Aide III 1Radiological Technologist 1Pharmacist 1Medical Technologist 1Staff 1Total Number of Respondents 8

Instrumentation and Data CollectionAccording to Saunders (2000), most research questions are answered using some combination of secondary and primary data and it is the same for this research. Data collection process consisted of three stages in this study.The first stage includes using literatures as secondary data, which was explained in the previous chapter.In the second stage, primary data will be gathered through interviews within Bacnotan District Hospital to find out their view and refine this research in order to be more relevant. In this stage, experts among the staff of the hospital who were non user of Computerized Billing System but familiar with the system will be interviewed. The purpose of this stage is to gather suggestions and opinions for the betterment of this study.In the third stage, primary data will be collected through distributing checklists and within Bacnotan District Hospital. This determines the ICT resources of the hospital. Data collected will be verified through ocular inspection to determine the status of the ICT resources to whether they are working properly and will its environment can support the system to be develop.The Rapid Application Model as shown in Figure 2 will be used as model in developing the Billing System of Bacnotan District Hospital.As the name suggests, Rapid Application Development (RAD) model is anincremental software process modelthat focuses on short development cycle time. This model is a high-speed model which adapts many steps fromwaterfall modelin which rapid development is achieved by usingcomponent based construction approach.Figure 2. The RAD DiagramIn case if project requirements are well understood andproject scopeis well known then RAD process enables a development team to create a fully functional in short period of time.RAD model is like other processmodels mapsinto the common and major framework activities. These are the phases of RAD Model: Communicationis an activity which works to understand the business problem and the information characteristics that should beaccommodateby the software. In RAD modelPlanningis required because numerous software teamsworksin parallel on different system functions. Modellingincludes 3 major phases: Business modeling; Data modeling; Process modelingConstructionfocuses mainly on the use of existingsoftware componentsand the application of automatic code generation. In the last stageDeploymentestablishes a basis for subsequent iterations if necessary.A checklist will be distributed to the target respondents to evaluate the Level of Usability of the developed system. This also determine whether the system fits the specifications and expectation of Bacnotan District Hospital. The evaluation of the level of usability will be done in the last activity in the RAD diagram which is deployment.

Analysis of DataThe researcher will use various data analysis for each problem in the study. For problem 1, a checklist will be given to determine the ICT resources of Bacnotan District Hospital. This checklist will determine the existence of the resources in terms of Hardware, Software, Peopleware, and Network.The data from the checklist that will determine the level of usability of the developed system will be treated statistically and will be interpreted using the Likert scale:Numerical EquivalentStatistical RangeDescriptive Equivalent RatingDescriptive Interpretation

54.20 5.00Very Strongly AgreeVery Highly Usable

43.40 4.19Strongly AgreeHighly Usable

32.60 3.39AgreeUsable

21.80 2.59Moderately AgreeFairly Usable

11.00 1.79DisagreeNot Usable

Responses ranging from 4.20 5.00 will be interpreted as Very Highly Usable, for which the system have met the requirements of the users and also means that the system is 100 percent usable. Responses ranging from 3.40 4.19 will be interpreted as Highly Usable which means that the system is 85 percent usable. Responses ranging from 2.60 3.39 will be interpreted as Usable, and this means that the system has 70 percent of usability. Responses ranging from 1.80 2.59 will be interpreted as Fairly Usable that means the system is 55 percent usable. And responses ranging from 1.00 1.79 will be interpreted as Not Usable which means that it has only 40 percent of usability.

LITERATURE CITED

Harrell, C. M. (2011), The Importance of Hospital Billing in the Medical Community. Retrieved on February 12, 2015 from ezinearticles.com/?The-Importance-of-Hospital-Billing-in-the-Medical-Community&id=6199569

Keen, A. (2012), Improved Hospital Billing and Operational Benifits with EHR Adaption. Retrieved on February 15, 2015 from http://www.sooperarticles.com/finance-articles/insurance-articles/improved-hospital-billing-operational-benefits-ehr-adoption-1054214.html

Mott, E. (2015), Advantages & Disadvantages of Using a Computerized Patient Billing System. Retrieved on February 12, 2015 from http://smallbusiness.chron.com/advantages-disadvantages-using computerized-patient-billing-system-70240.html

Penwarden, R. (2014), Descriptive Research: Defining Your Respondents and Drawing Conclusions. Retrieved on March 8, 2015 from http://fluidsurveys.com/university/descriptive-research-defining-respondents-drawing-conclusions/

Potter, B. A.(2014), Medical office Administration, United States of America, U.S., Elsevier Health Sciences

Quinn, F. (2013), Importance/Benifits of Electronic Medical Billing. Retrieved on February 12, 2015 from http://medcitynews.com/2013/10/importancebenefits-electronic-medical-billing/

Richey, R. C. (1994), Developmental Research: definition and Scope, page 9. Retrieved on March 8, 2015 from http://eric.ed.gov/?id=ED373753

Wavomba, Z (2012), Advantages & Disadvantages to Using a Computerized Patient Billing System. Retrieved on March 10, 2015 from http://www.ehow.com/info_8596264_advantages-computerized-patient-billing-system.html

Appendix A

SURVEY CHECKLIST TO DETERMINE THE STATUS OF INFROMATION AND COMMUNICATIONS TECHNOLOGY PROFILE OF BACNOTAN DISTRICT HOSPITAL

Dear Respondents,Please complete the checklist by filling up the appropriate responses on the space provided. Please rate the availability of the following variables in BDH.Respectfully yours,The Researcher

Name: (Optional) __________________________________________________Position: (Please specify) ___________________________________________Direction: Please check () the following scale that corresponds to your answer.

IndicatorsExisting Not ExistingRemarks

Hardware

a. Monitor

b. Printer

c. Scanner

d. Photocopying Machine

Software

a. Computers with Windows XP/Vista/7/8

b. Computers with Microsoft Office

Peopleware

a. ICT Administrator

b. Database Administrator

c. Computer Programmers

d. Computer Technicians

e. Data Encoders

f. Database Manager

Network

a. Router

b. Internet Subscription

c. Telephone Line

d. Network Cabling System

e. Wireless Connection

This is the end of the Survey Checklist. Thank you very much.____________________________ Signature of EvaluatorAppendix BSURVEY CHECKLIST TO DETERMINE THE LEVEL OF USABILITY OF THE BILLING SYSTEM OF BACNOTAN DISTRICT HOSPITAL

Dear Respondents,Please complete this checklist honestly by putting a check () on the appropriate responses on the numbers provided. Please rate the following as you perceive the system.Thank you very much.

Very truly yours,The Researcher

Name: __________________________________________________________________Position: ________________________________________________________________

Direction: Please the system to determine the usability of the Billing System of Bacnotan District Hospital by checking the items using the scale below.ScaleDescriptive Equivalent Rating

5Very Strongly Agree

4Strongly Agree

3Agree

2Moderately Agree

1Disagree

Efficiency54321

1. This software responds to inputs quickly.

2. This software is a great help to my work.

3. It is obvious that the user needs have been fully taken into consideration.

4. The software lessen work effort.

5. The software makes the process faster.

Affect54321

1. I enjoy working with this software.

2. Working with this software is satisfying.

3. I would like to use this software every day.

4. Using this software is frustrating.

Helpfulness54321

1. The instructions and prompts are helpful.

2. I find the information given by this software helpful.

3. The way that system information presented is clear and understandable.

4. There is enough information given by the software when its needed.

5. Error prevention messages are adequate.

Control54321

1. I feel in command of this software when I am using it.

2. I can understand and act on the information provided by this software.

3. Tasks can be performed in a straightforward manner using this software.

4. It is easy to learn to use all the features that is offered by the software.

Learnability54321

1. Learning to operate this software is easy and satisfying.

2. It is easy to learn the software commands.

3. I do not have to look at the guide to use this software.

4. Learning how to use the software functions is very easy.

This is the end of the SURVEY CHECKLIST. Thank you very much for your generous time and generous cooperation.

Respondents Signature