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Date Created:    April 19, 2024    Last Updated:  May 7, 2024

Overview: 

Cornell Healthprovides a variety of health services to registered students on campus.  Bursar billing is fed from Point N Click to the bursar system for billing tostudents for copay on health services if the student opts for this payment method. Otherwise, the student can pay with cash, check or credit card. In addition, Cornell Health bills a health fee to students through the bursar as part of each semester’s tuition billing.All are charged HF if in either the Ithaca area OR NYC area.Students and staff can purchase OTC, prescriptions, or other medical supplies from the pharmacy and pay with cash, check or credit card (or bursar billed for students). Cornell Health bills insurance carriers on behalf of the students, in some cases based on pre-negotiated rates with the provider. Cornell Health reconciles accounts receivable and revenue from each system to the general ledger to ensure revenue is recorded accurately in the financial statements for the month/semester that the income is earned.  

Criticality:  High

Frequency:  Daily

Turnaround:  Other

Key Parties / Contacts: 

Student:  The studentreceives services at Cornell Health and pays a co-pay.  All registered students students are billed a health fee.  

Billing Staff:  The The billing staff are responsible for processing transactions in Point N Click and ensuring they use the correct billing codes and that transactions feed over to to the bursar system without error/failure. 

Pharmacy Staff:  The pharmacy staff are responsible for processing transactions in QS1and ensuring they use the correct billing codes and that transactions feed over to the bursar system without error/failure. 

Unit Finance Staff: Reconcile accounts receivable for QS1 and for Point N Click systems.  Responsible for the reconciliation of the student revenue from billing system all the way through to the general ledger. 

Shared Services Center (SSCSSC):  Issues identified must be brought to the attention of the unit so they can be addressed appropriately and corrected. 

Key Documents / Sources of Information:

  • Point N Click transactions for billing and payments 
  • Reports on accounts receivable balances 
  • QS1 billing and payments 
  • Kuali Kuali Financial System GL transactionstransactions  
  • Bursar System

System Access Needed:

  • Point N Click 
  • QS1 
  • BursarBursar  
  • Kuali Financial System (KFS) 
  • OAS Reporting Dashboard (KDW) 
  • Cardpointe 
  • Waystar 
  • Econcile 
  • Nelnet 

Common Problems or Issues Encountered: 

  1. Student status, if student becomes unregistered or goes on leave, bursar may reject the transaction. 
  2. Transactions failing to feed to the Bursar 
  3. Delayed notification of student registration status

Step by Step Procedures:

QS1 and Point n Click 

  1. CH Billing procedure 5.14.24.docx | Powered by Box 
  2. 6 - PnC Bursar Procedure.docx | Powered by Box 
  3. Pharmacy Bursar Procedure.docx | Powered by Box 
  4. 5 - Applying Insurance Payments In PNC.docx | Powered by Box 
  5. Collections Procedure 4.23.docx | Powered by Box 

QS1 

Patient picks up Rx/OTC 

Is patient bursar billable? 

Yes – charges sent to bursar 

No – payment collected at time of pick up 

PNC Continued 

All the stops should then go to payment/collection process 

  • Is student bursar billable – charges sent to bursar – stop 
  • Did patient pay at visit 
    • Yes – daily deposit process 
    • No – invoice process 
      • was invoice paid – yes – daily deposit process 
      • was charge outstanding after 90 days? 
        • Collection process – 3 invoices, 3 phone calls 
          • Paid – daily deposit process 
          • No – submit for bad debt approval and write of in PNC 

Revenue Recognition 

CH runs end of month reports from PNC/QS1 – files sent to SSC to upload or record in the KFS GL as income as transactions flow through a clearing account  

Reconciliation 

A/R Reconciliation  

  •  A/R account Reconciliation reports run from KFS, PNC and QS1.   
  • Any variances to ending balances between the GL and the PNC or QS1 systems are identified and documented, and the report is sent to the SSC 

Payment reports are created in PNC/QS1 

  • Reports are pulled from Bursar 
    • Do totals match – yes – stop 
      • No – what tickets are identified as not matching 
        • Correct in PNC/QS1  -stop 
  • Reports are pulled from CC vendor 
    • Do totals match – yes – stop 
      • No – what tickets are identified as not matching 
        • Correct in PNC/QS1  -stop 
  • Reports are pulled from KFS income clrg account, QS1, Cardpoint, PNC and Econcile 
    • Do cash/checks/insurance/credit card payment totals match – yes – stop 
      • No – what tickets are identified as not matching 
        • Correct in PNC/QS1  -stop 
    • Variances and/or timing issues are identified and documented and reconciliation is sent to SSC 

Key Risks 

Key Controls 

Transactions not fed to Bursar from originating system. 

1.      
  1. Reconciliations are done monthly to verify all billed transactions in Point N Click and QS1 reconcile to the bursar transactions and the KFS GL total for the month. 
2.      
  1. Variances are researched and credits or corrections made as needed. 

Billing Errors: Mistakes in invoicing, such as incorrect pricing, wrong billing codes,etc. can lead to disputes with insurance providers and delays in insurance

payments

payments. Billing errors may result from manual data entry or inadequate review processes. 

1.      
  1. PNC has a built-in claim scrubbing tool to detect any possible billing issues before a claim is submitted to insurance.  Cornell Health uses an insurance clearinghouse to submit claims, which has an additional scrubbing tool. 

Regulatory Compliance:Health Information Privacy Act (

HIPAA

HIPAA) compliance is critical. 

1.      


  1. Staff must complete
HIPAA
  1. HIPAA training at hire and annually. 
2.      

DEA Registration Certificate or NYS pharmacy license expired or invalid

1.       DEA Certificates and NYS license are valid for 3 years.

2.       The pharmacist tracks expiration dates with notifications 60 days prior to expiration.

3.       Renewals are emailed at 60 days and 30 days.

4.       Vendors require updated licenses and send reminders as well.

5.       Inhouse compliance staff also track and monitor.

  1. Cornell Health has a HIPAA Compliance Officer.
  1.  

Data Security and Privacy: Handling sensitive customer information, such as payment details and personal data, exposes the university to risks of data breaches, identity theft, and PCI regulatory non-compliance.  

1.      
  1. Employee access is limited to the part of the system needed for their specific job duties. 
2.      
  1. Access audits are conducted by IT. 

Non-payment or discounted payment by Insurance Providers: Can result in higher insurance allowances and write offs. 

1.      
  1. Cornell Health has contractual agreements with 2
payers
  1. payers and is working to include additional insurances to minimize exposure. 

Metrics:

  • Student enrollment 
  • Insurance provider contract rates 
  • Insurance revenue allowance trends 
  • AR write offs 
  • Budget vs actual results

Glossary of Key Terms/Acronyms:

  • KFS – Kuali Financial System 
  • OAS – Oracle Analytics Server, financial reporting tool (formerly known as OBIEE) 
  • GL – General Ledger 
  • SSC – Shared Services Center that processes financial transactions for Cornell Health

Revenue Recognition and Receivables Tracking Process Flow Chart

Revenue Recognition Point of Sale Template

Revenue Recognition Student Charges