Page History

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

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title	Key Parties / Contacts

:

Student: The student receives 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 (

SSC

SSC): Issues identified must be brought to the attention of the unit so they can be addressed appropriately and corrected.

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title	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 transactions
Bursar System

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title	System Access Needed

:

Point N Click
QS1
Bursar
Kuali Financial System (KFS)
OAS Reporting Dashboard (KDW)

Cardpointe

Cardpointe
Waystar
Econcile
Nelnet

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title	Common Problems or Issues Encountered

:

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

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title	Step by Step Procedures

:

QS1 and Point n Click

CH Billing procedure 5.14.24.docx | Powered by Box

6 - PnC Bursar Procedure.docx | Powered by Box

Pharmacy Bursar Procedure.docx | Powered by Box

5 - Applying Insurance Payments In PNC.docx | Powered by Box

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

stop

Did patient pay at

visit

visit

- Yes – daily deposit

process

- process

- No – invoice

process

- process

- - was invoice paid – yes – daily deposit

process

- - process

- - was charge outstanding after 90 days?

- - - Collection process – 3 invoices, 3 phone

calls

- - - calls

- - - - Paid – daily deposit

process

- - - - process

- - - - No – submit for bad debt approval and write of in

PNC

- - - - 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

Reconciliation

A/R

account

account Reconciliation

reports

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

SSC

Payment reports are created in PNC/

QS1

Reports are pulled from

Bursar

Bursar

- Do totals match – yes –

stop

- stop

- - No – what tickets are identified as not

matching

- - matching

- - - Correct in PNC/

QS1

- - - QS1 -

stop

- - - stop

Reports are pulled from CC

vendor

vendor

- Do totals match – yes –

stop

- stop

- - No – what tickets are identified as not

matching

- - matching

- - - Correct in PNC/

QS1

- - - QS1 -

stop

- - - stop

Reports are pulled from KFS income clrg account, QS1, Cardpoint, PNC and

Econcile

Econcile

- Do cash/checks/insurance/credit card payment totals match – yes –

stop

- stop

- - No – what tickets are identified as not

matching

- - matching

- - - Correct in PNC/

QS1

- - - QS1 -

stop

- - - stop

Variances and/or timing issues are identified and documented and reconciliation is sent to

SSC

SSC

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title	Key Risks and Controls

Key Risks	Key Controls
Transactions not fed to Bursar from originating system.	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. 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. Billing errors may result from manual data entry or inadequate review processes.	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) compliance is critical.	Staff must complete HIPAA training at hire and annually. Cornell Health has a HIPAA Compliance Officer.
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.	Employee access is limited to the part of the system needed for their specific job duties. Access audits are conducted by IT.
Non-payment or discounted payment by Insurance Providers: Can result in higher insurance allowances and write offs.	Cornell Health has contractual agreements with 2payers and is working to include additional insurances to minimize exposure.

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title	Metrics

:

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

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title	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