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Date Created:    April   April 19, 2024    2024    Last Updated:  May 7 June 17, 20242026

Overview: 

Cornell Health provides a variety wide range of health healthcare services to registered students on campus.  . Charges for student copays may be billed through the University Bursar system. Bursar billing information is fed transmitted from Point N and Click to the bursar system for billing to students for copay on health services if the student opts for this payment method. Otherwise, the student can pay with cash, (PnC) to the Bursar. Alternatively, students may pay copays directly by check or credit card. In addition to service-related charges, Cornell Health bills assesses a health fee to students through the bursar each semester through Bursar as part of each semester’s tuition billing. All are charged HF if The health fee is charged to students located 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), Geneva, or New York City areas. Cornell Health’s pharmacy sells over-the-counter medications, prescription medications, and other medical supplies. Purchases may be paid for by bursar, check, or credit card. Cornell Health bills insurance carriers on behalf of the students, in students for covered healthcare services. In some cases, reimbursement rates are based on pre-negotiated rates agreements with the provider. insurance providers. To ensure the accuracy of financial reporting, Cornell Health reconciles accounts receivable and revenue from each system recorded in its operational systems to the University’s general ledger to . These reconciliations help ensure that revenue is recorded recognized accurately in the financial statements for the month/semester that the income is earned.appropriate accounting period, whether monthly or semester based. 

Criticality:  High

Frequency:  Daily

Turnaround:  Other

Expand
titleKey Parties / Contacts
: 

Student:

  The student receives services at

Students receive healthcare services through Cornell Health and

pays a co-pay.  All registered students are billed a health fee

may be required to pay a copay for certain services. In addition, all registered students on the Ithaca, Geneva, or New York City campuses are charged a health fee as part of their enrollment with the University.

Billing Staff:

  The billing staff are responsible

Responsible for processing healthcare service transactions in the Point

N Click and ensuring they use the correct billing codes and that transactions feed over to the bursar system without error/failure

and Click (PNC). Their responsibilities include applying the appropriate billing codes, submitting charges to insurance, applying payments to patient accounts and ensuring that transactions are accurately transmitted to the Bursar.

Pharmacy Staff:

  The pharmacy staff are

responsible for processing pharmacy transactions in

QS1and ensuring they use the correct billing codes and that transactions feed over to the bursar system without error/failure

the QS1 system. They ensure that insurance is billed appropriately and copays are collected at time of pick up via credit card or bursar.

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):

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

Responsible for processing pharmacy transactions in the QS1 system. They ensure that insurance is billed appropriately and copays are collected at time of pick up via credit card or bursar.

Expand
titleKey Documents / Sources of Information
:
  • Point
N
  • n Click (PnC) transactions for billing and
payments
  • payments 
  • Reports on accounts receivable
balances
  • balances 
  • QS1 transactions for billing and
payments
  • payments 
  • Kuali Financial System GL transactions
  • Bursar System
Expand
titleSystem Access Needed
:
  • Point N Click
  • QS1
    • Bursar
    • PNC
    • QS1 
    • Bursar 
    • Peoplesoft 
    • Kuali Financial System (KFS) 
    • OAS Reporting Dashboard (KDW) 
    • Cardpointe 
    • Waystar 
    • EnlivenHealth 
    • Nelnet
    • Seed
    Expand
    titleCommon 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
    Expand
    titleStep by Step Procedures
    :

    QS1 and Point n Click

    1. CH Billing procedure 5.14.24.docx | Powered by Box 
    1. 6 - PnC Bursar Procedure.docx | Powered by Box 
    1. Pharmacy Bursar Procedure.docx | Powered by Box 
    1. 5 - Applying Insurance Payments In PNC.docx | Powered by Box 
    1. 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 EnlivenHealth
      • 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 
    Expand
    titleKey Risks and Controls

    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
    1. PNC 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. 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) compliance is critical.

    1.      
    1. Staff must complete 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 and is working to include additional
    insurances
    1. insurers to minimize exposure.
    Expand
    titleMetrics
    :
    • Student
    enrollment
    • enrollment 
    • Insurance provider contract
    rates
    • rates 
    • Insurance revenue allowance
    trends
    • trends 
    • AR write offs
    • Budget vs actual results
    Expand
    titleGlossary of Key Terms/Acronyms
    :
    • KFS – Kuali Financial System
    • OAS – Oracle Analytics Server, financial reporting tool (formerly known as OBIEE)
    • GL – General Ledger
    • PnC – Point and Click System
    • QS1 – Pharmacy System
    • SSC – Shared Services Center that processes financial transactions for Cornell Health
    Cornell Health Revenue & AR

    Revenue Recognition and Receivables Tracking Process Flow Chart

    Image Added

    Revenue Recognition Point of Sale Template

    Image Added

    Revenue Recognition Student Charges

    Image Added