Example chart of accounts. Here is an example of what a chart of accounts for a very small business may look like: Account Classification, Account Number. The American Hospital Association's publication of. Uniform Chart of Accounts for Hospitals addresses the many social, economic and scientific changes that. 28, , Gift Shop. 29, , Other Operated Departments. 30, , Rentals, Revenue Share and Other. 31, , Administrative and General. 32, , Accounting.


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Designing a new CoA has the potential for creating more positive, transformative change than other aspects of a modern Enterprise Resource Planning ERP system.


The CoA is hospital chart of accounts throughout both health and departmental systems that drive the business, from transactional systems for managing revenue and hospital chart of accounts, to defining and managing budgets, people, and organizational structures, to tracking and managing assets and facilities, and many other areas.

The CoA also facilitates integration, communication, policies, and procedures across organizations both within and outside the healthcare organization. More people within a hospital organization will interact with the CoA daily knowingly or unknowingly than any other part of the business and its systems.

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Healthcare providers must understand their overall profitability so they can recognize which treatments will likely make money and which treatments, products, and service lines will break even or lose money.

This recognition should be at an operational level e. Cost method, amount of physician time, clinician time, supplies, fixed overhead, variable overhead, and waste Groupings of CPT ranges, diagnostic procedures, laboratory codes, office surgeries, and hospital hospital chart of accounts codes individual breakdowns may still be required to track the frequencies of each hospital chart of accounts for actual calculations Overhead costs including external costs such as exposures for at-risk contracting Salaries and related costs of nurses and other clinical staff who typically split time among numerous clinical activities considered among groupings of services or total costs e.

So how do we maximize a CoA redesign project to make it transformational?

Chart of accounts for hospitals in SearchWorks catalog

We start by understanding the concept of a multidimensional data model hospital chart of accounts like MS Excel pivot tables or a traditional x- y- and z-axis view of data. In other words, leverage the GL Structure in conjunction with the Natural Accounts to revise the available data for actionable information via the CoA.

During redesign, considerations for product and service hospital chart of accounts can be addressed, along with data available in sub-modules, to provide multidimensional or pivots of traditional transaction data. The activities in the approach are deliberately put in a particular sequence.

This sequence is intended to gather background information and strategic vision early in the design process when it is still possible to preserve open-minded thinking that is unencumbered by constraints that naturally come when the structure of the Hospital chart of accounts system is better understood.

It is expected and intended that information gathered will transcend the specific needs of the CoA design process. Stat Codes allow General Ledger journal lines to be posted with both an amount and a statistical amount to the same regular non-statistical account.

Chart of Accounts (COA) Redesign for Healthcare - Sierra-Cedar

For example, post both the hours and dollars for payroll on the same line e. Statistical Accounts Establish units of measure Interface payroll hours and other stat accounts from other ancillary systems along with patient financial system stats Create accrual ledgers; many use the accrual allocations for payroll info Join stat hours with the payroll dollars in the stat amount field using the same account number.

Hospital chart of accounts ledgers to allow better control over open periods STAT ledgers capture statistical information not directly associated with dollar amounts. It does not require a hospital chart of accounts account.

You can post stat amounts to regular expense accounts using the stat code, stat amount, and unit of measure fields. For those venturing into the new world where a CoA will support quality outcomes and actionable KPIs and metrics, consider the following hospital chart of accounts learned: The new CoA should serve as the primary financial reporting tool across all healthcare entities, so consider both fiscal, statistical and outcomes reporting requirements: Exhaustive requirements gathering is likely not necessary.

Understand needs to a sufficient level to support development of a CoA prototype. The proof of concept, value development, and mapping exercises will provide additional opportunity to assess needs, so focus on the following considerations: Is this going to be a transformational opportunity?

Look at the new financial system implementation as the catalyst for change management required as part of a new Hospital chart of accounts.