Manual of Standards for Management of Hospital Finance Service

LIST OF ACRONYMS

AD Accounting Department 24. COD Cash Operations Department 2. ADA Advice to Debit Account 25. COH Chief of Hospital 3. ADDO Aging of Due and Demandable Obligations 26. CQI Continual Quality Improvement
4 AFR Annual Financial Report 27. CRJ Cash Receipt Journal 5. AGDBs Authorized Government Depository Banks 28. CRR Cash Receipt Record 6. AO Accountable Officer 29. CSC Civil Service Commission 7. AOM Audit Observation Memorandum 30. DBM Department of Budget and Management 8.

APP Approved Procurement Plan 31. DO Disbursing Officer 9. AR Accounts Receivable 32. DOH Department of Health 10. BAC Bids and Awards Committee 33. DPCR Division Performance Commitment and Review 11. BAR Budget Accountability Report 34. DSWD Department of Social Welfare and Development 12. BCD Billing and Claims Department 35. DV Disbursement Voucher 13. BD Budget Department 36. ER Emergency Room 14. BED Budget Execution Documents 37. FAR Financial Accountability Report
15. BPR Budget Performance Review 38. FE Financial Expenses 16. BTr Bureau of Treasury 39. FMO Financial and Management Officer
17. BURS Budget Utilization Request and Status 40. FMS Finance Management System 18. CAF Certification of Availability of Funds 41. FS Finance Service
19. CAO Chief Administrative Officer 42. GAA General Appropriation Act 20. CDC Cash Disbursement Ceiling 43. GAAM Government Accounting and Auditing Manual 21. CDJ Cash Disbursement Journal 44. GAM Government Accounting Manual 22 CO Capital Outlay 45. GARO General Allotment Release Order 23. COA Commission on Audit 46. GAS Government Accountancy Sector

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Manual of Standards for Management of Hospital Finance Service

GDB Government Depository Bank

LGE Local Government Executives 48. GFI Government Financial Institution
71. LGU Local Government Unit 49. GJ General Journal 72. LOA Letter of Authorization 50. GJB General Journal Book 73. MAIP Medical Assistance to Indigent Patient 51. GL General Ledger 74. MCC Medical Center Chief 52. GOCC Government-Owned and Controlled Corporation 75. MDS Modified Disbursement System 53. HFDB Health Facility Development Bureau
76. MFO Major Final Output 54. HIMS Health Information Management Service 77. MOB Management by Objectives 55. HMO Health Maintenance Organization 78. MOOE Maintenance and Other Operating Expenditures 56. HOPSS Hospital Operation and Patient Support Service 79. NBB No Balance Billing 57. HPDPB Health Policy Development and Planning Bureau 80. NC Non-Conformity 58. ICD International Classification of Disease 81. NCA Notice of Cash Allocation 59. IPCR Individual Performance Commitment and Review 82. NCAA Non-Cash Availment Authority 60. ISA Institute for Solidarity in Asia
83. NG National Government 61. ISO International Organization for Standardization 84. NGA National Government Agency 62. JBR Journal of Bills Rendered 85. NGO Non-Governmental Organization 63. JCD Journal of Checks Disbursed 86. NKTI National Kidney and Transplant Institute 64. JCI Journal of Checks Issued 87. NOH National Objectives for Health 65. JE Journal Entry 88. OPCR Office Performance Commitment and Review 66. JEV Journal Entry Voucher 89. OPIF Organizational Performance Indicator Framework 67. LASA List of Allotments and Sub-Allotments 90. ORS Obligation Request and Status 68. LCP Lung Center of the Philippines 91. PAGCOR Philippine Amusement and Gaming Corporation 69. LDDAP List of Due and Demandable Accounts Payable 92. PAP Program, Activity and Project

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Manual of Standards for Management of Hospital Finance Service

PCF Petty Cash Fund 113. RAOD Registry of Allotments, Obligations and Disbursements 94. PCV Petty Cash Voucher 114. RAPAL Registry of Appropriation and Allotments 95. PCSO Philippine Charity Sweepstakes Office 115. RBUD Registry of Budget Utilization and Disbursement 96. PDCA Plan, Do, Check and Act 116. RCA Revised Chart of Accounts 97. PEM Public Expenditure Management 117. RCD Report of Collections and Deposits 98. PETDO Professional Education Training and Development Office 118. RROR Registry of Revenue and Other Receipts 99. PGS Performance Governance System
119. RTH Return to Hospital 100. PHC Philippine Heart Center 120. RVS Relative Value Scale 101. PHIC Philippine Health Insurance Corporation 121. SAAODB Statement of Appropriations, Allotments, Obligations, Disbursements and Balances 102. PI Performance Indictor 122. SAAODBOE Statement of Appropriations, Allotments, Obligations, Disbursements and Balances BY Object of Expenditures 103. PMS Performance Management System 123. SABUDB Statement of Approved Budget, Utilizations, Disbursements and Balances 104. PPE Property, Plant and Equipment 124. SARO Special Allotment Release Order 105. PPMP Project Procurement Management Plan 125. SL Subsidiary Ledger 106. PPSAS Philippine Public Sector Accounting Standards 126. SOA Statement of Account 107. PS Personnel Service 127. SPMS Strategic Performance Management System 108. PWD Person With Disability 128. TWG Technical Working Group 109. QFS Quantified Free Service 129. UACS Unified Account Code Structure 110. QMS Quality Management System 130. UHC Universal Health Care 111. QRROR Quarterly Report of Revenue and Other Receipts
131. WFP Work and Financial Plan 112. RAL Responsibility, Accountability and Liability

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LIST OF TABLES PAGE/S 1 Proposed Staffing Standards for Level 3 Government Hospital with 200 to 1,500 Beds 25 2 Qualification Standards and Level of Competence Required 26-28 3 Procurement Process 50 4 SPMS Five-Point Rating Scale 198 5 Main clauses and requirements under ISO 9001:2015 203-204

LIST OF FIGURES PAGE 1.1 Basic Organizational Structure for Level 1 Hospital 18 1.2 Basic Organizational Structure for HOPSS in a Level 1 Hospital
19 1.3 Basic Organizational Structure for Level 2 Hospital 20 1.4 Basic Organizational Structure for HOPSS in Level 2 Hospital
21 1.5 Basic Organizational Structure for Level 3 Hospital 22 1.6 Organizational Structure for FS in Level 3 Hospital 23 1.7 Proposed Organizational Structure for FS in Level 3 Hospital 23 2.1 Financial Management Strategic Process Map 44 2.2 Supply Management from Acquisition to Disposal 48 3.1 Budget Cycle 80 4.1 Basic Organizational Structure for Government- Owned and Controlled Specialty Hospitals 119 4.2 Organizational Structure of Finance Services Department in the GOCC Specialty Hospitals 120 5.1 Budget Process in LGU Hospital 146 6.1 Basic Steps in Risk Management (ISO 31000:2018 Standards) 186

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Manual of Standards for Management of Hospital Finance Service

LIST OF FIGURES PAGE 6.2 List of Common Identified Risks in Finance Service 187 6.3 Four Quadrants of Risk (COSO-ERM:2017) 188 6.4 Identified Common Financial Risks using the Four Quadrants 188 6.5 Sample of Risk Management Plan for Finance Service 190 7.1 Repetitive four-stage PDCA cycle model for continuous improvement 202

Manual of Standards for Management of Hospital Finance Service TABLE OF CONTENTS PART CONTENTS PAGE

Authorization
i

Messages ii

Foreword iv

Preface v

Acknowledgement vii

List of Acronyms xv

List of Tables and Figures xviii

PART 1

Chapter 1 Introduction

1.1 Background
1

1.2 Purpose and Intent of the Manual 2

1.3 Coverage of the Manual 3

1.4 Structure of the Manual 3

1.5 Contents of the Manual 3 Chapter 2 Hospital Finance Service : An Overview

2.1 The DOH Policy Framework 6

2.2 The Hospital Finance Service: Statement of Vision, Mission and Objectives 8 Chapter 3 Legal Frameworks, General Policies and Guiding Principles

3.1 General Policies on Government Financial Management System 11

3.2 Guiding Principles in Government Accounting 13 Chapter 4 Finance Service: Organizational Structure and
Staffing Requirements

4.1 Organizational Structure
17

4.2 Human Resource in the Finance Service 24 Chapter 5 Space and Equipment Requirements

5.1 Applicable Laws, Rules and Regulations 29

5.2 Standard Space Requirements 31

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Manual of Standards for Management of Hospital Finance Service PART CONTENTS PAGE

5.3 Equipment Requirements 37 Chapter 6 Finance Service Roles, Accountability and Responsibilities

6.1 Major Key Roles of Financial Service in Hospital
Operation
39

6.2 Key Responsibilities of Finance Service 40

6.3 Public Accountability and Stewardship in the Finance Service 42

6.4 Process Approach in Finance Service 43

6.5 Activities to Achieve Good Financial Management 45

6.6 Integrative Approach to Financial Management
46

6.7 Interrelation of Financial Management Process with
Critical Hospital Operation Process 47

6.8 Statutory and Regulatory Standards 53

Part II

Chapter 7 Financial and Management Officer: Head of Finance Service

7.1 Interested Parties 56

7.2 Duties and Responsibilities
56

7.3 Guiding Principles 58

7.4 Core Process 59

7.5 Reportorial and Documentary Requirements 61 Chapter 8 Accounting Department

8.1 Interested Parties 62

8.2 Guiding Principles 63

8.3 Duties and Responsibilities 64

8.4 Core Processes 65

8.5 Process Flow 66

8.6 Reportorial and Documentary Requirements 74 Chapter 9 Budget Department

9.1 Interested Parties 77

9.2 Guiding Principles 78

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Manual of Standards for Management of Hospital Finance Service PART CONTENTS PAGE

9.3 Duties and Responsibilities 78

9.4 Core Processes 80

9.5 Process Flow 83

9.6 Reportorial and Documentary Requirements 88 Chapter 10 Cash Operations Department

10.1 Interested Parties 90

10.2 Guiding Principles 91

10.3 Duties and Responsibilities 92

10.4 Core Processes 93

10.5 Process Flow 98

10.6 Reportorial and Documentary Requirements 104 Chapter 11 Billing and Claims Department

11.1 Interested Parties 105

11.2 Guiding Principles 106

11.3 Duties and Responsibilities 107

11.4 Core Processes 108

11.5 Process Flow 113

11.6 Reportorial and Documentary Requirements 117 Chapter 12 Financial Management System in Government- Owned and Controlled Specialty Hospitals

12.1 Organizational Set-up 119

12.2 Finance Services Department 120

12.3 Interested Parties 121

12.4 Accounting Division 122

12.5 Billing and Claims Division
127

12.6 Budget Division
133

12.7 Cash Operation or Treasury Division
138 Chapter 13 Financial Management System in Local Government Hospitals

13.1 Organizational Set-up 144

13.2 Financial Management System for Local Hospitals 144

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Manual of Standards for Management of Hospital Finance Service PART CONTENTS PAGE

13.3 Interested Parties 145

13.4 Core Processes and Process Flow 145

13.5 Reportorial and Documentary Requirements
152

PART III

Chapter 14 Good Governance and Social Responsibility in Hospital Finance Service

14.1 Concepts and Principles 153

14.2 Good Governance in Finance Service for Public Sector
156

14.3 Social Responsibility in the Hospital Finance Service 158

14.4 Implementation of Universal Health Care Law 161

14.5 Institutionalization of Malasakit Centers and Programs in the Hospitals 163

14.6 Declaration of the Rights of the Patients 165 Chapter 15 Revenue and Cost Management

15.1 Sources of Healthcare Funds 171

15.2 Cost Accounting and Management
172 Chapter 16 Quantified Free Services and Discounts

16.1 Quantified Free Service Defined 178

16.2 Purpose of Setting up the Quantified Free Services 179

16.3 Computation of Quantified Free Services 180

16.4 Recording of Quantified Free Services 181

16.5 Policy Recommendations 182

16.6 Goals 183 Chapter 17 Financial Risk Management

17.1 Importance of Risk Management in Finance Service 185

17.2 Basic Steps in Risk Management 186

17.3 Risk Management Plan 190

17.4 Challenges/Barriers of Risk Management 190 Chapter 18 Finance Service Continuous Quality Improvement

18.1 Framework 191

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Manual of Standards for Management of Hospital Finance Service

18.2 Performance Management 195

18.3 Performance Management: Strategies, Tools and
Approaches
196

18.4 Accreditation 200

PART CONTENTS PAGE

PART IV

A Glossary of Terms 205 B Appendices

B.1 Summary List of Accounting Books, Registries, Records, Forms and Reports 216

B.2 Standard Forms For Finance Service

    B.2.1   Accounting Forms

227

    B.2.2   Budget Forms

284

    B.2.3    Cash Operations Forms

321

    B.2.4    Billing, Claims and Other Forms

354

B.3 Finance Service Self-Assessment Tool

364 C Issuances

C.1 RA 11223 and its Implementing Rules and
Regulations
384

C.2 RA 11463 Malasakit Centers Act

402

C.3 COA Circular 2020-001 408

C.4 COA Circular 2004-007 411

C.5 Administrative Order No. 2020-0034 413

C.6 Reporting Tool of Financial Data on Revenues and Expenses

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Manual of Standards for Management of Hospital Finance Service 1

CHAPTER 1 IN NTTR RO OD DU UC CTTIIO ON N

1.1 Background

With the financial challenges in managing hospital operations, the Department of Health (DOH) recognized the need for more effective, efficient and transparent financial management system for hospital administration, a system that will serve as enabling mechanism for the DOH mandate of overseeing and coordinating the implementation of the different programs of the hospital. Thus, the DOH, through the Health Facility Development Bureau (HFDB), issued Department Personnel Order (DPO) No. 2016-4941 in 2016, and created a Technical Working Group (TWG) composed of selected Financial and Management Officers, Accountants, Administrative Officers (Budget Officers/Cash Management Officer/Billing Officer), and other selected hospital finance management officers to draft and formulate the Manual of Standards for Management of Hospital Finance Service

In 1999, during the implementation of the Health Sector Reform Agenda one of the organizational changes identified was the institutionalization of Financial and Procurement System. One of the strategies was the strengthening of the Hospital Financial System, including separation of the Finance Service from the Administrative Service.

The Manual was once incorporated in the 2008 edition of the Manual of Organization and Management of the Administrative and Finance Service for the Hospitals. However, in 2013 DOH and Department of Budget and Management (DBM) issued the Revised Organizational Structure and Staffing Standards for Government Hospitals, wherein DOH hospitals were restructured and a separate Finance Service (FS) was established. Concomitantly, the need to establish a common standard for the finance management system had been duly recognized with the implementation of the Quality Management System (QMS) using ISO 9001 standards and application of the latest Commission on Audit (COA) rules and regulations.

As basis, TWG reviewed and revisited the 2008 Manual vis-à-vis the latest issuances of the DOH, DBM, COA, and other pertinent documents relevant to the current trends in hospital administration and financial management system. These substantiated the contents of the Manual of Standards for Management of Hospital Finance Service that the TWG developed.

Manual of Standards for Management of Hospital Finance Service Introduction 1.2 Purpose and Intent

This Manual shall serve as reference and guide for hospital administrators, Financial and Management Officers, and staff in the operations and management of hospitals with the objective of ensuring the efficient and effective delivery of quality health care services. It aims to provide a single and definitive source of the policies and procedures governing the core processes involved in effectively and efficiently management of hospital resources from its conceptualization to its termination.

Specifically, the Manual intends to:

1.2.1 Ensure compliance with laws, rules and regulations in financial transactions, thereby, providing reasonable assurance that the hospital funds (from all sources) are properly utilized;

1.2.2 Ensure strict adherence to the official documentary requirements relative to key financial processes such as but not limited to: 1.2.2.1 Grant and liquidation of cash advances, 1.2.2.2 Post-Transaction Payments, and
1.2.2.3 Requisition, recording, monitoring, reconciliation and reporting of Property, Plant and Equipment (PPE) and supplies;

1.2.3 Assist in complying with Audit Observation Memorandum (AOM) and Notices of Suspension and Disallowances pertinent to rules and regulations prescribed by COA;

1.2.4 Use as guides in the timely liquidation of cash advances and ensure reconciled balances of supplies and PPE Accounts;

1.2.5 Guide all the interested parties in the financial processes in managing hospital resources;

1.2.6 Identify the accountability, responsibility and obligation of all the finance and hospital personnel in charge in the implementation of the processes described herein; and

1.2.7 Identify and manage the financial risks that will affect the sustainability and liquidity of the hospital.

The intent of this Manual is to facilitate improved financial decision-making by providing the key officers and financial management staff with an “easy to understand” guide to the basic principles of healthcare accounting, reimbursement, and finance.

This Manual shall include finance documentary reports, which can be used as reference as these illustrate general points and principles.

Manual of Standards for Management of Hospital Finance Service 3 Introduction 1.3 Coverage of the Manual

This Manual shall cover all the major financial management processes including financial policies and procedures applicable and necessary to the following offices under the FS in the hospital setting: 1.3.1 Financial and Management Officer: Head of the Finance Service
1.3.2 Accounting Department (AD) 1.3.3 Budget Department (BD) 1.3.4 Cash Operations Department (COD) 1.3.5 Billing and Claims Department (BCD)

The mandated functions of each department define the key financial processes that will be discussed and presented in this Manual.

References shall be made to other related policies and procedures developed for the processes in the other offices of the hospital, in particular, the procurement and human resource development management processes.

1.4 Structure of the Manual

This Manual has been structured in a manner that will make it possible to be used as reference to formulate amendments as and when required. In the discussion of the particular section, it shall contain the following structure:

1.4.1 Policy Objective refers to the brief description of the primary purpose and objectives of the specific office.

1.4.2 Policy Statement refers to the key guiding rules and principles relating to the specific office.

1.4.3 Procedures refer to the particular office stating the step by step actions in fulfilling the requirements of the policy statement.

1.4.4 Key Control Processes refer to the discussion of the policy framework, processes and procedures, and applicable flowcharts indicating the line of authority and level in the organization and the documentary requirements, required for each office in the FS.

1.4.5 Responsibility Matrix shall provide the roles and responsibilities of the different positions aligned in each office of the FS.

1.5 Contents of the Manual

This Manual shall be divided into three (3) parts containing major parts, as follows:

Manual of Standards for Management of Hospital Finance Service Introduction Part I covers the introduction and discussion of the basic principles and concepts to be used as basis for the implementation of an effective financial management in public services. It shall include the following six (6) major chapters:

Chapter 1 shall cover the introduction stating the short background, coverage, structure, contents, purpose and intent of the Manual.

In Chapters 2 and 3, the discussion covers the basic principles and concepts to be used as basis in the implementation of an effective financial management in public healthcare institutions. It shall include the following:  Overview covering the Statement of Vision, Mission, Objectives and Core Values of the Department of Health and Finance Service; and  Legal framework, general policies and guiding principles in financial management.

Chapters 4 and 5 illustrate the basic organizational structure for the Finance Service at all levels of hospital service capability – Levels 1, 2 and 3. These also include as reference the space and equipment requirements to operate the different units under the FS.

Chapter 6 discusses the different roles, accountabilities and responsibilities of the FS in the operations of the hospital. It also provides concepts and principles to effectively and efficiently manage the Finance Service as to:  Responsibility, accountability and liability over Government funds and property;  Disbursement of public funds;  Benefits of and activities to achieve good financial management;
 Integrative approach to financial management; and  Integration of financial management processes with critical hospital operations processes

Part 2 covers the discussion of the functions, standard policies and procedures of the Core Processes of the different departments/sections/units under the Finance Service; and the Role of the Financial Management Officer II as Head of the Finance Service. It shall also cover the chapter discussing the Finance Management System in Specialty Hospitals and Local Government hospital:

Chapter 7 identifies the roles, duties and responsibilities of the Financial and Management Officer II, or the head of the Finance Service, in the performance of their mandated functions, by setting standard policies and procedures, and the strategic process map indicating the general supervision of the different units under the Service.

Chapters 8, 9, 10 and 11 discuss and define the different functions, governing general policies, interested parties (both internal and external), accountabilities, duties and responsibilities, major core processes and the reportorial and documentary requirements of the following departments under the FS: Accounting, Budget, Cash Operations, and Billing and Claims.

Manual of Standards for Management of Hospital Finance Service 5 Introduction Chapter 12 discusses the financial management system in Government Owned and Controlled Specialty Hospitals. It also includes general policies, financial transaction flows and processes including the system’s reportorial and documentary requirements.

Chapter 13 covers the discussion of the financial management system in hospitals under the Local Government Units.

Part 3 shall provide the user with reference in handling the management and operation of the Finance Service. It shall cover the discussion of concepts and principles in good governance, social responsibility, performance based evaluation and financial risk management. It also includes revenue and cost management, and quantified free services and discounts to set a common standard in handling the resources of the hospital. Chapter 14 discusses Good Governance and Social Responsibilities in Hospitals in accordance with the DOH mandate and objectives in the implementation of Universal Health Care in the Philippines.

Chapter 15 provides the guidelines, principles and formula in setting rates, cost management and revenue enhancement for hospitals.

Chapter 16 discusses the purpose of setting up, computation and recording of Quantified Free Services (QFS) and Discounts.

Chapter 17 identifies the common financial risks, risk management and its impact to effectively and efficiently manage the Finance Service.

Chapter 18 discusses the strategies, tools and resources in establishing performance management system in Finance Service and programs for Continuing Quality Improvement of the Quality Management System as to processes in delivery of services.

In the Appendices, the following are included which can be used as reference of the user of this Manual:

Glossary of Terms - common financial terms are defined based on the DBM and COA standards
Illustrative Chart of Accounts https://www.coa.gov.ph/phocadownload/userupload/Issuances/Circulars/Circ2020/ COA_C2020-001_Annexes/Annex_A-Vol_III_RCA.pdf
List of Book of Accounts
Standard Forms Used based on GAM for NGAs
RA 11223 Otherwise known as Universal Health Care Act
RA 11463 Otherwise known as Malasakit Center Act
Other Pertinent issuances and references

6
Manual of Standards for Management of Hospital Finance Service

CHAPTER 2

HOSPITAL FINANCE SERVICE:
AN OVERVIEW

2.1 The DOH Policy Framework

The Department of Health is the leading agency holding the over-all technical authority on health as it is a national health policy-maker and regulatory institution. The DOH plays three major roles in health sector, namely:  Leadership in Health  Enabler and capacity builder; and
 Administrator of specific services.1

The DOH is also the provider of special tertiary health care services and technical assistance to health providers and stakeholders.

The DOH has set the policy framework in setting the standards, policies, objectives and plans, as follows:2

A. Vision – The DOH envisions “Filipinos as among the healthiest people in
Southeast Asia by 2022, and Asia by 2040”.

B. Mission – The DOH shall lead the country in the development of productive, resilient, equitable and people-centered health system.

C. Core Values – The DOH shall embody at all times professionalism, responsiveness, integrity, compassion and excellence in carrying out its tasks and responsibilities.

D. Goals – The F1 + 1 for Health aims to ensure better health outcomes, a more responsive health system, and a more equitable health care financing.

1 From the DOH Website 2 From AO No. 2018-0014 dated May 30, 2018

7 Manual of Standards for Management of Hospital Finance Service Hospital Finance Service: An Overview E. Strategic Pillars – The DOH shall organize health sector initiatives into four (4) pillars, namely: Financing, Service Delivery, Regulation, Governance, plus a cross-cutting initiative on Performance Accountability.

DOH adheres to the highest values of work, and has adopted the following Core Values:

 Professionalism – The DOH performs its functions in accordance with the highest ethical standards, principles of accountability and full responsibility.

 Responsiveness – The DOH provides accessible, affordable and quality health care services to the public.

 Integrity – The Department believes in upholding truth and pursuing honesty, accountability and consistency in performing its functions.

 Compassion and respect for human dignity – While DOH upholds the quality of life, respect for human dignity is encouraged by working with sympathy and benevolence for the people in need

 Excellence – The DOH continuously strives for the best by fostering innovation, effectiveness and efficiency, pro-action, dynamism and openness to change.

The DOH Four (4) Strategic Pillars have its own objectives, sub-pillars and key interventions, as follows:

a. Strategic Pillar 1: Financing - The objective is to secure sustainable investments to improve health outcomes and ensure efficient and equitable use of health resources. It shall be governed with the following key interventions:  Efficiently mobilize and equitably distribute more resources for health  Rationalize health spending  Focus financial resources towards high impact interventions

b. Strategic Pillar 2: Service Delivery – The objective is to ensure the availability of essential quality health products and services at appropriate levels of care. It shall be governed with the following key interventions:  Increase access to quality essential health products and services  Ensure equitable access to quality health facilities  Ensure equitable distribution of human resources for health (HRH)  Engage Service Delivery Network (SDN) to deliver comprehensive package of health services

c. Strategic Pillar 3: Regulation - The objective is to ensure high quality and affordable health products, devices, facilities and services. It shall be governed with the following key interventions:  Harmonize and streamline regulatory systems and processes  Develop innovative mechanism for equitable distribution of quality and affordable health goods and services.

8 Manual of Standards for Management of Hospital Finance Service Hospital Finance Service: An Overview d. Strategic Pillar 4: Governance – the governance pillar aims to strengthen leadership and management capacities, coordination, and support mechanism necessary to ensure functional, people-centered and participatory health systems. It shall be governed with the following key interventions:  Strengthen sectoral leadership and management  Improve organizational development and performance  Improve processes for procurement and supply chain management to ensure availability and quality of health commodities  Ensure generation and use of evidence in health policy development, decision making and program planning and implementation

e. “PLUS” Performance Accountability across all pillars. The objective of the Performance accountability is to use systems that would drive better execution of policies and programs in the DOH while ensuring responsibility to all stakeholders. It shall be governed with the following key interventions:  Institute transparency and accountability measures at all levels  Shift to outcome-based management approach

2.2 The Hospital Finance Service: Statement of Vision, Mission and Objectives

DOH together with the hospital administrators as policy makers acknowledge the importance of strengthening the financial management systems in hospitals and other healthcare facilities. One major strategy in this regard is the review of the organizational structures of support services in the hospital setting.

Prior to the Revised Organizational Structure and Staffing Standards for Government Hospitals, support services were directly supervised by the Administrative Service. Different departments providing finance services – Accounting, Budget, Cash Operations and Billing and Claims – reported directly to the head of the Administrative Service. With the 2013 revision, the Finance Service (FS) was established as a separate division for Level 3 hospitals.

The primary objectives in the establishment of a Finance Service in health care institutions are:  Strengthen the capacity to effectively and efficiently manage public funds as Stewards of Resources;  Be financially stable to sustain the implementation of the different programs projects and activities; and
 Ensure that the programs are within the bounds of laws and regulations.

The FS also aims to provide an effective financial management system in hospital operations, providing leadership in delivering proactive financial services including sound financial controls and effective and efficient use of resources.

9 Manual of Standards for Management of Hospital Finance Service Hospital Finance Service: An Overview The FS shall be recognized as an integral component in the healthcare organization providing the highest level of service consistent with the local and international standards, statutory laws and regulations. Thus, the Finance Service envisions:

“To be Recognized as an Excellent Provider of Finance Services to the Health Care Institution, Compliant to Local and International Financial Standards”

For its mission, the FS aims for the provision of the following:  Effective, efficient and transparent financial support services;

 Appropriate, accurate and reliable financial reports compliant to local and international standards; and

 Proactive continuing professional development and capacity building to develop the competency of finance personnel.

The FS’s Shared Core Values shall be:

I INTEGRITY

A ACCOUNTABILITY

C COMPETENCY

C CUSTOMER DRIVEN

T TRANSPARENCY

To realize the vision-mission, the Service shall nurture these values through:

P Provide valued service to customers, stakeholders and other interested parties in a courteous and responsive manner R Respect beliefs and values of others in service delivery O Optimize the use of resources through responsible stewardship V Value all employees through empowerment, development and recognition I Instill accountability and sustainability in using resources D Direct openness and transparency in all its dealings and operations E Espouse the virtues of truth, integrity, honesty, tolerance, competence and professionalism R Reinforce and strengthen teamwork and meritocracy

10 Manual of Standards for Management of Hospital Finance Service Hospital Finance Service: An Overview

Financial management is more than just keeping accounting records. It is an essential part of organizational management, and it can neither be seen as a separate task nor a mere minor function performed by a small group. Financial management involves planning, organizing, controlling and monitoring of financial resources in order to achieve the quality objectives set by any organization, and it involves a range of financial tactics and strategies.

Sound financial management shall involve medium to long-term strategic planning and short-term operations planning. Effective financial management results from a sound organizational plan, which addresses a well-defined set of objectives agreed, developed, evaluated and cascaded to all the interested parties of the organization.

Manual of Standards for Management of Hospital Finance Service 11

CHAPTER 3 LEGAL FRAMEWORK,
GENERAL POLICIES AND
GUIDING PRINCIPLES

3.1 General Policies on Government Financial Management System

This Manual shall be guided with the relevant legal framework covering government financial management systems. The hospital’s Finance Service shall be guided by the Philippine Constitution as well as by principles, specifically those by the COA, such as but not limited to COA Circulars, the GAM for NGAs, the DBM and its budget circulars, the General Appropriations Act for the fiscal year, and other special laws issued by the CSC, the DOH, and other government agencies.

As a general rule, management of government finances is governed by Section 29, Article VI of the Philippine Constitution: “No money shall be paid out of the Treasury except in pursuance of an appropriation made by law.”1 All laws, rules and regulations issued by implementing bodies strictly adhere to this Constitutional provision.

This Constitutional provision also establishes the need for all government entities to undergo the budgeting process, including budget legislation, to secure funds needed to carry out their mandate and to implement their programs, activities and projects (P/A/Ps) accordingly. Section 32 of the Administrative Code of the Philippines states that, “All moneys appropriated for functions, activities, projects and programs shall be available solely for the specific purposes for which these are appropriated.”2 This emphasizes the need for judicious planning of P/A/Ps and for establishing strong financial controls to ensure that funds are made available solely for the duly approved P/A/Ps.

Section 2 of Presidential Decree (P.D.) No. 1445 (Government Auditing Code of the Philippines) states that, “All resources of the government shall be managed, expended or utilized in accordance with laws and regulations, and safeguarded against loss or wastage through illegal and improper disposition, with a view to ensuring efficiency, economy and effectiveness in the operations of government. The responsibility to ensure that such policy

1 From the 1987 Constitution of the Philippines 2 From the Administrative Code of the Philippines

Manual of Standards for Management of Hospital Finance Service Legal Framework, General Policies and Guiding Principles is faithfully adhered with rests directly with the chief or head of the government agency concerned.”3

To strictly adhere to the foregoing stated policies, Section 5, Chapter 2 (General Provisions, Basic Standards and Policies) of GAM for NGAs also provides the fundamental principles as promulgated under Section 4 of PD 1445, Government Auditing Code of the Philippines, to be strictly adhered to by Finance Service staff and those implementing the P/A/Ps, to wit:

3.1.1 No money shall be paid out of public treasury or depository except in pursuance of an appropriation law or other specific statutory authority.

3.1.2 Government funds or property shall be spent or used solely for public purposes.

3.1.3 Trust funds shall be available and may be spent only for the specific purpose for which the trust fund was created or the funds received

3.1.4 Fiscal responsibility shall, to the greatest extent, be shared by all those exercising authority over the financial affairs, transactions and operations of the government agency.

3.1.5 Disbursements or dispositions of government funds or property shall invariably bear the approval of the proper officials or person in authority.

3.1.6 Claims against government funds shall be supported with complete documentation.

3.1.7 All laws and regulations applicable to financial transactions shall be strictly adhered to.

3.1.8 Generally accepted principles and practices of accounting as well as of sound management and fiscal administration shall be observed, provided that they do not contravene to existing laws and regulations.4

The GAM for NGAs is prescribed by COA pursuant to Article IX-D, Section 2 par. (2) of the 1987 Constitution: “The Commission on Audit shall have exclusive authority, subject to the limitations in this Article, to define the scope of its audit and examination, establish the techniques and methods required therefor, and promulgate accounting and auditing rules and regulations, including those for the prevention and disallowance of irregular, unnecessary, excessive, extravagant, or unconscionable expenditures, or uses of government funds and properties”.5 (Chapter 1, Section 1, GAM for NGAs)

3 Section 2, Auditing Code of the Philippines, Presidential Decree No. 1445 4 From the Government Accounting Manual 5 From the 1987 Constitution, as cited from the Government Accounting Manual

Manual of Standards for Management of Hospital Finance Service 13 Legal Framework, General Policies and Guiding Principles 3.2 Guiding Principles in Government Accounting

Section 3, Chapter 2 of the GAM for NGAs provides the Responsibility, Accountability and Liability (RAL) over government funds and property, and the following are specifically stated therein:

3.2.1 Responsibility over Government Funds and Property

3.2.1.1 It is the declared policy of the State that all resources of the government shall be managed, expended or utilized in accordance with laws and regulations, and safeguarded against loss or wastage through illegal or improper disposition, with a view to ensuring efficiency, economy and effectiveness in the operations of government. The responsibility to take care that such policy is faithfully adhered to rests directly with the chief or head of the government agency concerned. (Sec. 2, P.D. No. 1445)

3.2.1.2 Fiscal responsibility shall, to the greatest extent, be shared by all those exercising authority over the financial affairs, transactions, and operations of the government agency. (Sec. 4(4), P.D. No. 1445)

3.2.1.3 The head of any agency of the government is immediately and primarily responsible for all government funds and property pertaining to his agency. Persons entrusted with the possession or custody of the funds or property under the agency head shall be immediately responsible to him, without prejudice to the liability of either party to the government. (Sec. 102, P.D. No. 1445)

3.2.2 Accountability over Government Funds and Property

3.2.2.1 Every officer of any government agency whose duties permit or require the possession or custody of government funds or property shall be accountable therefor and for the safekeeping thereof in conformity with law. Every AO shall be properly bonded in accordance with law. (Sec. 101, P.D. No. 1445; Section 50, Chapter 9, Subtitle B, Book V, Executive Order (E.O.) No. 292)

3.2.2.2 Transfer of government funds from one officer to another shall, except as allowed by law or regulation, be made only upon prior direction or authorization of the Commission or its representative. (Sec. 75, P.D. No. 1445)

3.2.2.3 When government funds or property are transferred from one AO to another, or from an outgoing officer to his successor, it shall be done upon properly itemized invoice and receipt which shall invariably support the clearance to be issued to the relieved or outgoing officer, subject to regulations of the Commission. (Sec. 77, P.D. No. 1445)

Manual of Standards for Management of Hospital Finance Service Legal Framework, General Policies and Guiding Principles 3.2.3 Liability over Government Funds and Property

3.2.3.1 Expenditures of government funds or uses of government property in violation of law or regulations shall be a personal liability of the official or employee found to be directly responsible therefor. (Sec. 103, P.D. No. 1445)

3.2.3.2 Every officer accountable for government funds shall be liable for all losses resulting from the unlawful deposit, use, or application thereof and for all losses attributable to negligence in the keeping of the funds. (Sec. 105(2), P.D. No. 1445)

3.2.3.3 No Accountable Officer shall be relieved from liability by reason of his having acted under the direction of a superior officer in paying out, applying, or disposing of the funds or property with which he is chargeable, unless prior to that act, he notified the superior officer in writing of the illegality of the payment, application, or disposition. The officer directing any illegal payment or disposition of the funds or property shall be primarily liable for the loss, while the Accountable Officer who fails to serve the required notice shall be secondarily liable. (Section 106, P.D. No. 1445)

3.2.3.4 When a loss of government funds or property occurs while they are in transit or the loss is caused by fire, theft, or other casualty or force majeure, the officer accountable therefor or having custody thereof shall immediately notify the Commission or the auditor concerned and, within 30 days or such longer period as the Commission or auditor may in the particular case allow, shall present his application for relief, with the available supporting evidence. Whenever warranted by the evidence, credit for the loss shall be allowed. An officer who fails to comply with this requirement shall not be relieved of liability or allowed credit for any loss in the settlement of his accounts. (Sec. 73, P.D. No. 1445)

3.2.4 Proper Management of Revenues

Finances are not merely focused on monitoring the utilization of released funds, but they also involve the proper management of revenues. Section 4, Chapter 2 of the GAM for NGAs provides the following fundamental principles to govern all revenues accruing to NGAs.

3.2.4.1 Unless otherwise specifically provided by law, all revenues accruing to an entity by virtue of the provisions of existing law, orders and regulations shall be deposited/remitted in the National Treasury (NT) or in any duly authorized government depository, and shall accrue to the General Fund (GF) of the NG. (Sec. 65(1), P.D. No. 1445)

Manual of Standards for Management of Hospital Finance Service 15 Legal Framework, General Policies and Guiding Principles

3.2.4.2 Except as may otherwise be specifically provided by law or competent authority, all moneys and property officially received by a public officer in any capacity or upon any occasion must be accounted for as government funds and government property. (Sec. 42, Chapter 7, Title I(B), Book V, E.O. No. 292)

3.2.4.3 Amounts received in trust and from business-type activities of government may be separately recorded and disbursed in accordance with such rules and regulations as may be determined by a Permanent Committee composed of the Secretary of Finance as Chairman, and the Secretary of Budget and Management and the Chairman, COA, as members. (Sec. 65(2), P.D. No. 1445)

3.2.4.4 Receipts shall be recorded as revenue of Special, Fiduciary or Trust Funds or Funds other than the GF, only when authorized by law as implemented by rules and regulations issued by the Permanent Committee. (Sec. 66, P.D. No. 1445)

3.2.4.5 No payment of any nature shall be received by a collecting officer without immediately issuing an official receipt in acknowledgement thereof. The receipt may be in the form of postage, internal revenue or documentary stamps and the like, officially numbered receipts, subject to proper custody, accountability, and audit. (Sec. 68(1), P.D. No. 1445)

3.2.4.6 Where mechanical devices (e.g. electronic official receipt) are used to acknowledge cash receipts, the COA may approve, upon request, exemption from the use of accountable forms. (Sec. 68 (2), P.D. No. 1445)

3.2.4.7 At no instance shall temporary receipts be issued to acknowledge the receipt of public funds. (Sec. 72, GAAM Volume I)

3.2.4.8 Pre-numbered ORs shall be issued in strict numerical sequence. All copies of each receipt shall be exact copies or carbon reproduction in all respects of the original. (Sec. 73, GAAM Volume I)

3.2.4.9 An officer charged with the collection of revenue or the receiving of moneys payable to the government shall accept payment for taxes, dues or other indebtedness to the government in the form of checks issued in payment of government obligations, upon proper endorsement and identification of the payee or endorsee. Checks drawn in favor of the government in payment of any such indebtedness shall likewise be accepted by the officer concerned. At no instance should money in the hands of the CO be utilized for the purpose of cashing private checks. (Sec. 67(1) and (3), P.D. No. 1445)

3.2.4.10 Under such rules and regulations as the COA and the Department of Finance (DOF) may prescribe, the Treasurer of the Philippines and all AGDB shall acknowledge receipt of all funds received by them, the acknowledgement bearing the date of actual remittance or deposit and indicating from whom and on what account it was received. (Sec. 70, P.D. No. 1445)

Manual of Standards for Management of Hospital Finance Service Legal Framework, General Policies and Guiding Principles

3.2.5 Hospital Income Retention

DOH, DOF and DBM Joint Circular No. 2003-1, “Guidelines on the Retention and Use of Hospital Income” provides that all national government hospitals under the DOH shall be authorized to retain and utilize their income provided that no amount of said income shall be used for the payment of salaries and other allowances.

Other specific general policies as stated in the GAM for NGAs governing the policy framework, processes, policies and procedures of the different departments under the Finance Service shall be discussed in the succeeding chapters.

Manual of Standards for Management of Hospital Finance Service 17

CHAPTER 4

4.1 Organizational Structure

Joint Circular No. 2013-1 dated September 23, 2013 between the DBM and the DOH, prescribed the revised standards on organizational structure and staffing pattern of government hospitals. The Circular covered only government general hospitals classified by DOH as Level 1, Level 2 and Level 3, excluding Special Hospitals or other health facilities per DOH Administrative Order No. 2012-0012, “Rules and Regulations Governing the New Classification of Hospitals and Other Health Facilities in the Philippines.” It provided the framework for categorization of hospitals as basis in determining the number and levels of positions appropriate for each hospital capability level and bed capacity.

Level 1 and Level 2 hospitals have four basic organizational units: Office of the Chief of Hospital, Medical Service, Nursing Service, and Hospital Operations and Patient Support Service (HOPSS). Internal management functions are combined under one organizational unit, the HOPSS, which subsumes both administrative and finance services.

A Level 3 hospital shall be provided with an additional division-level entity, the Finance Service, to handle accounting, budgeting, billing and claims and cash operations. Given the need to attain financial sustainability of hospitals, Finance Service shall be tasked to improve revenue generating capacity and to seek and focus on optimal financing, allocation and control of all resources of the healthcare organization.

For clear distinction, illustration of organizational structure is presented for each different level of hospitals.

Manual of Standards for Management of Hospital Finance Service Finance Service Organizational Structure and Staffing Requirements

4.1.1 Level 1 Hospital with 25-, 50- and 75-Bed Capacity

The Organizational Structure of the HOPSS for Level 1, as shown in Figure 1.1, showed that the supervision of the finance service departments, Accounting, Budget, Billing and Claims and Cash Operations is under the Head of HOPSS.

Figure 1.1 - Basic Organizational Structure for Level 1 Hospital

Manual of Standards for Management of Hospital Finance Service 19 Finance Service Organizational Structure and Staffing Requirements

The minimum Administrative and Finance functions as shown in Figure 1.2 performed in a Level 1 hospital are usually done by a single unit. Usually, the flow of transactions for this type of hospital is governed by the Local Government Code of the Philippines.
However, Level 1 retained hospitals under the supervision of the DOH Regional Office, shall follow the finance transactional flow issued for national government.

Figure 1.2 - Organizational Structure for HOPSS in a Level 1 Hospital

Manual of Standards for Management of Hospital Finance Service Finance Service Organizational Structure and Staffing Requirements 4.1.2 Level 2 Hospitals with 100-, 150- and 200-Bed Capacity

For Level 2, there are also three major services similar to Level 1 Hospitals as shown in Figure No. 1.3.

For Level 2 hospitals under the Local Chief Executives (LCE) of cities and provinces, the supervision of the Finance Service remains under the Head of the HOPSS or a designated unit by the LCE. For DOH-retained Level 2 hospitals, direct supervision is under the DOH Regional Office and shall follow the financial transactional flow issued for national government.

Figure 1.3 - Basic Organizational Structure for Level 2 Hospital Office of the Medical Center Chief Integrated Hospital Operations & Management Program Medical Service
Nursing Service
Hospital Operation & Patient Support Service

Manual of Standards for Management of Hospital Finance Service 21 Finance Service Organizational Structure and Staffing Requirements

As shown in Figure 1.4, the supervision of the Accounting, Billing and Claims, Budget, and Cash Operations for Level 2 hospitals is still under the Head of the HOPSS.

Figure 1.4 - Organizational Structure for HOPSS in Level 2 Hospital

Manual of Standards for Management of Hospital Finance Service Finance Service Organizational Structure and Staffing Requirements

4.1.3 Level 3 Hospitals with 200-, 300-, 400- and 500-Bed Capacity

The basic organizational standard was modified to showcase the distinction of the major role of the Administrative Management Functions as implemented by HOPSS and the Finance Management Functions as implemented by FS.
Finance Service has been created to form part of the basic organizational structure, as shown in Figure 1.5.

Figure 1.5 - Basic Organizational Structure for Level 3 Hospital Office of the Medical Center Chief

Integrated Hospital Operations & Management Program Professional, Educational and Training
Medical
Nursing
Non-Medical
Medical Service
Nursing Service
Hospital Operation & Patient Support Service Finance Service

Manual of Standards for Management of Hospital Finance Service 23 Finance Service Organizational Structure and Staffing Requirements

The supervision of the Finance Service in Level 3 hospitals shall be under the FMO II, for National Government Hospitals or designated Officers for Local Government Hospitals.

The proposed organizational structure for FS in Level 3 hospital shall be:

Figure 1.6 - Organizational Structure for FS in Level 3 Hospital Figure 1.7 - Proposed Organizational Structure for FS in Level 3 Hospital

Manual of Standards for Management of Hospital Finance Service Finance Service Organizational Structure and Staffing Requirements

It shall be applicable for Level 3 hospitals either as teaching and training or as a medical center. Each department shall be further sub-divided into several units/sections based on its nature, functions and relationship within the hospital set-up and operation.

4.2 Human Resource in the Finance Service

DBM-DOH Joint Circular No. 2013-1 provided the standard staffing requirement for general hospitals. Guidelines in the staffing pattern for the FS are determined based on the assigned classification, bed capacity and organizational structure, as follows:

4.2.1 The number and level of positions prescribed for each hospital category shall be the maximum that will be allowed for the various organizational units. However, hospitals may adopt a lesser number and lower levels of positions and/or merge different staff offices in the internal management and support units, depending on their financial capability.

4.2.2 Hospitals that qualify for the next higher category shall adopt the corresponding Organizational Structure and Staffing Pattern (OSSP) herein prescribed. However, the hospital management has the option to adopt a leaner OSSP by merging the prescribed organizational units or using lower-level positions. If the authorized bed capacity of a hospital falls between two of the specified bed capacities in the standard staffing pattern, the higher set of standards shall be applied if the number of beds is in excess of one half of their difference.

4.2.3 In addition to the hospital administrator, there will be required assistants, clerks, bookkeepers, cooks, engineers, attendants, nurse aide, orderlies, janitors, maintenance crew and others so that the total hospital personnel shall be approximately be two and one half for each occupied bed.

4.2.4 Staffing Requirements

It was concurred that pending the approval of the submitted proposed standard staffing pattern for the FS, the ideal number of staff to respond to expanding needs in providing quality service has been indicated as below.

Manual of Standards for Management of Hospital Finance Service 25 Finance Service Organizational Structure and Staffing Requirements Table 1: Proposed Standard Staffing Pattern for Finance Service

       *Subject to changes based on the Department of Budget and Management latest issuances

Manual of Standards for Management of Hospital Finance Service Finance Service Organizational Structure and Staffing Requirements 4.2.5 Eligibility and Competency Requirements

In levelling up the quality of performance in all the units under the Finance Service, the qualification standards and level of competence required shall be as follows:

Table 2: Qualification Standards and Level of Competence Required

Manual of Standards for Management of Hospital Finance Service 27 Finance Service Organizational Structure and Staffing Requirements Table 2: Qualification Standards and Level of Competence Required

Manual of Standards for Management of Hospital Finance Service Finance Service Organizational Structure and Staffing Requirements Table 2: Qualification Standards and Level of Competence Required

Manual of Standards for Management of Hospital Finance Service

CHAPTER 5

SPACE AND EQUIPMENT
REQUIREMENTS

5.1 Applicable Laws, Rules and Regulations

Some of the Finance Service Departments are providing direct frontline services to external clients. These are the Billing and Claims, and Cash Operations. There is also a direct interface with the different units in the hospital. In order to provide an effective, accurate, timely and efficient services to external clients, the space to be provided to the frontline services department shall be accessible and near the other frontline services of the hospital.

Hospitals and other health facilities shall be planned and designed to observe appropriate architectural standards, to meet prescribed functional requirements, and to conform to applicable codes as part of normal professional practice. References shall be made to the following:

5.1.1 P. D. 1096 – National Building Code of the Philippines and its Implementing Rules and Regulations

5.1.2 P. D. 1185 – Fire Code of the Philippines and Its Implementing Rules and Regulations

5.1.3 P. D. 856 – Code on Sanitation of the Philippines and Its Implementing Rules and Regulations

5.1.4 B. P. Blg. 344 – Accessibility Law and Its Implementing Rules and Regulations

5.1.5 R. A. 1378 – National Plumbing Code of the Philippines and Its Implementing Rules and Regulations

30 Space and Equipment Requirements Manual of Standards for Management of Hospital Finance Service

5.1.6 R. A. 184 – Philippine Electrical Code and Its Implementing Rules and Regulations

5.1.7 Manual on Technical Guidelines for Hospitals and Health Facilities Planning and Design. Department of Health, Manila, 1994 with updated edition for 250-Bed Level 3 Hospital, 2017

5.1.8 Signage Systems Manual for Hospitals and Offices. Department of Health, Manila. 1994

5.1.9 Health Facilities Maintenance Manual. Department of Health, Manila. 1995

5.1.10 Manual on Hospital Waste Management. Department of Health, Manila. Revised 2013

5.1.11 RA 10070 – An Act Establishing an Institutional Mechanism to Ensure the Implementation of Programs and Services for Persons with Disabilities in Every Province, City and Municipality, amending Republic Act 7277, otherwise known as the “Magna Carta for Disabled Persons, as amended and for other Purposes.

5.1.12 National Structural Code of the Philippines 2015 and Its Implementing Rules and Regulations

5.1.13 RA 4226 - Hospital Licensure Act and its Amendments and Implementing Rules and Regulations

5.1.14 Administrative Order No. 2012-0012 dated July 18, 2012 – Rules and Regulations Governing the New Classification of Hospitals and Other Health Facilities in the Philippines, as amended

31 Space and Equipment Requirements
Manual of Standards for Management of Hospital Finance Service

5.2 Standard Space Requirements

In the planning and design of a Hospital and other health facilities, the following shall be observed:

5.2.1 A hospital and other healthcare facilities shall provide and maintain a safe environment for patients, personnel and the general public. The building shall be of such construction so that no hazards to the life and safety of patients, personnel and public exist. It shall be capable of withstanding weight and elements to which they may be subjected.

5.2.2 Interconnectivity of frontline services shall provide the clients with a one-stop shop traffic flow. A business center comprising of the billing and claims, cashier, medical social service, admitting departments would be ideal to allow for a more efficient process flow of transactions among departments.

5.2.3 There shall be effective visual aids (e.g. citizen’s charter) and devices (e.g. queuing system) arranged to provide information, orientation, direction, identification, prohibition, warning and official notice considered essential to the optimum operation of a hospital and other health facilities.

5.2.4 For business offices, the required space area shall be 5.02 sq. m /staff. Work area per staff includes space for one desk and one chair and allocable space for common area (ex. reception area, pantry, comfort room and records/storage area). (Source: Guidelines in the Planning and Design of a Hospital and other Health Facilities 2004).

32 Space and Equipment Requirements Manual of Standards for Management of Hospital Finance Service For illustration, refer to the diagrams as follows:

33 Space and Equipment Requirements
Manual of Standards for Management of Hospital Finance Service

34 Space and Equipment Requirements Manual of Standards for Management of Hospital Finance Service

35 Space and Equipment Requirements
Manual of Standards for Management of Hospital Finance Service

36 Space and Equipment Requirements Manual of Standards for Management of Hospital Finance Service

37 Space and Equipment Requirements
Manual of Standards for Management of Hospital Finance Service 5.3 Equipment Requirements

There are basic equipment requirements based on the service capability of the different departments under the Finance Service. The requirements for finance service and its sub-units may vary depending on the levels of the hospital. Below are the lists of basic equipment.

5.3.1 Information and Communication Technology (ICT) Equipment / Semi Expendable Office Equipment

5.3.1.1 Computer unit with UPS, printer and bundled with latest version of Operating System (OS) software

5.3.1.2 Computer server (File and Web) bundled with latest operating system software

5.3.1.3 ENGAS Operating System

5.3.1.4 Laptop/Notebook computer and LCD projector and monitor for multi- media presentation

5.3.1.5 Video/digital camera for documentation

5.3.1.6 Audio Visual System for training/public health information

5.3.1.7 Closed Circuit Television (CCTV) system

5.3.1.8 Queue Management Device System for frontline services (Cashier and Billing)

5.3.1.9 Telecommunication System both Local Area Network (LAN) and external network system

5.3.1.10 Other IT devices and peripherals

5.3.2. Office Equipment / Semi Expendable office equipment

5.3.2.1 Typewriter

5.3.2.2 Calculator/Adding machine

5.3.2.3 Duplicating Machine/Photocopier

38 Space and Equipment Requirements Manual of Standards for Management of Hospital Finance Service 5.3.2.4 Fax Machine

5.3.2.5 White Board/Cord Board

5.3.2.6 Multi-purpose Scanner with feeder

5.3.2.7 Paper Shredder

5.3.2.8 Barcode Scanner/Reader

5.3.2.9 Counting Machine/Money Counterfeit Detector

5.3.2.10 Cash Register

5.3.2.11 Biometric Attendance System

5.3.3. Furniture and Fixtures / Semi Expendable office equipment

5.3.3.1 Office Table (executive, managerial and clerical)

5.3.3.2 Chair (executive, managerial and clerical)

5.3.3.3 Computer Table (dual for computer and printer)

5.3.3.4 Computer Chair

5.3.3.5 Filing Cabinet (open shelves and cabinet type -4-5 layers)

5.3.3.6 Conference Table and Chairs

5.3.3.7 Air-conditioning /Ventilation units (electric fan and exhaust fans)

5.3.3.8 Cash Vault (size depending on capacity) in all designated collection section/units

5.3.3.9 Push Cart

5.3.3.10 Ladder (adjustable)

5.3.3.11 Emergency lights

5.3.3.12 Fire Extinguisher (based on BFP requirements)

5.3.3.13 Signages

Manual of Standards for Management of Hospital Finance Service

CHAPTER 6

FINANCE SERVICE ROLES,
ACCOUNTABILITY AND
RESPONSIBILITIES

Finance Service is one of the major systems in the hospital administration and operation. The system is being performed by four major departments namely Accounting, Budget, Billing and Claims and Cash Operation, each with its own set of objectives, functions, policies, and procedures. The level of support services varies based on the level of category of the hospital.

Financial management in a hospital setting is the process of seeking the optimal financing, allocation, and control of all resources of the healthcare organization. It is through the accumulation of financial data and its results, the month-end and year-end accounting and statistical reports are prepared. Financial reports and statements are useful in planning, organizing, directing and controlling the activities of any organization.

6.1 Major Key Roles of Financial Service in Hospital Operation

6.1.1 Financial Accounting – to provide summary accounts to top management, external users and regulatory bodies. It involves the recording of all monetary transactions and the production of summary ﬁnancial statements that reﬂect the performance and ﬁnancial status of the organization. The Accounting Department is primarily responsible for Financial Accounting.

6.1.2 Cost Accounting - to provide data for effective budget planning and projection of short, medium and long term plans. It involves detailed analysis on suitable cost drivers and evaluation of costs incurred in relations to activities conducted. It also involves the defining of costs as

40
Finance Services Roles, Accountability and Responsibilities Manual of Standards for Management of Hospital Finance Service direct materials, direct labor, fixed overhead, variable overhead and period costs. It entails the setting of equitable rates for all the services provided in the hospital.

6.1.3 Management Accounting – to provide ﬁnancial information internally to top management for an effective and efficient decision making and strategic planning to achieve the set goals and objectives. This includes budgets and plans, costing and ﬁnancial appraisal of programs and activities.

6.1.4 Financial Resources Management – to ensure the organization has adequate funds and resources to meet all of its current obligations and financially support future plans and programs. It includes the sourcing of funds to meet the organization’s needs. It shall also involve planning for long-term capital requirements – such as, new facilities and equipment – and deciding on capital investments and how they should be ﬁnanced.

6.1.5 Risk Management – to identify related risks that arise from operation and clinical activities. Internal controls are used to analyze, manage and mitigate risk.

6.2 Key Responsibilities of Finance Service

The primary role of financial management in any healthcare organization is to manage financial resources and risks in a way that helps to achieve the financial goals of the hospital. If the institution has a strong and organized financial management plans, they are able to provide efficient and quality healthcare service to all their patients.

The basic activities involved in financial management in any healthcare organizations include the following core processes:

6.2.1 Financial Planning Process - Financial Planning is the process of evaluating and managing utilization of financial resources optimally for the achievement of the organization’s goals and objectives. Burdened with limited resources, sound budgeting and financial planning in healthcare organizations are crucial to maintain the standard of cares and sustain operations. (Source: Financial Management for Hospital Administration, GR Kulkami, et al, 2009)

41 Finance Services Roles, Accountability and Responsibilities Manual of Standards for Management of Hospital Finance Service  Comparative Benchmarks - Benchmarking is a process of learning good practices from other organizations, implementing the practices and setting measurable standards to track progress. Regular reviews will enable the Top Management to identify opportunities for savings and ways to fill budget gaps.

 Accurate and High Performing Budgeting - Setting of budget for each department shall be based on benchmarks and past performance. Low performing departments may be given targeted cost per workloads goals and be evaluated more often to monitor improvements.

 Establishing Accountability - Setting clear objectives and identifying person responsible in achieving the targets shall instill accountability into the process. Improving financial planning means that each department is required to meet its target within the allotted budget and be actively involved in tracking the progress of any given program or activity.

 Monitoring Variances and Achieving Balances - By tracking the expenses during the implementation of programs, immediate corrective actions can be taken to noted variances before cost centers get out of control. While reducing costs is a primary objective, delivery of quality healthcare services and continually improving quality, customer’s satisfaction and employees’ fulfillment shall not be taken for granted.

For example, if incurred expenses suddenly increase for an outsourced like CT-Scan/MRI, the management may decide to plan for the hospital’s expansion of services and invest in procuring the equipment required to do the procedure. Considering that this plan entails a long-term investment decision, thorough analysis and feasibility study are necessary. Will the procurement of CT-Scan/MRI equipment be the right solution? Will this increase the hospital’s income, or will this eat up the hospital’s budget for its operating costs? Cost benefit analysis of the gains and losses shall be done based on the budget available in the hospital’s coffer. The management may adopt an alternative way of having this diagnostic procedure available in the hospital, looking at other outsourcing arrangements in the end.

6.2.2 Financial Risk Management – this comprises the clinical and administrative systems, processes and reports employed to detect, monitor, assess, mitigate, and prevent risks. By employing risk management, the healthcare organization can ensure patient safety, reduce medical errors that may jeopardize the hospital’s ability to achieve its mission and protect the hospital against any financial liability. The head of Finance Service shall be responsible in managing and mitigating financial risks from occurrence.

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Finance Services Roles, Accountability and Responsibilities Manual of Standards for Management of Hospital Finance Service

6.2.3 Financial Decision Making. Financial analysis is part of the financial decision making process. It may involve analysis of financial problems that the hospital faces and deciding which course of action should be taken. When making financial decisions, the head of FS shall take into consideration the following elements:

 Nature and riskiness of the business operation  Capital structure desired
 Length of time the assets will be needed  Cost of alternative financing  Availability of resources and its prioritization

6.3 Public Accountability and Stewardship in the Finance Service

The Finance Service processes shall be guided with all the laws, rules and regulations issued by implementing bodies shall be strictly adhered thereto. Cognizant of the well-established tenet, “Public Office is a Public Trust”, the Department of Health is committed to promoting the highest level of responsibility and accountability among its officials and personnel by ensuring, among others, responsible stewardship of public resources. Finance Service ensures that said thrust be properly implemented and monitored.

Public accountability and stewardship require that expenditure incurred and revenues received be classified, accounted for and reported upon in the same way as they were initially authorized. This is achieved through the preparation of financial statements using the same classification and format as the Annual Estimates. However, in addition, Management should be able to monitor actual performance, detect variations from plans, and take corrective action to achieve the intended results. This can only be achieved with the development and use of management accounting and management information.
Healthcare Institution with an effective and organized financial management plan shall be able to provide efficient and quality healthcare to its patients.

The works of Finance Service shall be guided by:

 The existing government budgeting, accounting and auditing rules and regulations shall govern the financial transactions and operations of the hospital.

43 Finance Services Roles, Accountability and Responsibilities Manual of Standards for Management of Hospital Finance Service  The highest standard of honesty, objectivity and consistency shall be observed in keeping the Books of Accounts.

 The existing government directives on patient’s rights, benefits and privileges, whenever applicable, shall be incorporated in the patient’s billing and claims.

 Cash flow shall be properly monitored to alert management of the available money to sustain hospital operation.

The legal framework, general policies and guiding principles are discussed in Chapter 3 of this Manual.

6.4 Process Approach in Finance Service

Finance Service has established its Strategic Process Map indicating the interrelationship of processes to meet the customer’s requirements. The process as defined in the standards set in ISO 9001:2015 refers to the set of interrelated or interacting activities that use inputs to deliver an intended result.

Each department under Finance Service has its respective mandated functions.
The process approach includes establishing the organization’s processes to operate as an integrated and complete system. (Source: ISO Whitepaper: The Process Approach in ISO 9001:2015 involves:

6.4.1 The management system integrates processes and measures to meet objectives.

6.4.2 Processes define interrelated activities and checks, to deliver intended outputs.

6.4.3 Detailed planning and controls can be defined and documented as needed, depending on the organization’s context.

44
Finance Services Roles, Accountability and Responsibilities Manual of Standards for Management of Hospital Finance Service To illustrate:

ACCOUNTING DEPARTMENT Hospital Core Process

BUDGET DEPARTMENT Customer Requirements

BILLING AND CLAIMS DEPARTMENT

CASH OPERATIONS DEPARTMENT

FINANCE SERVICE Internal Support Services MMD, EFMD, Procurement, HRM, HRD, General Services, IHOMU

Customer Satisfaction Continual Quality Improvement Process Internal Audit/Management Review Budget Planning, Allotment. Obligation, Monitoring and Control Processing of SOA, PhilHealth and other Claims, Credit and Collection
Collection and Disbursement Processing of Payments. Financial Statements and other financial reports
Internal Clients: Hospital Employees External Clients: Patients, suppliers, regulatory agencies External Support
Outsource Service Provider Support Process FINANCE SERVICE PROCESS MAP Figure No. 2.1: Financial Management Strategic Process Map

45 Finance Services Roles, Accountability and Responsibilities Manual of Standards for Management of Hospital Finance Service 6.5 Activities to Achieve Good Financial Management

The benefits of high-quality government financial management are substantial. These benefits can be achieved through the application of the typical financial management activities such as:

6.5.1 Enhanced fund sourcing

6.5.1.1 Identification of the most effective revenue sources.
6.5.1.2 Proper management of the collection of revenues and other receipts
6.5.1.3 Management of the receipt of external resources, including loans and official development assistance, through proper procedures and controls, which comply with requirements of lenders and donors.

6.5.2 Optimized resource allocation decisions to achieve hospital’s priority objectives

6.5.2.1 Planning and prioritization of investments and their funding. 6.5.2.2 Systems establishment and management to identify policy priorities, cost and benefits of decision alternatives, presenting information and implementing monitoring and reporting on outcomes.

6.5.3 Improved financial management and expenditure control through more effective processes and control mechanisms

6.5.3.1 Planning and budgeting systems for revenues and expenditures.
6.5.3.2 Establishment of systems for preparing, reviewing and consolidating medium-term financial plans and budgets.
6.5.3.3 Implementation and monitoring of policies.

6.5.4 Increased financial viability of inflows and outflows

6.5.4.1 Anticipating the liquidity needs of the hospital for deploying surpluses to achieve maximum use of liquid funds.

6.5.5 Improved technical efficiency in managing and utilizing resources

6.5.5.1 Ensuring that expenditures and other resources are applied to the maximum advantage of government. 6.5.5.2 Directing resources to high priority through cost benefit analysis.

6.5.6 Enhanced transparency and accountability of government, providing better historic information as a guide to the future.

46
Finance Services Roles, Accountability and Responsibilities Manual of Standards for Management of Hospital Finance Service 6.5.6.1 Recording and accounting for the financial transactions, assets and liabilities of government.

6.5.7 Good management of public funds and assets, resulting in reduction in the levels of corruption and leakages

6.5.7.1 Protecting and enhancing the right of government to receive maximum benefits for its money’s worth.
6.5.7.2 Carry out the necessary financial transactions of government, e.g. bills to settle, staff to pay and revenues to collect.
6.5.7.3 Ensuring better government’s financial reputation among customers, investors etc.

6.6. Integrative Approach to Financial Management

The government financial management is a circular process made up of several interrelated systems and these are as follows:

6.6.1 Strategic and operational planning 6.6.2 Budgeting for recurrent expenses and funds derived from income 6.6.3 Fund release and cash management 6.6.4 Accounting and monitoring 6.6.5 Internal and external audit; and
6.6.6 Feedback and reporting.

Integration of these subsystems is important for decision making, control and monitoring. Developments in information technology makes the integrated approach to financial management possible.

The benefits from integration of these subsystems are substantial. The information outflows from one component are inflows to another component. Recognition of the linkages and commonality can improve performance within each sub- component, and hence of the system as a whole. By treating the system as a whole, more effective procedures, information flows, training, and systems tools can be developed. Modern information technology makes it both more feasible and the gains greater, to treat financial management as a single system.

The sources of inputs and outputs of the different departments under the Finance Service may come from all the internal and external source such as other services, departments, sections and units in the hospital as internal clients; and patients, suppliers, external service providers, DOH, DBM, COA and other government (local

47 Finance Services Roles, Accountability and Responsibilities Manual of Standards for Management of Hospital Finance Service and national), government-owned or controlled corporations, even those non- government organizations and other professional groups.

6.7 Interrelation of Financial Management Process with Critical Hospital Operation Process

The management and operation of a healthcare institution is also like managing an industry. The difference is that healthcare industry is the delivery of quality healthcare services to people. It has to effectively and efficiently manage the inventories of its resources such as medical supplies, drugs and medicines, reagents, medical and laboratory equipment and other inventories necessary in the delivery of quality healthcare services.

To illustrate the interrelation of financial management process with hospital operation process, critical support and operating processes have been identified.

6.7.1 Property, Plant, Equipment and Supplies Requisition, Recording, Monitoring, Reconciliation, Retention, Disposal and Reporting

This process involves the end-user/program managers as the requisitioning agent, Material Management, Procurement, Bids and Awards Committee (BAC), Finance Service (Budget and Accounting Department), and Disposal Committee.

6.7.1.1 Provision of policies, procedures, guidelines and documentary requirements for the requisition, procurement, recording, monitoring, reconciliation and reporting of PPE and Supplies.
6.7.1.2 Ensuring the reconciliation of balances of PPE and supplies as per physical inventory and as per financial records. 6.7.1.3 Promoting greater accountability and better controls over agency assets and resources.

Property, Plant and Equipment (PPE) as defined are tangible assets that are purchased, constructed, developed or otherwise acquired; held for use in the production or supply of goods or services or to produce program outputs; for rental to others; for administrative purposes; expected to be used during more than one reporting period and not intended for resale in the ordinary course of operations (Chapter 10, Section 2.k., GAM for NGAs)

48
Finance Services Roles, Accountability and Responsibilities Manual of Standards for Management of Hospital Finance Service To illustrate:

The physical inventory of Property Plant and Equipment (PPE) and supplies serves as basis for preparing accounting reports. The Accounting and Material Management Departments shall reconcile their records at the end of each month. Conduct of physical inventory shall be undertaken at least two (2) times a year (June and December) and PPE once a year (every December). Likewise, the inventory of supplies and materials in stock shall be made monthly.

END-USER/PROGRAM MANAGER PLANNING – Determination of Requirements

MATERIAL MANAGEMENT Verification – if for replacement/ or for acquisition BUDGET/ ACCOUNTING DEPARTMENT

Availability of Funds/ Funding Source PPE Requisition and Planning PROCUREMENT/ BAC Preparation of Procurement Management Program Plan (APP) for approval of the Head of the Hospital PROCUREMEN T/BAC Conduct of Public Bidding/Procure ment process

MMD/End-user Acceptance of Delivery/ Recording/Reporting/ Issuance of AR to End-user/Submission to Accounting ACCOUNTING DEPARTMENT

Recording/Processing of Payment/Journal entry

Procurement Process, Recording and Reporting MMD/INVENTORY COMMITTEE/ ACCOUNTING Conduct physical inventory/reconciliation with record ACCOUNTING DEPARTMENT Adjustment entries/ Retention/Depreciation/ Drop-off/write-off

DISPOSAL COMMITTEE Conduct disposal through public auction/
Submission of report

PPE Retention and Disposal Figure 2.2: Supply Management from Acquisition to Disposal

49 Finance Services Roles, Accountability and Responsibilities Manual of Standards for Management of Hospital Finance Service 6.7.2 Procurement Process

Procurement refers to the process of acquisition of goods, services and contracting for Infrastructure Projects by the procuring entity.

It is the declared policy of the State to promote the ideals of good governance in all its branches, departments, agencies, subdivisions, and instrumentalities, including government-owned and/or controlled corporations and local government units in the Procurement of Infrastructure Projects, Goods and Consulting Services, regardless of source of funds, whether local of foreign, subject to the provisions of Commonwealth Act No. 138. Any treaty or international or executive agreement affecting the subject matter of this Act, to which the Philippine government is signatory, shall be observed. (Government Procurement Reform Act, Republic Act No. 9184, January 10, 2003)

All the procuring entity in the government shall be governed by the following policies:

6.7.2.1 Transparency in the procurement process and in the implementation of procurement contracts.

6.7.2.2 Competitiveness by extending equal opportunity to enable private contracting parties who are eligible and qualified to participate in public bidding.

6.7.2.3 Streamlined procurement process that will uniformly apply to all government procurement. The procurement process shall be simple and shall be made adaptable to advances in modern technology in order to ensure an effective and efficient method.

6.7.2.4 System of accountability where both the public officials directly or indirectly involved in the procurement process, as well as in the implementation of procurement contracts and the private parties that deal with government are, when warranted by circumstances, investigated and held liable for their actions relative thereto.

6.7.2.5 Public monitoring of the procurement process and the implementation of awarded contracts with the end in view of guaranteeing that these contracts are awarded pursuant to the provisions of this Act and its implementing rules and regulations, and that all these contracts are performed strictly according to specifications.

6.7.2.6 No government procurement shall be undertaken unless it is in accordance with the Annual Procurement Plan (APP) of the procuring entity.

50
Finance Services Roles, Accountability and Responsibilities Manual of Standards for Management of Hospital Finance Service To illustrate:

Activities
Person in Interest Processes

Procurement Planning – this entails the forecasting of the needed operating requirements (PPE and supplies) for inclusion to the agency proposed budget. This is usually done every first quarter of the preceding year before the Fiscal year. End-users, Program Managers and other operating units Prepares the Project Procurement and Management Plan (PPMP), indicating the resources requirements for every targeted programs and activities.

Division Chief Concerned of the operating units
Consolidates the submitted PPMP and forwards the same to the Budget Department Budget Department
Reviews to ensure that the submitted PPMP conforms to the Hospital’s thrusts and targeted objectives. It also ensures that the submitted PPMP conforms to the proposed budget. Then forwards the same to BAC for consolidation into APP

Bids and Awards Committee Secretariat
Consolidates the submitted PPMP duly reviewed by the Budget Department into the hospitals APP for approval of the head of the agency.

Head of the Agency
Approves the submitted APP.

Bids and Awards Committee Processes the Public biddings of items included in the APP.

Acquisition of Supplies, services and contracting of infrastructure projects through Public Bidding Procurement Department BAC, End-users and program managers concerned
Budget Department Accounting Department Strictly adheres to the provision of RA 9184 otherwise known as the Reformed Procurement Act in the conduct of the procurement process including the timelines set therein

As a general rule, all procurements shall be undertaken through competitive or public bidding.
Competitive Bidding refers to a method of procurement which is open to participation by any interested party. This consists of the following processes: a. Advertisement b. Pre-bid conference c. Screening of bid eligibility d. Evaluations of bids e. Post-qualification f. Awarding of contract, the specific requirements and mechanics are defined in the IRR of RA 9184. This is undertaken by the Bids and Awards Committee.

In some instances, alternative method of procurement can be resorted to in cases wherein there are already two failed biddings; purchase of items has already been consumed and additional items are needed; there is an unforeseen contingency requiring immediate purchase; and other conditions as stated in the provisions under Rule VI, IRR of RA 9184.

Table 3: Procurement Process

51 Finance Services Roles, Accountability and Responsibilities Manual of Standards for Management of Hospital Finance Service

6.7.3 Human Resource Management and Development Processes

Human resource management is a process, which contains four main activities, namely:

 Hiring and selection of qualified people  Development of people  Motivation of people  Maintenance of human resources

The Civil Service Commission provides the policies, rules and regulations in managing the human resources and establishes the standards for the recruitment, skills development higher levels of motivations, and ensuring the level of commitments including disciplines and performance evaluation and monitoring.

While financial management is about making financial decisions based on data collected and processed, human resource management is about placing of right person at the right place and right time. Human resources are considered one of the major assets of the organization, and their development into a high performance team is necessary. High performance can be achieved with provision of continual learning development programs, career advancement opportunities and measures for enhancing on-the-job satisfaction. Human resource development entails the integration of employees’ individual goals with the organizational goal, which may result in increased productivity and high performance result. The organization compensates its employees adequately for the purpose of improving employees’ competencies to respond to needs and standards and achieve goals.

6.7.4 Infrastructure and Asset Management

Infrastructure asset management refers to the integrated, multidisciplinary set of strategies in sustaining public infrastructure assets such as buildings, water treatment plan, sewer lines, roads, utility grids, bridges and railways (Wikipedia).
Generally, the financial process focuses the later stages of the facility’s life cycle specifically in its maintenance, rehabilitation and replacements. The fundamental goal is to preserve and extend the service life of long-term infrastructure assets.

52
Finance Services Roles, Accountability and Responsibilities Manual of Standards for Management of Hospital Finance Service

The basic premise of infrastructure asset management is to intervene at strategic points in an asset’s normal life cycle to extend the expected service life, and thereby maintain its performance. While each improvement raises an asset's condition curve, each rehabilitation resets an asset's condition curve, and complete replacement returns condition curve to new level or upgraded level. Therefore, strategically timing these interventions will aid in extending an asset's life cycle.

Essential processes and activities for infrastructure asset management include the following: 6.7.4.1 Maintaining a systematic record of individual assets (an inventory)—e.g., acquisition cost, original service life, remaining useful life, physical condition, repair and maintenance consistency. 6.7.4.2 Developing a defined program for sustaining the aggregate body of assets through planned maintenance, repair and replacement. 6.7.4.3 Implementing and managing information systems in support of these systems. These processes and activities are interrelated and interdependent aspects that usually cross organizational boundaries including finance, engineering and operations.

53 Finance Services Roles, Accountability and Responsibilities Manual of Standards for Management of Hospital Finance Service

6.8 Statutory and Regulatory Standards

These enacted laws, regulations and issuances serve as guide and reference in monitoring compliances of the different process owners in the performance of the mandated function in the hospitals.
For Hospital operations and management, the following statutory and regulatory standards shall be observed:

Laws, Regulations and Issuances Title

Description Republic Act (R.A.)
No. 11223 Universal Health Care Act, “An Act Instituting Universal Health Care Law for All Filipinos, Prescribing Reform in the Health Care System and Appropriation of Funds Therefor” R.A. No. 11463 Malasakit Center Act, “An Act Establishing Malasakit Centers in all DOH Hospitals in the Country and in the Philippine General Hospital (PGH), providing Funds Therefor and for Other Purposes”

R.A. No. 10173 Data Privacy Act of 2012, “An Act Protecting Individual Personal Information in Information and Communication Systems in the Government and the Private Sector Creating for this purpose a National Privacy Commission, and for Other Purposes”

R.A. No. 4226 Hospital Licensure Act, "An Act Requiring the Licensure of All Hospitals in the Philippines and Authorizing the Bureau of Medical Services to Serve as the Licensing Agency"

R.A. No. 9184 Government Procurement Reform Act, "An Act Providing for the Modernization, Standardization and Regulation of the Procurement Activities of the Government and for Other Purposes"

54
Finance Services Roles, Accountability and Responsibilities Manual of Standards for Management of Hospital Finance Service R.A. No. 6541 National Building Code of the Philippines, "An Act to Ordain and Institute a National Building Code of the Philippines”

R.A. No. 6713 Code of Conduct and Ethical Standards for Public Officials and Employees, "An Act Establishing a Code of Conduct and Ethical Standards for Public Officials and Employees, to Uphold the Time- Honored Principle of Public Office Being a Public Trust, Granting Incentives and Rewards for Exemplary Service, Enumerating Prohibited Acts and Transactions and Providing Penalties for Violations Thereof and for Other Purposes"

R.A. No. 10912 Continuing Professional Development Act of 2016, "An Act Mandating and Strengthening the Continuing Professional Development Program for All Regulated Professions, Creating the Continuing Professional Development Council, and for Other Related Purposes" R.A. No. 11058 "An Act Strengthening Compliance with Occupational Safety and Health Standards and Providing Penalties for Violations Thereof"

R.A. No. 6541 National Building Code of the Philippines, "An Act to Ordain and Institute a National Building Code of the Philippines"

R.A. No 11210 105-Day Expanded Maternity Leave Law, "An Act Increasing the Maternity Leave Period to One Hundred Five (105) Days for Female Workers with an Option to Extend for an Additional Thirty (30) Days Without Pay, and Granting an Additional Fifteen (15) Days for Solo Mothers, and for Other Purposes"

COA Circular No. 2017- 004 Guidelines on the Preparation of Financial Statements and Other Financial Reports and Implementation of the Philippine Financial Reporting Standards by Government Corporations Classified as Government Business Enterprises and Philippine Public Sector Accounting Standards by Non-Government Business Enterprises

55 Finance Services Roles, Accountability and Responsibilities Manual of Standards for Management of Hospital Finance Service DOH Administrative Order No. 2012-0012 Rules and Regulations Governing the New Classification of Hospitals and Other Health Facilities in the Philippines (as amended)

Other Issuances Affecting the internal and external processes in Finance Service and hospital operations  BIR Issuances and revised forms
 PhilHealth Issuances and revised list of requirements  Civil Service Commission Issuances
 DOH Issuances  COA Issuances  DBM issuances  GPPB Issuances in Implementing RA 9184  GSIS issuances including the insurance of hospital Physical plants and assets  BTr Issuances  HDMS Issuances

Manual of Standards for Management of Hospital Finance Service

CHAPTER 7

FINANCIAL AND
MANAGEMENT OFFICER:
HEAD OF FINANCE SERVICE

The Finance Service shall oversee the financial status of the hospital by providing financial projections and directly providing assistance in all strategic and tactical matters as they relate to budget management, cost benefit analysis, forecasting needs, and securing of possible other funding sources. The Finance Service is headed by the Financial and Management Officer (FMO) II. The FMO shall be reporting directly to the Medical Center Chief. The FMO shall be coordinating with the Chief Medical Professional Staff, Chief Nurse, Chief Administrative Officer and all the department heads pertaining to the strategic plans and goals of the hospital.

7.1 Interested Parties Internal Top Management – Medical Center Chief
Chief Medical Professional Staff Chief Administrative Officer Chief Nurse

All Department Heads

Hospital Committee

Employees

External Department of Health

Commission on Audit

Civil Service Commission

Legislative Bodies

Department of Budget and Management

Bureau of Internal Revenue

Bureau of the Treasury

Other National Government Agencies and Government Owned and Control Corporation

Patients/relatives

Service providers, private and other interested parties

7.2 Duties and Responsibilities

The head of the Finance Service shall be primarily responsible for managing the hospital’s finances, including financial planning, management of risks, records

57 FMO: Head of Finance Service Manual of Standards for Management of Hospital Finance Service keeping and financial reporting. The FMO shall be responsible for instilling discipline among the finance service staff to strictly adhere to the guiding principles in managing resources.

Specifically, the head of Finance Service shall be responsible in performing the following duties and responsibilities:

7.2.1 Policy and Regulation

7.2.1.1 Set goals, objectives, strategic and tactical action plans in mobilizing hospital resources; 7.2.1.2 Be proactive in terms of recommending new policies or revising existing ones in order to improve the financial operation of the hospital; 7.2.1.3 Formulate, institutionalize and administer internal financial policies for approval of the head of agency; 7.2.1.4 Ensure compliance to existing statutory laws, rules and regulations; and; 7.2.1.5 Coordinate with the chief of the hospital or medical center on the implementation of financial policies and procedures as it affects the medical operations of the facility.

7.2.2 Planning and Organization

Assist in the conduct of the hospital’s strategic planning activities to help analyze the hospitals financial strengths and weaknesses and propose the corresponding financial action plans aligned with the hospital’s major strategies.

7.2.3 Financial Management

7.2.3.1 Supervise, direct and control the activities of all offices under Finance Service; 7.2.3.2 Responsible for the accuracy and integrity of all financial data; 7.2.3.3 Ensure timely reporting of hospital financial performance and condition; 7.2.3.4 Identify and implement corrective actions for any non-conformity within the Finance Service; 7.2.3.5 Monitor compliance to COA Audit Observation and Recommendation and DOH Internal Audit Service (IAS) findings; 7.2.3.6 Implement efficient cash flow monitoring and financial planning; 7.2.3.7 Ensure proper allocation and optimize utilization of hospital resources;
7.2.3.8 Provide financial advisory services to management and other interested parties; and 7.2.3.9 Ensure viability and sustainability of hospital resources.

58 FMO: Head of Finance Service Manual of Standards for Management of Hospital Finance Service

7.2.4 Human Resource Management

7.2.4.1 Ensure continuing learning development intervention program for all personnel in the Finance Service; and 7.2.4.2 Pursue a continuing program of formal and informal education and training in financial management areas to maintain, strengthen and broaden concepts, ability and skills.

7.2.5 Facilities and Equipment

7.2.5.1 Endorse to the hospital management for approval such capital expenditure projects for improvement and/or renovations of the facilities including purchase of equipment with due consideration on hospital resources; and 7.2.5.2 Align the review of the hospital’s financial performance with the physical condition and operational performance of the facilities and equipment.

7.2.6 Other Managerial Functions

7.2.6.1 Conduct regular meeting with Department Heads of Finance Service; 7.2.6.2 Participate in meetings with executive management, medical departments and other offices which require financial updates and advisory services; 7.2.6.3 Maintain network with other government agencies on matters concerning fiscal and monetary policies; and 7.2.6.4 Have an open line communication link for transparency on the financial status of the hospital.

7.3 Guiding Principles

7.3.1 Impose disciplinary action among Finance Service Officers and employees found to be blatantly violating laws, regulations and policies.

7.3.2 Hold the concerned unit or individual responsible for the restitution of any disallowances due to non-compliance with existing COA and accounting rules and regulations.

7.3.3 Be abreast with the current issuances, decisions and trends in financial management.

7.3.4 Ensure that accurate, appropriate and timely reports are accomplished and submitted.

59 FMO: Head of Finance Service Manual of Standards for Management of Hospital Finance Service 7.3.5 Ensure that Key Performance Targets in the departments/sections under Finance Service have been met.

7.3.6 Keep a friendly environment in dealing with issues and concerns of internal and external interested parties.

7.4 Core Process

The FMO or head of the Finance Service performs the following core processes:

Organization Management Process Management Technology and Data Management Strategic Financial Management Functional Plan
Finance Quality Manual E-NGAS; Transaction Processing System Planning, Budgeting & Forecasting Organizational Structure for Finance
Methodology, Strategies and Governance

Strategic Planning / Risk management Cost Management Control Measures Data Management Reporting & Analytics Effective Leadership – Role Model Continual Improvement Leadership Effectiveness Assessment Tools Learning Development Strategies High Performance Team
Professional development Reporting and Analytics tool Capacity building Talent Management Capacity building Customer Satisfaction Survey Tools Succession Planning Performance Management
Key Performance Indicators (KPI) Balance Scorecard Performance Bonus/Incentives

60 FMO: Head of Finance Service Manual of Standards for Management of Hospital Finance Service Start Receive Hospital Goal for the Year Assess and report action plan progress Implement and Track Strategic Plan
Action Planning
Activities and Methods Set Vision, Mission, goals and objectives Analyze Current Situation End

7.4.1 Strategic Planning Process

Key Process Flow Key Person Key Tasks

FMO/ Head of FS

FMO/ Head of FS FS Departments/
Unit heads

FS Departments/
Unit heads

Receives the Goals set at the Execom Meeting and reviews accomplishment of prior years.

Determines current status and conducts SWOT Analysis to determine the strengths, weaknesses, opportunities and threats.

Revisits the current vision, mission, goals and objectives. Determines where and what needs to be attained for the year and onward.

Determines the strategies, activities and plans to achieve the set goals and objectives. Indicates the indicators with specific timelines and needed resources.

Implements the different strategic plans set, monitors and evaluates whether the set indicators have been met.

Assesses and submit report for Management Review.
Determines the progress rate and cause for non-compliance, if any

61 FMO: Head of Finance Service Manual of Standards for Management of Hospital Finance Service

7.5 Reportorial and Documentary Requirements

7.5.1 Monthly Report of Attendance (MRA) of Finance Staff 7.5.2 Quality Objective and Plan (QOP) Monitoring Report
7.5.3 Minutes of Management Meeting 7.5.4 Performance Balance Scorecard Report of Accomplishment 7.5.5 Performance Evaluation Report (DPCR) 7.5.6 Annual Accomplishment Report 7.5.7 Action Taken on Noted Non-Conformities, if any 7.5.8 Other reports as needed by the Executive Committee and the Department of Health

Manual of Standards for Management of Hospital Finance Service

CHAPTER 8

ACCOUNTING DEPARTMENT

The Accounting Department shall direct and coordinate to all concerned units the systematic recording of all financial transactions, preparation of financial statements and relevant reports, as well as the maintenance and safekeeping of Books of Accounts. Government Accounting entails analyzing, recording, classifying, summarizing and communicating all transactions, which involve receipt and use of government funds and property. It also includes the reporting and interpretation of results of these transactions. (PD 1445: Ordaining and Instituting Government Auditing Code of the Philippines). Government accounting shall aim to:

 Produce information concerning past operations and present conditions;  Provide a basis for guidance for future operations;  Provide control for the acts of public bodies and officers in the receipt, disposition and utilization of funds and property; and  Report on the financial position and status and the results of operations of government agencies for the information of all persons concerned.

For Level 3 hospitals, Accounting Department is headed by an Accountant IV who reports directly to the Financial and Management Officer (FMO) II. For level 1 and level 2 hospitals, the head of the Accounting Department / section shall be reporting to the head of the Hospital Operations and Patient Support Service (HOPSS).

8.1 Interested Parties

Provides services to: Internal Top Management – Medical Center Chief/Chief of Hospital Chief Medical Professional Staff Head, Hospital Operations and Patient
Support Service
Head, Finance Service Head, Nursing Service

All Department Heads

Hospital Committees

Employees

63 Accounting Department Manual of Standards for Management of Hospital Finance Service External Department of Health

Commission on Audit

Legislative Bodies

Department of Budget and Management

Bureau of Internal Revenue

Bureau of the Treasury

Other National Government Agencies and Government Owned and Control Corporations

Patients/Relatives Authorized Government Depository Bank

Suppliers/Service providers, private and other interested parties

Expects Output/services from:

Internal Budget Department

Billing and Claims Department

Cash Operations Department

Human Resource Management Department

Procurement Department

Materials Management Department

Pharmacy Department

Cost and Revenue Centers

Nutrition and Dietetics Department

Health Information Management Department

Central Supply Unit

Medical Social Work Department

Other Hospital Operation and Patient Support Units

8.2 Guiding Principles:

8.2.1 No funds shall be disbursed and no expenditures shall be incurred without first securing the certification of its Chief Accountant or head of accounting unit and budget unit as to the availability of funds and the allotment to which the expenditure or obligation may be properly charged.

8.2.2 Proper classification of accounts and use of the coding structure in the new chart of accounts shall be followed to achieve uniformity in recording transactions.

8.2.3 The following General Purpose Financial Statements (GPFS) shall be prepared and presented to ensure comparability with previous periods:  Statement of Financial Position
 Statement of Financial Performance  Statement of Changes in Net Assets/Equity (SCNA/E)  Statement of Cash Flows  Statement of Comparison of Budget and Actual Amount (SCBAA)

64 Accounting Department Manual of Standards for Management of Hospital Finance Service  Notes to Financial Statements comprising a summary of significant accounting policies and other Explanatory notes

8.2.4 Responsibility for the fair presentation and reliability of the general purpose financial statements rests with the management particularly the Head of the Agency or his/her authorized representative and Financial and Management Officer/Head of the Accounting Department.

8.2.5 Financial recording and reporting shall strictly adhere to generally accepted government accounting principles in accordance with the Philippine Financial Reporting Standards (PFRS), Philippine Public Sector Accounting Standards (PPSAS) and pertinent laws, rules and regulations.

8.3 Duties and Responsibilities

The head of the Accounting Department shall be primarily responsible for managing the operation and works in the department, including financial planning, management of risks, record keeping and financial reporting. He/she shall be responsible for instilling discipline among the accounting staff to strictly adhere to the guiding principles and policies instilled in the hospital, observe the Code of Ethics for Accountants and continually improve the quality of works being provided to the interested parties being served.

Specifically, the Accounting Department shall be responsible in performing the following duties and responsibilities:

8.3.1 Direct and implement the generally accepted accounting and auditing principles and other pertinent laws, rules and regulations;

8.3.2 Process financial transactions;

8.3.3 Process and certify as to the availability of funds of contracts and purchase orders;

8.3.4 Process and certify as to the availability of cash, propriety and completeness of supporting documents for disbursements;

8.3.5 Implement and monitor the systematic recording of financial transactions;

8.3.6 Maintain/update the Books of Accounts per fund cluster;

8.3.7 Prepare and analyze Financial Statements;

8.3.8 Maintain/reconcile General Ledger Accounts with subsidiary ledgers;

8.3.9 Provide data of available funds from sources other than GAA;

65 Accounting Department Manual of Standards for Management of Hospital Finance Service 8.3.10 Provide Notice of Obligation Request and Status Adjustment (NORSA) and Notice of Budget Utilization Request and Status Adjustment (NBURSA);

8.3.11 Provide technical assistance on financial matters;

8.3.12 Provide financial information that is useful in making decisions involving the effective and efficient allocation and control of government resources;

8.3.13 Sign clearance for the money accountability of personnel and certificate of remittances (GSIS, HDMF, PHIC, BIR, etc.);

8.3.14 Monitor and prepare liquidation reports for any financial assistance;

8.3.15 Monitor status of liquidation of cash advances granted to officers and employees; and

8.3.16 Perform other related accounting works.

8.4 Core Processes

The Accounting Department shall be responsible for the following major processes:

8.4.1 Processing of Purchase Orders/Contracts, which require review and verification of the documentary requirements and certification as to availability of funds before the approval of the contract by the Head of the Agency.

8.4.2 Processing of all disbursement vouchers for payment of completed financial transactions based on approved obligations, completeness of supporting documents and availability of cash.

8.4.3 Preparation of Financial Reports – the Accounting Department shall ensure the accuracy, completeness, reliability and timeliness in the preparation and submission of all the required reports and its supporting documents.

8.4.4 Preparation and submission of fund utilization report – this pertains to the collation of all charges to various financial assistance received and submission of the same for liquidation.

66 Accounting Department Manual of Standards for Management of Hospital Finance Service 8.5 Process Flow

8.5.1 Processing of Purchase Order (PO)
Key Process Key Person Responsible Key Tasks

Accounting Staff (Receiving)

Accounting Clerk

Head of Accounting (HOA)

Accounting Clerk

Receives the PO with the supporting documents.
Stamps “RECEIVED” and indicates the date of receipt on the face of the PO.

Records in the logbook for PO, with the corresponding number, name of supplier and total contract amount and ORS/BURS number

Reviews, verifies and checks the propriety of supporting documents
Verifies and checks the source of fund as indicated in the attached ORS/BURS

Checks as to completeness of supporting documents and as to its appropriateness

If complete, forwards the PO with all the supporting documents for processing.

If not, returns to originating office with noted deficiencies

Records in the fund control record book, the PO number and date, name of creditor, and the total contract amount

Signs availability of funds portion of the PO and forwards to Head of Agency for approval

NO Return to concerned office YES START Receive PO, Stamps “RECEIVED” and indicate date of PO Review, verify and check the propriety of supporting documents Check
Completeness Forward the PO for processing Record in the fund control record book Sign the PO and forward to the HOA for approval END

Record in the logbook for PO

67 Accounting Department Manual of Standards for Management of Hospital Finance Service

8.4.1.2 Processing of Disbursement Voucher (DV) for Payment

Key Process Key Person Responsible Key Tasks

Accounting Staff (Receiving Clerk)

Accounting Staff

Receives Disbursement Voucher with supporting documents. Stamps “RECEIVED” and indicates the date of receipt in the face of the DV.

Assigns DV number and record in the corresponding receiving Logbook

Checks as to completeness of supporting documents and as to its appropriateness

If complete, forwards the DV with all the supporting documents for processing.

If not, forwards the DV and supporting documents with noted deficiencies to the concerned office.

Indicates source of fund based on the attached Obligation Request and Status (ORS)/Budget Utilization Request and Status (BURS)

Retrieves index if with prior payment

A START

Receive DV with supporting documents YES NO Assign DV number and record in the logbook Check
Completeness

Review / Process DV Retrieve Index of Payment Return the DV to concerned Office Start 1 Indicate source of fund on the ORS/BURS

68 Accounting Department Manual of Standards for Management of Hospital Finance Service

Key Process Key Person Responsible Key Tasks

Accounting Staff

Head of Accounting

Checks if with prior payment.

If YES, return DV to concerned office, if ORS/BURS tallies with DV

If NO prepares (NORSA) / (NBURSA)

Reviews the DV and supporting documents, and prepares Journal entries on box B.

Records DV in the index of payment. Initials and forwards to Head of the Accounting

Retrieves Registry of Allotments and Notice of Cash Allocation (RANCA) / Registry of Allotment and Notice of Transfer of Allocation (RANTA) from file and determines availability of Cash.

A B

Check if with prior payment YES NO Return DV to concerned office Prepare NORSA/NBURSA C Review DV and supporting documents/prepares journal entry Record DV in the index of payment Retrieve RANCA /RANTA for availability of cash

69 Accounting Department Manual of Standards for Management of Hospital Finance Service

Key Process

Key Person Responsible

Key Tasks

Accounting Staff

Receiving / Releasing Staff

Accounting Staff

If Yes, returns to concerned section for correction.

If No, based on reports submitted, classifies, summarizes and records each account with corresponding account code and prepares the following special journals:

Check Disbursements Journal – for Report of Checks Issued (RCI)
Cash Receipts Journal – for Report of Collections and Deposits (RCD)
Cash Disbursements Journal – for payroll
General journal

for other reports
non cash transactions
adjustments

Based on Special Journals, prepares appropriate Journal Entry Voucher. -Refer to chart of Accounts of GAM for NGAs

Reviews Journal Entry Voucher prepared by Accounting Staff

Review and sign box C of DV Forward to the Head of the agency for approval

Cash Available? END Retain Voucher Yes No B

70 Accounting Department Manual of Standards for Management of Hospital Finance Service

8.4.13 Financial Report Process Key Process Key Person Responsible Key Tasks

Receiving Staff

Accounting Staff

Receives reports from different departments: Cash Operations -Report of Checks Issued (RCI)/Report of ADA Issued RADAI -Report of Unreleased Checks -Report of Collections and Deposits (RCD) -Payroll Billing and Claims -Report of Bills Rendered (RBR) Materials Management Section -Daily Report of Deliveries -Report of Supplies and Materials Issued -Report of Donation -Inventory and Inspection Report of Unserviceable Property (IIRUP) -Report of Lost Stolen Destroyed, Damaged Property (RLSDDP)
Pharmacy Department -Drugs and Medicines Consumption Report -Laboratory -Central Supply Room -Dental -Dietary -Radiology Retrieves index if with prior payment

Reviews and checks report against the supporting documents.

START Receive reports

Review and check A

71 Accounting Department Manual of Standards for Management of Hospital Finance Service Key Process Key Person Responsible Key Tasks

Accounting Staff

If Yes, returns to concerned section for correction.

If No, based on reports submitted, classifies, summarizes and records each account with corresponding account code.

Prepares the following journals:

Check Disbursements Journal – for Report of Checks Issued (RCI)
Cash Receipts Journal – for Report of Collections and Deposits (RCD)
Cash Disbursements Journal – for payroll
General journal

for other reports
non cash transactions
adjustments

Based on Special Journals, prepares appropriate Journal Entry Voucher. -Refer to chart of Accounts of GAM for NGAs

Reviews Journal Entry Voucher prepared by Accounting Staff

Yes No With Discrepancies?

Classify, summarize and record account with account code Prepare Journal Entry Voucher (JEV)

Review JEV, Journals and Analyze Return to concerned office A B

Prepare Special Journals

72 Accounting Department Manual of Standards for Management of Hospital Finance Service Key Process Key Person Responsible Key Tasks

Accounting Staff

Accounting Staff (AS) /Head of the Accounting (HOA)

AS/HOA

Posts the monthly summarized journal entries from the Special Journals and General Journal to the respective General Ledgers.

Posts the source / summarizing documents to the respective SLs

Foots and Extracts the balances of GLs and SLs

Based on the balances in the GL, prepares the unadjusted Trial Balance to check the equality of debits and credits

Prepares Adjusting Journal Entries through the Journal Entry Voucher for unrecorded transactions and for all accounts that need to be adjusted/corrected

Records the Journal Entry made for adjustment in the General Journal and affected Subsidiary ledgers

Foots and Extracts the balances of GLs and SLs

Based on the General Ledgers, prepares Post Closing Trial Balance

B C Post monthly summarized journal entries Record the Journal Entry and affected subsidiary ledgers

Foot and Extract the balances of GLs and SLs Post the source / summarizing documents to the respective SLs

Prepare Adjusting Journal Entries Prepare the unadjusted Trial Balance

Foot and Extract the balances of GLs and SLs Prepare Post Closing Trial Balance

73 Accounting Department Manual of Standards for Management of Hospital Finance Service Key Process Key Person Responsible Key Tasks

AS/HOA

Reconciles the supporting schedules presented in the Notes to Financial Statements with the amounts in the Post-Closing Trial Balance.

If not reconciled, prepares the necessary corrections through JEV. Records the JEV in the GJ

Posts the GJ in the respective GLs, and prepares the revised Post-Closing Trial Balance.

Reviews and signs “Certified Correct by” portion of the Post- Closing Trial Balance and supporting schedules

Based on the Post Closing Trial Balance prepares the Financial Statements:
-Statement of Financial Position,
-Statement of Financial Performance -Statement of Cash Flows -Statement of Changes in Net Assets/Equity -Statement of Comparison of Budget and Actual Amounts; and
-Notes to Financial Statements, comprising a summary of significant accounting policies and other explanatory notes

Submits monthly and quarterly reports to COA Auditor, DBM and DOH

Submits year-end financial statements and reports to COA Auditor , DBM and COA- Government Accountancy Sector (GAS)

Reconcile supporting schedules

Post the GJ and prepare revised post-closing trial balance Prepare necessary corrections and record the JEV Prepare Financial Statement Review and sign post- closing trial balance and supporting schedules Submit report to COA, DBM, DOH or COA, DBM, GAS END

74 Accounting Department Manual of Standards for Management of Hospital Finance Service 8.6 Reportorial and Documentary Requirements

8.6.1 Monthly Reports

Submitted to COA Resident Auditor, DBM and DOH within ten (10)

days after the end of the month:

8.6.1.1 Trial Balance (TB) and Supporting Schedules 8.6.1.2 Monthly Report of Disbursements (FAR 4) 8.6.1.3 Monthly Report of Internally Generated Funds (Income) 8.6.1.4 Monthly Report of Business Related Funds (Revolving Fund) 8.6.1.5 Report on the Status of Unpaid Authorized Personnel Benefits 8.6.1.6 Cash Disbursement Journal 8.6.1.7 General Journal 8.6.1.8 Cash Receipts Journal 8.6.1.9 Check Disbursements Journal 8.6.1.10 Journal of Bills Rendered 8.6.1.11 Bank Reconciliation Statement 8.6.1.12 Accomplishment Report 8.6.1.13 Other reports as needed by the Department of Health Central Office 8.6.1.14 Statement of Appropriations, Allotments, Obligations Balances and Disbursements (SAAOBD)

8.6.2 Quarterly Reports

Submitted to COA Auditor, DBM and DOH

Based on COA-DBM Joint Circular (JC) No. 2019-1 dated January 1, 2019 prescribing the updated guidelines relative to Budget and Financial Accountability Reports (BFARs) starting FY 2019, the timeline for submission of FAR Nos. 1, 1-A, 1-C, 2, 2-A, 5 and 6 is within 30 days after the end of each quarter. Unless the primary intention is to submit reports for management use/review, and later submission to the external users.

8.6.2.1 Statement of Appropriations, Allotments, Obligations, Disbursements and Balances (FAR No.1) 8.6.2.2 Summary of Appropriations, Allotments, Obligations, Disbursements and Balances by Object of Expenditures (FAR No.1-A) 8.6.2.3 Statement of Appropriations, Allotments, Obligations, Disbursements and Balances for Inter-Agency Fund Transfers (FAR No.1-C) 8.6.2.4 Statement of Approved Budget, Utilizations, Disbursements and Balances (FAR No.2) 8.6.2.5 Statement of Approved Budget, Utilizations, Disbursements and Balances by Object of Expenditures (FAR No.2-A) 8.6.2.6 Quarterly Report of Revenue and Other Receipts (FAR No.5)

75 Accounting Department Manual of Standards for Management of Hospital Finance Service 8.6.2.7 Statement of Approved Budget, Utilizations, Disbursements and Balances for Trust Receipts (FAR No. 6)

Submitted within ten (10) days after the end of each quarter.

8.6.2.8 Report of Income 8.6.2.9 Trial Balance 8.6.2.10 Statement of Financial Position 8.6.2.11 Detailed Statement of Financial Position 8.6.2.12 Statement of Financial Performance 8.6.2.13 Detailed Statement of Financial Performance 8.6.2.14 Statement of Changes in Net Assets/Equity 8.6.2.15 Statement of Cash Flows 8.6.2.16 Report on Salaries and Allowances (ROSA) of three highest officers of the hospitals 8.6.2.17 Cash Advances Report
8.6.2.18 Other reports as needed by the Department of Health Central Office

8.6.3 Semestral Reports

8.6.3.1 Actual MOOE & CO Provided by Audited Agency 8.6.3.2 Aging of Receivables and Payables 8.6.3.3 Status Reports on Cash Advances 8.6.3.4 Fund Transfers and other receivables 8.6.3.5 Performance Evaluation Report of Accounting Staff (SPCR and IPCR) 8.6.3.6 Other reports as needed by the Department of Health Central Office

8.6.4 Annual Reports

These reports must be submitted on the prescribed timeline.

8.6.4.1 Pre-closing Trial balance 8.6.4.2 Post-closing Trial balance 8.6.4.3 Detailed and Condensed Statement of Financial Performance (SFPer) 8.6.4.4 Detailed and Condensed Statement of Financial Position (SFP) 8.6.4.5 Statement of Changes in Net Assets / Equity (SCNA/E) 8.6.4.6 Statement of Cash Flows 8.6.4.7 Statement of Comparison of Budget and Actual Amount
(SCBAA) 8.6.4.8 Notes to Financial Statements
8.6.4.9 Statement of Management Responsibility 8.6.4.10 Statement of Allotments, Obligations, Balances and
Disbursements (SAOBD) 8.6.4.11 Aging of Unpaid Obligations (FAR No.3) 8.6.4.12 Schedule/Aging of Payables 8.6.4.13 Schedule/Aging of Receivables

76 Accounting Department Manual of Standards for Management of Hospital Finance Service

8.6.4.14 Report on Salaries and Allowances (ROSA) of three highest officers of the hospitals 8.6.4.15 Report on the Status of Unpaid Authorized Personnel Benefits 8.6.4.16 Budget Execution Document (BED No. 3) 8.6.4.17 Other reports as needed by the Department of Health Central Office 8.6.5 Other Reports

8.6.5.1 Hospital Scorecard
8.6.5.2 Other reports as needed by the Department of Health Central Office

Manual of Standards for Management of Hospital Finance Service CHAPTER 9

BUDGET DEPARTMENT

The Budget Department shall direct and coordinate the consolidation and preparation of the budget proposal and Work and Financial Plan including its implementation and monitoring. Primarily, the Budget Department aims to:

 Provide technical assistance in the planning of the strategic direction and structure of the agency.

 Directs the effective and efficient utilization of the agency’s resources in implementing plans, programs and activities.

 Measure agency performance. For Level 3 hospitals, Budget Department is headed by the Supervising Administrative Officer (SAO) who reports directly to the Financial and Management Officer II (FMO).
For level 1 and level 2 hospitals, the head of the Budget Department / Section shall be reporting to the head of the Hospital Operations and Patient Support Services (HOPSS).

9.1 Interested Parties

  Provides services to:

Internal Top Management – Medical Center Chief/Chief of Hospital
Chief Medical Professional Staff Head, Hospital Operations and Patient
Support Service
Head, Finance Service Head, Nursing Service

All Department Heads

Hospital Committees

Employees

External Department of Health

Commission on Audit

Legislative Bodies

Department of Budget and Management

Bureau of the Treasury

Other National Government Agencies and Government

78 Budget Department Manual of Standards for Management of Hospital Finance Service Owned and Control Corporation

Suppliers/Service providers, private and other interested parties

Expects Output/services from:

Internal

Accounting Department Billing and Claims Department Cash Operations Department

Human Resource Management Department

Procurement Department

Materials Management Department

Pharmacy Department

Cost and Revenue Centers

Nutrition and Dietetics Department

Health Information Management Department

Central Supply Unit

Medical Social Work Department

Hospital Quality Management System Office

Ancillary Services Departments/units Bids and Awards Committee

All other Sections/Units/Department under Medical Services, Nursing Services and Hospital Operation and Patient Support Units

9.2 Guiding Principles 9.2.1 Government laws and regulations on expenditures of government funds shall be strictly observed. 9.2.2 Availability of allotment shall be certified in accordance with the General Appropriation Act (GAA) and other sources. 9.2.3 All financial transactions shall be in accordance with the Work and Financial Plan and Annual Procurement Plan supported with complete documents. 9.2.4 Financial forecasts shall be regularly monitored and periodically updated for the attainment of hospital goals and objectives.

9.3 Duties and Responsibilities The head of the Budget Department shall be responsible in managing the operation and works in the department. He/she shall be responsible in instilling discipline among the budget staff to strictly adhere to the guiding principles, policies and standards based on existing rules and regulations; observe strictly the code of conduct and ethical standards of public officials and employees; and continually improve the quality of works being provided to the interested parties being served. Specifically, the Budget Department shall be responsible in performing the following duties and responsibilities:

Budget Department Manual of Standards for Management of Hospital Finance Service

9.3.1 Direct, analyze, consolidate and submit Budget Proposal, and Work and Financial Plan;

9.3.2 Analyze, monitor and control allotment and fund utilization report;

9.3.3 Allocate available funds to hospital programs, activities and projects based on approved guidelines, policies and priorities;

9.3.4 Certify Availability of Allotment/Budget and the purpose of obligation/utilization;

9.3.5 Maintain registries of appropriations, allotments, obligations, and disbursements;

9.3.6 Ensure the accuracy and correctness of the Obligation Requests/Budget Utilization Requests;

9.3.7 Consolidate, encode and submit the URS generated copy of the Budget Execution Documents (BEDs) to the Department of Budget and Management (DBM) and Budget and Financial Accountability Reports (BFARs) to the DBM, DOH and Commission on Audit – Government Accountancy Sector (COA-GAS).

9.3.8 Plan, direct and prepare request for realignment/reprogramming of funds;

9.3.9 Provide technical assistance to and coordinate with all units regarding budget related matters;

9.3.10 Forecast future hospital operating income for planning and for decision making;

9.3.11 Prepare various communications/requests relating to the release of additional/supplemental allotment and other matters relating to the budget of the hospital;

9.3.12 Serve as the hospital’s liaison officer for budgetary matters; and

9.3.13 Performs other technical and related tasks in support to the uninterrupted management of the hospital operation.

80 Budget Department Manual of Standards for Management of Hospital Finance Service

9.4 Core Process

Government Budget is the financial plan of a government for a given period, usually for a fiscal year, which shows what its resources are, and how they will be generated and used over the fiscal period. The budget is the government's key instrument for promoting its socio-economic objectives. The government budget also refers to the income, expenditures and sources of borrowings of the National Government (NG) that are used to achieve national objectives, strategies and programs. {Source: GAM for NGAs Vol. I, Chapter 2, Section 2(h)}.

As such, budgeting is a critical exercise in allocating revenues and borrowed funds to attain the country’s goals. It entails the management of government expenditures that will create the most economic impact from the production and delivery of goods and services while supporting a healthy fiscal position. Through the budget, the government is able to plan and manage its financial resources to support the programs and projects that best promote the nation’s development. Through the budget, the government can prioritize plans, programs and policies within its financial capability, which may be pressured by economic conditions. (DBM Primer on Government Budgeting Updated June 07, 2017). The hospital’s own budget shall be vital in the effective and efficient management of its operations, and shall ensure proper implementation in the planning and managing of financial resources.

All budget functions in government institution are governed by the standards implemented by the Department of Budget and Management (DBM) through the issuance of the National Budget Call during the first quarter of the ensuing year.

There are established four phases of Budget Cycle, in which the Budget Department shall be responsible in managing, implementing and monitoring these budget major processes:

Figure No. 3.1: Budget Cycle

Budget Department Manual of Standards for Management of Hospital Finance Service 9.4.1 Budget Preparation

Budget preparation starts upon receipt of the Budget call issued by DBM. It includes the criteria, parameter and procedures in preparing the hospital budget proposal. The head of Budget Department shall coordinate with the top management and all the heads of departments, units and programs to submit their priority programs and activities and estimated cost to implement them; consolidate, validate, participate in the deliberation and submit the Budget Proposal for approval by the Executive Committee (Execom)/Management Committee (Mancom) of the hospital before submission to the DOH and DBM. The timeline for this process usually starts on the first quarter prior to the next fiscal year.

9.4.2 Budget Legislation/Authorization

The proposed budget of the hospital passes through series of stages from its submission to final approval. All the Budget Proposals are consolidated at the DOH level, and together with the DOH Budget Proposal shall be forwarded to DBM through Online Submission of Budget Preparation System (OSBPS). The DBM is responsible for consolidating and drafting the National Budget based on the major thrust of the President of the Philippines. The National Budget passes through the scrutiny of the legislative body, Committee on Appropriations of the House of Representatives and Senate Finance Committee before it will be passed into Law to be approved by the President of the Philippines.

9.4.3 Budget Execution/Implementation

Upon approval of General Appropriations Act (GAA) as allotment order, the head of the Budget Department of the hospital executes the approved expenditure programs. Obligations are incurred chargeable against the regular hospital budgets based on the approved program for the year. It ensures that the process by which financial resources are made available to the hospital operation are directed and controlled towards achieving the purposes for which the budget was approved in strict compliance to existing accounting, budgeting, and auditing rules and regulations.

9.4.4 Budget Accountability

The Budget Department of the hospital submits Budget and Financial Accountability Reports (BFARs) on a monthly or quarterly basis, as

82 Budget Department Manual of Standards for Management of Hospital Finance Service

required by DBM and COA (COA-DBM JOINT CIRCULAR Nos. 2014-1 dated July 2, 2014, and 2019-1 January 1, 2019). Proper monitoring is being done, verifying whether the set targets and objectives have been achieved based on the approved targeted outcomes, outputs and performance indicators of the hospital. These are reflected in the hospital’s BEDs, which effectively serve as the hospital’s approved plans for the year.
Any deviation or discrepancies shall be reported to the Head of the Finance Service and the head of the agency.

Budget Department Manual of Standards for Management of Hospital Finance Service 9.5 Process Flow
9.5.1 Preparation of Budget Proposal Key Process
Key Person Responsible Key tasks

MCC, FMO, Accountant, Budget Head

MCC

Budget Staff

Hospital Budget Deliberation Committee

Head, Budget Department

Head, Budget Section

Attends forum and receives Budget Call guidelines from DBM

Issues Hospital Memorandum for the submission of budget proposal

Collects and consolidates necessary data needed for budget deliberation from concerned offices

Conducts Budget Deliberation for validation of proposals

Finalizes Budget Proposal based on the results of budget deliberation

Forwards to the FMO II and MCC the finalized Budget Proposal for review/initial/ Approval

START Collect and Consolidate data
Conduct Budget Deliberation Attend DBM Budget Forum

Finalize Budget Proposal

Forward for approval
Issue Hospital Memorandum A

84 Budget Department Manual of Standards for Management of Hospital Finance Service Key Process
Key Person Responsible Key tasks

Budget Staff

Head, Budget Section

Receives approved budget proposal for submission to the Department of Health (DOH)

Submits Budget Proposal to DOH copy furnished DOH- Field Implementation and Coordination Tem (FICT) and regional office if necessary

END Receive approved budget proposal

Submit Budget Proposal
A

Budget Department Manual of Standards for Management of Hospital Finance Service 9.5.2 Processing of Obligation Request & Status (ORS} and Budget Utilization Request & Status (BURS)
Key Process Key Person Key Task

Receiving/ Releasing Staff

Budget Staff

Receives ORS/BURS including DV/Payroll, Contract/Purchase Order (PO) and other Supporting Documents (SDs).

Verifies completeness of the documents based on attached checklist and Stamps “Received” and indicate the date of receipt in the ORS/BURS.

If Yes, records in the logbook and forwards to Budget Staff

If No, returns to concerned office for completion of documents

Verifies availability of allotment/budget based on the RAOD

If yes, assigns number on the ORS/BURS based on the control logbook.
Records the amount in the Registry of Allotment, Obligation and Disbursement, initials in Box B then forward all documents to Head of Budget for signature

If the allotment is not available, returns the documents to the office/personnel concerned

Receive ORS/BURS Assign number on the ORS/BURS. Record the amount of RAOD and forward to Head of the Budget for signature Allotment Available? Return to concerned office Start Verify availability of allotment/budget A NO YES Record in the logbook and forward to Budget staff Complete document? NO YES Return to concerned office

86 Budget Department Manual of Standards for Management of Hospital Finance Service END Forwards ORS/BURS
A Review and Certify Availability of Allotment Key Process Key Person Key Task

Head, Budget Department

Receiving/ Releasing Staff

Reviews the ORS/BURS and SDs & Certifies availability of allotment and purpose of obligation/ utilization

Forwards ORS/BURS and SDs to Accounting Department for the processing of claim. Retain original copy of ORS/BURS for monitoring of obligation/ utilization status.

Budget Department Manual of Standards for Management of Hospital Finance Service 9.5.2 Preparation and Submission of Statement of Appropriations, Allotments, Obligations, Balances and Disbursements (SAAOBD) Key Activities Responsible person Responsibility/ Activity

Budget Staff

Head of Budget

Head of Accounting

FMO

MCC

Budget Staff

Gathers data from different registries summarize and encode in the SAAOBD Report.

Reviews the correctness of the data entered and initials the report and forwards to the Head of the Budget

Validation/Verification as to correctness of the data entered.

If incorrect, returns to budget staff for revision

If correct, Certifies the Correctness of the report and forwards to the accounting

Validates and certifies to the correctness of the report and forwards to the FMO

Initials the report and forwards to MCC for approval

Once signed, sends back the report to the Budget office.

Submits the scanned report to through email and hard copy to DOH

Gather data from registries Certify correctness of the report and forwards to accounting
Return to Budget Staff START Review and Initial the Report Yes No Correct data? Certify the correctness of the report Review and affix initial to the report Approve and sign the report Submit report to DOH Finance Div. END

88 Budget Department Manual of Standards for Management of Hospital Finance Service

9.6 Reportorial and Documentary Requirements:

9.6.1 Records/Documents

9.6.1.1 Registry of Revenue and Other Receipts (RROR) 9.6.1.2 Registry of Appropriations and Allotments (RAPAL) 9.6.1.3 Registry of Allotments, Obligations and Disbursement Personnel Service (RAODPS) 9.6.1.4 Registry of Allotments, Obligations and Disbursements Maintenance and Other Operating Expenses (RAODMOOE) 9.6.1.5 Registry of Allotments, Obligations and Disbursements – Financial Expenses (RAODFE) 9.6.1.6 Registry of Allotments, Obligations and Disbursements Capital Outlays (RAODCO) 9.6.1.7 Registry of Budget, Utilization and Disbursements Maintenance and Other Operating Expenses (RBUDMOOE) 9.6.1.8 Other reports as needed by the Department of Health Central Office

9.6.2 Monthly Reports

9.6.2.1 Statement of Appropriations, Allotments, Obligations, Balances and Disbursements (SAAOBD) 9.6.2.2 Other reports as needed by the Department of Health Central Office

9.6.3 Quarterly Reports

9.6.3.1 Quarterly Physical Report of Operation (QPRO) BAR No. 1 9.6.3.2 Statement of Appropriations, Allotments, Obligations, Disbursements and Balances (SAAODB) FAR No.1 9.6.3.3 Summary of Appropriations, Allotments, Obligations, Disbursements and Balances by Object of Expenditures (SAAODBOE) FAR No. 1-A 9.6.3.4 List of Allotments and Sub-Allotments (LASA) FAR No. 1-B 9.6.3.5 Statement of Obligations, Disbursements, Liquidations and Balances for Inter-Agency Fund Transfer FAR No. 1-C 9.6.3.6 Statement of Approved Budget, Utilizations, Disbursements and Balances (SABUDB) FAR No. 2 9.6.3.7 Statement of Approved Budget, Utilizations, Disbursements and Balances by Object of Expenditures (SABUDBOE) FAR No. 2-A 9.6.3.8 Statement of Approved Budget, Utilizations, Disbursements and Balances for Trust Receipts FAR No. 6 9.6.3.9 Other reports as needed by the Department of Health Central Office

Budget Department Manual of Standards for Management of Hospital Finance Service

9.6.4 Semestral Reports

9.6.4.1 Performance Evaluation Report of Budget Staff (DPCR/SPCR and IPCR) 9.6.4.2 Other reports as needed by the Department of Health Central Office

9.6.5 Annual Reports

9.6.5.1 Estimate of Income Collection and Utilization 9.6.5.2 Budget Proposal  BP Form 100B – Statement of Other Receipts/Expenditures  BP Form 201 – Actual Obligations  BP Form 201 – Current Program  BP Form 201 – Proposed Program  Budget Deliberation Forms  Cluster Deliberation Forms

9.6.5.3 Work and Financial Plan (WFP) 9.6.5.4 Financial Plan {Budget Execution Document (BED No. 1)} 9.6.5.5 Physical Plan {Budget Execution Document (BED No. 2)} 9.6.5.6 Aging of Unpaid Obligations FAR No. 3
9.6.5.7 Statement of Comparison of Budget and Actual Amount (SCBAA) 9.6.5.8 Other reports as needed by the Department of Health Central Office

Manual of Standards for Management of Hospital Finance Service

CHAPTER 10

CASH OPERATIONS DEPARTMENT

The Cash Operations Department shall direct the overall efficiency of cash management that includes collection and disbursement processes. The primary objective of Cash Operations is to efficiently maximize the use of cash in line with the direction, plans and goals of the hospital. Specifically, it aims to:

 Ensure the hospital’s financial capacity to meet obligations as needed;  Regulate, monitor and control the use of cash resources to protect the hospital against financial vulnerability and other risks; and  Maximize the value and use of cash resources.

For Level 3 hospitals, Cash Operations Department is headed by the Supervising Administrative Officer (SAO) who reports directly to the Financial and Management Officer II (FMO). For level 1 and level 2 hospitals, the head of the Cash Operations Department / Section shall be reporting to the head of the Hospital Operations and Patient Support Service (HOPSS).

10.1 Interested Parties

     Provides Services to:

Internal Top Management – Medical Center Chief/Chief of Hospital Chief Medical Professional Staff Head, Hospital Operations and Patient
Support Service (HOPSS) Head, Finance Service Head, Nursing Service

All Department Heads

Hospital Committees

Employees

PETO/PETRO

91 Cash Operations Department Manual of Standards for Management of Hospital Finance Service External Patients/Patient Relatives

Commission on Audit Bureau of the Treasury Authorized Government Depository Bank (AGDB)

Affiliating Schools

Suppliers/Service providers, private and other interested parties

Expects Inputs/services from:

Internal
Accounting Department Billing and Claims Department

Human Resource Management Department

Procurement Department

Materials Management Department

Pharmacy Department

Cost and Revenue Centers

Nutrition and Dietetics Department

Health Information Management Department

Central Supply Unit

Medical Social Services

Other Hospital Operation and Patient Support Units External Authorized Government Depository Bank (AGDB)

Suppliers, Service Providers, and contractors

10.2 Guiding Principles

Cash operations and management require strict compliance to generally-accepted accounting principles and practices as well as to sound management and fiscal administration in accordance with existing laws and regulations. Thus, in performing the mandated duties and responsibilities, the following fundamental principles must be observed:

10.2.1 There shall be separation of key duties so that no single individual can control a transaction from beginning to end;

10.2.2 Strict compliance shall be observed to the Expanded Modified Direct Payment Scheme (ExMDPS) for Accounts Payable due to creditors/payees as required under DBM Circular Nos. 2013-16, as amended, 2013-16A and 2013-16B;

10.2.3 All collecting and disbursing officers shall be properly bonded;

10.2.4 All collections shall be properly receipted, kept safe, and deposited intact immediately on the next banking day to authorized government depository bank; and

92
Cash Operations Department Manual of Standards for Management of Hospital Finance Service 10.2.5 Only cash items and cash equivalents collected in the ordinary course of business shall be placed in the safe.

10.3 Duties and Responsibilities

The head of the Cash Operations Department shall be primarily responsible in managing the operation of the department. He/she shall be responsible in instilling discipline among the Cash Operations staff to strictly adhere to the guiding principles, policies and standards based on existing rules and regulations; observe strictly the code of conduct and ethical standards for government employees; and continually improve the quality of service being provided to interested parties.

Specifically, the Cash Operations Department shall be responsible in performing the following duties and responsibilities:

10.3.1 Manage and monitor all collections, deposits and disbursements;

10.3.2 Verify/Certify the accuracy of the cash collections/remittances report and regular reports of accountabilities;

10.3.3 Maintain records of cash collections, deposits, disbursements and other related transactions;

10.3.4 Implement the prescribed disbursement systems and procedures based on existing accounting and auditing standards;

10.3.5 Prepare List of Due and Demandable Accounts Payable (LDDAP)/ Advice to Debit Account (ADA)/Advice of Checks Issued and Cancelled (ACIC);

10.3.6 Ensure the completeness of all attached documents before the preparation of checks and LDDAP-ADA;

10.3.7 Manage the safekeeping and monitoring of accountable forms;

10.3.8 Monitor unclaimed checks;

10.3.9 Act as Special Disbursing Officer for Petty Cash management and disbursement;

10.3.10 Coordinate with the government depository bank for Automated Teller Machine (ATM) transactions;

10.3.11 Pay compensation and other monetary benefits of hospital officials and employees;

10.3.12 Ensure the submissions of required reports within the required timeline;

10.3.13 Monitor cash balance regularly in coordination with the Accounting Department; and

93 Cash Operations Department Manual of Standards for Management of Hospital Finance Service

10.3.14 Perform other related functions as required.

10.4 Core Process

The major functions of the Cash Operations Department are focused on the following:

10.4.1 Disbursement

The different modes of disbursement are as follows: (Source: GAM for NGAs Chapter 6 Section 7)

 Checks (MDS or Commercial Check) – refers to a check issued by government agencies chargeable against the agency’s checking account with AGDBs. These are covered by income/receipts authorized to be deposited with AGDBs; and funding checks received by Operating Units from Central/Regional/Division Offices, respectively.

 Advice to Debit Account – refers to an authorization issued by the NGA/OU appearing in the lower portion of the List of Due and Demandable Accounts Payable-Advice to Debit Account (LDDAP- ADA). It serves as instruction to the Modified Disbursement System, Government Servicing Banks (MDS-GSBs) to debit a specified amount from its available NCA balance under regular MDS subaccount for payment of creditors/payees through the Expanded Modified Disbursement Payment Scheme (ExMDPS).

 Expanded Modified Disbursement Payment Scheme – refers to the payment procedures whereby the MDS-GSB shall pay the creditors/payees listed in the LDDAP-ADA not later than 48 hours but not earlier than 24 hours upon receipt of the said document from the NGA/OU:

 Direct credit to the creditor’s current/savings/ATM account (CA/SA/ATM) maintained with MDS-GSB; or

 Bank transfer, if creditor’s account is maintained outside the agency’s MDS-GSB, where corresponding bank charges shall be borne/paid by the creditor/payee concerned

 Cash (out of cash advance granted to authorized Disbursing Officer)

Common Internal Control Guidelines on Disbursements

When disbursements are made thru Check:

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Cash Operations Department Manual of Standards for Management of Hospital Finance Service 10.4.1.1 The Disbursing Officer (DO) should be familiar with the laws and regulations affecting his/ her work. He should not have access to or responsibility over, the accounting records related to disbursements. 10.4.1.2 The DO should maintain adequate records and should submit required reports regularly and on time.
10.4.1.3 Checks should be countersigned; the signing and countersigning should not be made in advance. 10.4.1.4 Disbursement procedure should be designed to ensure that payment is received by the correct party. 10.4.1.5 Vouchers and supporting papers should be stamped “PAID” upon payment. 10.4.1.6 Safe or similar facilities should be provided to ensure protection of unused checks and other documents. 10.4.1.7 The reconciliation of bank/treasury transactions should be done by persons other than those responsible for the issuance of the checks or the signing/countersigning thereof.
10.4.1.8 The sequence of check numbers should be checked when reconciling banking/ treasury transactions.
10.4.1.9 Checks shall be drawn only on duly approved Disbursement Voucher (DV) 10.4.1.10 Checks shall be used for payment of regular expenses which cannot be conveniently nor practically paid using the ADA or not authorized to be paid using the Petty Cash Fund or advances for operating expenses. 10.4.1.11 Checks issued shall be reported and recorded in the books of accounts whether released or unreleased to the respective payees.

When disbursements are made through cash:

10.4.1.12 Cash disbursements constitute payments out of cash advances granted to the regular and special disbursing officers for personal services, petty expenses and MOOE for field operating requirements. 10.4.1.13 As a general rule, disbursements should be made through check.
Only transactions authorized under existing regulations issued by the COA may be paid out of the cash advance granted to a duly authorized DO.
10.4.1.14 Documents supporting the transaction should be reviewed before any payment is made. 10.4.1.15 Rotations should be done for all employees in charge of the various phases of cash collection and disbursement.

95 Cash Operations Department Manual of Standards for Management of Hospital Finance Service 10.4.1.16 Disbursement procedures should eliminate the possibility of payment to wrong parties. 10.4.1.17 Payroll, vouchers and supporting documents should be stamped “PAID” upon payment. 10.4.1.18 The DO should have no access to the cash records kept by the accountant. 10.4.1.19 All cash payments shall be covered by duly approved DVs/payrolls/petty cash vouchers (PCVs). The cash advances may be granted to the cashiers/disbursing officers/officials and employees to cover the following: salaries and wages, travels, special time-bound undertakings and petty operating expenses

When disbursements are made through List of Due and Demandable Accounts Payable-Advice to Debit Accounts (LDDAP-ADA):

10.4.1.20 The use of LDDAP-ADA as a mode of settlement of accounts payable due the creditors/payees of all NGAs and their OUs was prescribed under DBM Circular Letter No. 2013-16 dated December 23, 2013 which implemented the ExMDPS, amended by DBM Circular Letter Nos. 2013- 16A and 2013-16B dated February 6, 2014 and February 25, 2014 respectively. The following are excluded from the implementation of ExMDPS:

 Payment of Terminal Leave and Retirement Gratuity (TL/RG) benefits which is governed by Republic Act No. 10154 as implemented by CSC Resolution No.1300237 and Budget Circular No. 2013-1;  Remittance of social insurance premium contributions to government corporations, such as GSIS, PHILHEALTH, and HDMF;  Payment of Accounts Payable to utility companies, such as: supplier of petroleum, oil and lubricants, water, illumination and power services, telephone, internet and other communication services; and  Other payables which cannot be conveniently nor practicably paid using the ADA.

10.4.2 Collection and Deposit

The Collection and Deposit System covers the processes of acknowledging and reporting income/receipts, deposit thereof to Authorized Government Depository Bank (AGDB) or through the GSBs for the account of the Treasurer of the Philippines, and recording of collections and deposits in the books of accounts of the agency.

The Cashier or Collecting Officer must deposit all his/her daily collections not later than the next banking day to Authorized Government Servicing Bank. It is important to record all deposits made in the Cash Receipts

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Cash Operations Department Manual of Standards for Management of Hospital Finance Service Record. Moreover, the Cashier or Collecting Officer must accomplish the Report of Collections and Deposits (RCD) at the end of each business day.

Policies on Collection 10.4.2.1 Except as may otherwise be specifically provided by law or competent authority, all money and property officially received by a public officer in any capacity or upon any occasion must be accounted for as government funds and government property (Chapter 3, Sec. 63, PD 1445) 10.4.2.2 No payment of any nature shall be received by a collecting officer without immediately issuing an official receipt (OR) in acknowledgment thereof. (Chapter 3, Sec. 68 (1), PD 1445) 10.4.2.3 In no instance shall temporary receipts be issued to acknowledge the receipt of public funds. 10.4.2.4 Pre-numbered Official Receipts shall be issued in strict numerical sequence. In preparing official receipts, all copies of each receipt shall be the exact copy or carbon reproduction in all respects of the original.
10.4.2.5 At no instance should money in the hands of the collecting officer be utilized for the purpose of encashing private checks (Sec. 67 (3), PD 1445) 10.4.2.6 Checks in payment for indebtedness to the government shall be made payable to the agency.
10.4.2.7 Under no circumstance shall the following checks be accepted:
 Checks drawn payable to the name of the agency head or any of its officers;
 Endorsed checks;
 Post-dated checks;
 Staled checks; or  Out-of-town checks, except those which are drawn by the Government or its instrumentalities. 10.4.2.8 The Collecting government entity issuing electronic Official Receipt (eOR) should generate and submit daily to the Auditor a copy of the RCD (Sec. 39 (c), Reporting of Collections and Deposits, Chapter 5, GAM for NGAs Volume I).
10.4.2.9 Public officers authorized to receive and collect moneys arising from revenues or receipts of any kind shall remit or deposit intact the full amounts so received and collected by them to the agency’s authorized government depository bank (AGDB). (Sec. 69 (1), PD 1445)

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Policies on Deposits

10.4.2.10 All Collecting Officers shall deposit intact all their collections, as well as collections turned over to them by sub-collectors to the AGDB or to the National Treasury daily or not later than the next banking day. They shall record all deposits made in the CRR. 10.4.2.11 All authorized depository banks shall acknowledge receipt of all funds received by them, through deposit slips bearing the date of actual remittance or deposit and indicating from whom and on what account it was received (Sec. 70, PD 1445).

General Rules on Internal Control over Cash Receipts and Collections (based on the Training Handbook on Cash Management and Control System, COA, June 2011)

10.4.2.12 The Collecting Officer should be familiar with the laws and regulations affecting his work. He should not have access to or responsibility over the accounting records related to cash (such as subsidiary ledger for accounts receivables). 10.4.2.13 Adequate records should be maintained with the reports regularly submitted. 10.4.2.14 Reconciliation of bank transactions should be done by persons other than those responsible for the handling of cash received and deposited. 10.4.2.15 Control over cash, including remittances through the mails, should be established immediately after it has been received; collections should be acknowledged with pre-numbered ORs and recorded promptly and properly. 10.4.2.16 Report of Accountability for Accountable Forms should be prepared and submitted by all accountable officers. 10.4.2.17 No disbursement should be made from cash receipts.
10.4.2.18 Safety vault and other safety devices shall be made available to ensure safeguard of cash and unused accountable forms. 10.4.2.19 Surprise cash examinations should be made frequently by internal and external auditors. 10.4.2.20 Government cashiers are prohibited from holding position as cashiers or treasurers of savings and loan associations or any other association or organization. (Section 9 Chapter II of the Revised Cash Examination Manual)

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10.5 Process Flow

10.5.1.1 Processing of Collections and Deposits Key Process
Key Person Responsible Key tasks

Collecting Officer

Head Collection Unit

Receives charge slip / order of payment / statement of account (SOA) from clients/creditors.

Receives cash / check from clients / creditors.

Issues official receipts (OR) for payment from clients/creditors.

Encodes all ORs in the Cash Receipts Record (CRR).

Tallies Cash Collections for the day against Cash Receipts Record (CRR).

Prepares deposit slip/ remittance advice for deposit to Authorized Government Depository Bank (AGDB) based on the remittance of collecting officer.

A START Receive cash / check

Issue Official Receipt

Prepare deposit slips / remittance advice

Encode all ORs

Tally Cash Collections
Receive Charge Slip / Statement of Account

99 Cash Operations Department Manual of Standards for Management of Hospital Finance Service Key Process
Key Person Responsible Key tasks

Head-Cash Operations

Bonded Colleting Officer

Reviews & signs the Deposit Slips (DS)

Checks the deposit slip if for pick up by AGDB

If yes, Deposits through pick up by the AGDB the collections together with the deposit slips

If no, requests for transport service from the Engineering and Facilities Management Department

Brings the cash/checks to Authorized Government Depository Bank (AGDB)

Request Transport Service Transport cash/checks to bank END

Deposit through pick up Review & sign
For Pick up by AGDB? Yes No

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10.5.1.2 Processing of Collections and Deposits through LDDAP-ADA

Key Process Key Person Responsible Key tasks

Cash Operations Staff

Head Cash Operations

Collecting Clerk/Officer

Collecting Officer

Receives notifications through phone call/email from various clients/creditors.

Verifies details of payment through WeAccess.

Issues official receipts (OR) for payment from clients/creditors.

Encode all official receipts in the Report of Collections and Deposits.

Bank Verification

Receive Notification

Issue Official Receipt

Encode all ORs START END

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10.5.2 Processing of Disbursements
Key Process
Key Person Responsible Key tasks

Cash Operations Staff

Disbursing Officer

Head-Cash Operations

Cash of Operations Staff

Receives duly approved DV in 3 copies together with complete Supporting Documents (SDs)

Checks completeness of signatories on the DV and identifies fund source

Prepares payment through checks / Advice to Debit Account (ADA) with Advice of Check Issued and Cancelled (ACIC) if applicable

Record the checks / ADA to Check and Advices to Debit Account Disbursement Records (CkADADRec)

Verifies completeness of signature on the DV. Reviews the amount of the check against the DV and SDs. Signs the check

Forwards the set of documents to the authorized countersigning official

A START Receive approved disbursement vouchers

Check signatures and fund source

Prepare Payment

Record checks / ADA
Verify/review/ sign Check/ADA
Forward to authorized signatories

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Cash Operations Department Manual of Standards for Management of Hospital Finance Service Key Process
Key Person Responsible Key tasks

Cash Operations Staff

Receives signed Check / ADA from authorized signatories

Releases checks to payees / submits signed LDDAP- ADA to AGDB

Secures Official Receipt from the payee and attaches to the disbursement voucher

A Release the checks / ADA END Secure Official Receipt
Receive signed Check/ADA

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10.5.2.1 Processing of Disbursements of Petty Cash Fund

Key Process Key Person Responsible Key tasks

Petty Cash Custodian

Receives approved Purchase Request before issuing Petty Cash Voucher form to the Requesting Personnel.

Issues Petty Cash Voucher to Requesting Personnel for accomplishment of required data and approval from immediate supervisor.

Receives approved Petty Cash Voucher from the Requesting Personnel.

Releases cash to requesting personnel and signs Box B “Paid by” portion upon granting the petty cash advance.

START

Release Cash Receive Approved Purchase Request Issue Petty Cash Voucher Receive approved Petty Cash Voucher END

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10.6 Reportorial and Documentary Requirements

   10.6.1 Daily Reports

10.6.1.1 Report of Collection and Deposit 10.6.1.2 Report of Advice of Checks Issued and Cancelled 10.6.1.3 Report of Checks Issued (RCI) 10.6.1.4 Report of Advice to Debit Accounts Issued (RADAI) 10.6.1.5 Daily Cash Monitoring 10.6.1.6 Other reports as needed by the Department of Health
Central Office

10.6.2 Monthly Reports 10.6.2.1 Reports of Accountability for Accountable Forms (RAAF) 10.6.2.2 Other reports as needed by the Department of Health Central Office

10.6.3 Semestral Reports

                   10.6.3.1 Performance Evaluation Report of Cash Operation Staff  
                                   (SPCR and IPCR)

10.6.2.2 Other reports as needed by the Department of Health Central Office

10.6.4 Annual Reports 10.6.4.1 Report of Unreleased Checks 10.6.4.2 Other reports as needed by the Department of Health Central Office

10.6.5 Other Reports 10.6.4.1 Report of Paid Petty Cash Vouchers 10.6.4.2 Management Review/Accomplishment Report 10.6.4.3 Hospital Scorecard 10.6.4.5 Other reports as needed by the Department of Health Central Office

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CHAPTER 11

BILLING AND CLAIMS
DEPARTMENT

The Billing and Claims Department shall direct and oversee the proper hospital billing system, and shall ensure timely and accurate charging of all hospital procedures, services, medical supplies, drugs and medicines provided to patients regardless of patient’s classification including the appropriate International Classification of Diseases (ICD)/Relative Value Scale (RVS) codes based on the final diagnosis.
Specifically, the Department aims to:

 Ensure accurate preparation of statement of account of patients and other claims,
 Ensure accurate processing and timely transmittal of PHIC and other claims, and  Ensure adherence to Republic Act No. 11223 (Universal Health Care Act) and Republic Act No. 11463 (Malasakit Centers Act).

For the Level 3 hospital, Billing and Claims Department is headed by a designated Administrative Officer who shall report directly to the Financial and Management Officer (FMO) II. For Level 1 and Level 2 hospitals, the billing unit shall report to the head of the Hospital Operations and Patient Support Services (HOPSS) and/or the head of the Accounting Department.

11.1 Interested Parties

Provides Services to:

Internal

Medical Center Chief/Chief of the Hospital Chief of the Finance Service Head, Hospital Operations and Patient
Support Service(HOPSS) Chief Medical Professional Staff Head, Nursing Service Cash Operations Accounting
Health Information Management Service
Medical Social Work Department Cost and Revenue Centers

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External Patients and relatives Department of Health Commission on Audit Philippine Health Insurance Corporation
Other interested parties (NGOs, HMOs, Private Institutions) Other Government Funding Agencies

Expects Output/services from:

Internal
Cost and Revenue Centers Accounting Department Cash Operations Department

Human Resource Management Department

Procurement Department

Materials Management Department

Health Information Management Department

Medical Social Work Department

Hospital Rates and Costing Committees

Other Hospital Operations and Patient Support Units Integrated Hospital Operations Management Program Unit

External PHIC and Government Funding Agencies (PCSO, PAGCOR, DOH, DSWD, etc.)

Health Maintenance Organization Private / corporate accounts

Affiliating Schools/Universities

11.2 Guiding Principles

The Billing and Claims Department is tasked with the preparation/consolidation of patient’s individual statement of account after all procedures, medicines, supplies and other support services have been billed accordingly. These patient accounts shall include those, which are company-sponsored, enrollees and dependents of PhilHealth, Health Maintenance Organization (HMO), insurance companies, research, referrals and other related institutional agencies. The primary goal of the Billing and Claims Department is to provide clear and consistent policies in a manner that promotes compliance, patient satisfaction and efficiency. Thus in the performance of the mandated duties and responsibilities, the following fundamental principles shall be observed:

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Billing and Claims Department

11.2.1 Strict application of mandated social legislation like coverages from Philippine Health Insurance (PhilHealth), discounts for senior citizens, person with disability (PWD) and similar socialized benefits in accordance with its respective implementing rules and regulations shall be observed.

11.2.2 All patients shall be appropriately and accurately billed based on existing laws, rules and regulations.

11.2.3 The Billing and Claims staff shall make the patients aware of their bills with the information of the applicable social legislation laws applied thereto.

11.2.4 PhilHealth Claims with complete supporting documents shall be prepared and transmitted within the prescriptive period.

11.2.5 All the Billing and Claims staff shall be equipped and kept abreast with latest hospital policies, Philhealth issuances, data privacy (R.A. No. 10173) and right to information laws and regulations, International Classification of Diseases (ICD), Universal Health Care Act (RA 11223), Malasakit Center Acts (R.A. No. 11463), Senior Citizen Act (R.A. No. 9994), and other applicable social legislation laws.

11.2.6 All Billing and Claims staff shall ensure efficiency, consistency, accuracy and equitable application of policies to meet patient satisfaction and requirements.

11.3 Duties and Responsibilities

The head of the Billing and Claims Department shall be primarily responsible in managing the operation of the department. He/she shall be responsible in instilling discipline among the Billing and Claims staff to strictly adhere to the guiding principles, policies and standards based on existing rules and regulations; observe strictly the code of conduct and ethical standards for government employees; and continually improve the quality of service being provided to interested parties.

Specifically, the Billing and Claims Department shall be responsible in performing the following duties and responsibilities:

11.3.1 Prepare progress billing and inform patients/relatives accordingly;

11.3.2 Prepare the final hospital bill of patients after verifying that all hospital charges are reflected on patient’s account;

11.3.3 Process and review PhilHealth claims prior to e-claims transmittal;

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11.3.4 Submit Philhealth claims electronically;

11.3.5 Monitor Philhealth claims filed and analyze causes of RTH and denied claims for appropriate action;

11.3.6 Institute measures to address or rectify RTH and denied claims;

11.3.7 Follow up outstanding & overdue accounts, and in doing, prepare and send at least three demand letters for overdue accounts;

11.3.8 Establish other measures to enforce collection of receivables;

11.3.9 Prepare and submit Summary of Bills Rendered to Accounting Department on or before the 5th day of the following month;

11.3.10
Conduct periodic reconciliation of accounts receivable with Accounting Department/Section and vice versa.

11.4 Core Processes

The major functions of the Billing and Claims Department are focused on the following processes:

11.4.1 Medical Billing Process - This process involves the procedures in the collection of information of patient’s medical status as to his/her registration, establishment the financial responsibility for the patient visit from admission, confinement up to date of discharge, submission of complete supporting documents in availing any applicable socialized benefits.

11.4.1.1 Proper billing of hospital services, drugs and medical supplies provided to patients shall be based on approved policies, rules and procedures.

11.4.1.2 Patients shall be assured of prompt access to billing information (progress billing) for all hospital services, drugs and supplies provided. Cut-off time in the discharge of patients and encoding of charges from Cost and Revenue Centers shall be observed.

11.4.1.3 All hospital diagnostic and therapeutic procedures and other services rendered including dispense of drugs, medicines and supplies to patients and other clients are properly billed as charged by the cost and revenue centers, and are reflected in the

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Billing and Claims Department Statement of Account. The Billing and Claims Department is responsible for summarizing all the charges but actual charging of services and supplies provided is the responsibility of the cost and revenue centers.

11.4.1.4 The Statement of Account shall be prepared in accordance with the requirements of PhilHealth and other agencies.

11.4.1.5 PhilHealth eligibility of patient shall be verified upon receipt of admission slip or notice of admission.

11.4.1.6 Patients/relatives shall be advised to submit pertinent requirements of PhilHealth and other agencies immediately upon admission.

11.4.1.7 Outstanding hospital bill from private ward shall be settled before transfer to basic/service ward. Transfer of patient to basic/service ward shall be cleared with the attending physician and communicated properly to concerned areas.

11.4.1.8 Retroactive charging of hospital fees shall be implemented if patient decides to transfer from basic ward to private ward.
Patient shall be required to settle their outstanding bill in full based on the adjusted rates. Relative/Guardian shall be assessed for capacity to pay by the Medical Social Work Department before transfer is allowed.

11.4.1.9 Settlement of hospital bill shall take precedence over professional fees.

11.4.2 Claims Processing - This process involves the preparation of the documentary requirements, checking and validation of the for coding and billing compliance, transmitting claims to PhilHealth and other insurance company, monitoring payer adjudication, generating patient statements and immediate compliance to Return-to-Hospital (RTH) claims, analyze cause of non-payment and other related matters.

11.4.2.1 Ensure completeness of required documents and strictly adhere to the prescribed timeline in the processing and transmittal of PhilHealth and other claims.

11.4.2.2 Monitor and report compliance to the PhilHealth No Balance Billing (NBB) Policy for eligible patients.

11.4.2.3 Prepare the monthly report of claims filed to Accounting Department

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11.4.3 Credit and Collection Process. This process involves the strategies in monitoring the collections of unpaid accounts such as but not limited to accounts not paid in full at the time of patient’s discharge, dues to be collected from use of hospital services and functions rooms.

11.4.3.1 Monitor the execution of promissory note for hospital bills based on approved policies, rules and procedures.

11.4.3.2 Ensure the timely and accurate preparation of Statement of Account for other services rendered such as but not limited to concessionaires, affiliation fees, clinic rental, rental of non- medical facilities (auditorium, canteen, etc.) shall be based on approved policies, rules and procedures.

11.4.3.3 Develop strategies to ensure accurate and timely collection of receivables.

11.4.3.4 Ensure that periodic monitoring and reconciliation of receivables from PhilHealth and other claims with Accounting Department shall be done.

11.4.4 Returned Claims

The goal of the Billing and Claims Department in this respect is to ensure that all PhilHealth claims get reimbursed within the specified time. However, clerical errors both human and electronic may cause unfortunate, unavoidable returns of claims for correction, or even denial. Therefore, it is important to work in progressively reducing and eliminating errors in this process. Unmitigated, returned and denied claims can mean risking the health and wealth of the institution.

There are two categories of returned claims:

11.4.4.1 Return-to-Hospital (RTH) - a rejected claim that contains one or more errors found when the claim is processed by Philhealth. RTH may be the result of a technical/clerical error, a mismatch between procedures and ICD codes or additional documents as required by PHIC. The claim will be returned to the agency for correction and resubmission. 11.4.4.2 Denied – claims that the Philhealth has processed and deemed not reimbursable to the agency. These claims may violate certain policies of Philhealth or they may contain some vital errors that need to be appealed and sent back by the agency for reprocessing. The process can be
time-consuming, and therefore costly on the part of the agency.

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Billing and Claims Department

Common Errors for RTH

Some of the common errors can cause claims to return are as follows:

Common Errors for RTH Claims Particulars Incorrect Patient Information

Sex, name, date of birth, no valid PHIC Identification No. (PIN), etc. Incorrect Health Care Institution Information Address, name, contact information, etc. Incorrect and Mismatched Medical Codes Entering confusing ICD codes with RVS codes, or vice versa, etc. Unreadable Scanned Documents Scanned documents adjudicated by PHIC as unclear and unencrypted Incomplete Philhealth Forms Philhealth forms (CF2, CSF, PMRF etc.) not properly accomplished Incomplete Statement of Account Not properly signed by the Billing Clerk or patient Incomplete supporting documents Diagnostic results, newborn screening result and sticker, Statement of Account

Common Errors for Denied Claims

Some of the common errors can cause claims to deny are as follows:

Common Errors for Denied Claims Particulars Filed beyond 60 days -
Filed beyond the prescribed statutory period for filing claims ICD/RVS Upcoding

The provider codes for more intensive procedures than what was adjudicated by PHIC as actually performed. This is a process wherein the provider intentionally or unintentionally misrepresents the services they provided on a patient.
Assigning an inaccurate billing code to (a medical procedure or treatment) to increase reimbursement. Benefits Exhausted

The 45 days’ period is the maximum number of days per year for each member and another 45 days for all his/her dependents the patient will be allowed to

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Billing and Claims Department Manual of Standards for Management of Hospital Finance Service avail benefit packages with PHIC.
However, the hospital provider will not have enough information to know that the benefit has already been exhausted by the patient causing the Philhealth claim to return as denied.
Violation of Single Period of Confinement

Availment of Philhealth benefit for the same illness within 90 days will not be covered by PHIC. Any claim reimbursement therefrom will be denied by PHIC. Overlapping Claims with other Providers Incompletely filled out Philhealth forms. PHIC will return the claim and ask for more information. Expired validity Expired enrolment to Point of Service (POS) Expired Philhealth accreditation Expired Philhealth accreditation of attending physician

Format of Monitoring Report for RTH and Denied Claims as of ___________.

SEQUENCE NO. PATIENT NAME CONFINEMENT DATE DATE RETURNED HF PF STATUS

TOTAL

Sample of the Letter of Appeal for Denied Claims.

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Billing and Claims Department

11.5 Core Processes and Flowcharts

11.5.1 Processing of Issuance of Statement of accounts Process Flow

Key Person Key Tasks

Billing Staff

Receives Notice of Discharge together with clearance slip from all major cost and revenue centers

Processes statement of account accordingly;

Applies
a. all mandatory discounts (Senior Citizen or PWD, etc.) if applicable
b. appropriate Philhealth benefit based on ICD10/RVS code indicated by the attending physician
c. other insurance benefits d. Medical Assistance

Prints and issues Statement of Account (SOA) to relative/guardian

If Yes, issues Discharge Clearance

If No, advises to proceed to Cash Operations Department for payment.

Receive Notice of Discharge
START Process SOA
Print and issue Statement of Account No Balance Billing / No excess hospital bill? Issue Discharge Clearance Advise to proceed to Cash Operations Department END Yes No

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Billing and Claims Department Manual of Standards for Management of Hospital Finance Service 11.5.2 Processing of Issuance of Discharge Clearance

Process Flow

Key Person Key Tasks

Billing Staff

Cash Operation Staff

Receives Official Receipt (OR)

Records OR number and amount paid

Issues Discharge Clearance for NBB

Issues Discharge Clearance for paid Hospital Bill

Receive Official Receipt (OR) START Record OR number and amount paid Issue Discharge Clearance END

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Billing and Claims Department

11.5.3
Processing of PhilHealth Claims

Key Activities Key Person
Key Tasks

Claims Staff

Verifies the completeness and correctness of all documents as required

If yes, fills up CF2 Part II items 9 & 10 and Part IV/CSF. Sorts all the documents for PhilHealth claim and forwards to the designated authorized signatory/ies

If no, returns to the concerned office to complete the document and information needed.

Verifies documents if properly signed

Scans required documents and encodes member & patient information, professional fees, final diagnosis, and data in CF2

Attaches scanned documents to e-claims portal

Transmits online the PhilHealth Claims

Monitors status of transmitted claims and receives feedback from Philhealth Forward to Designated Authorized signatory
Verify the completeness of required documents Verify documents if properly signed START Scan and encode documents
Complete? Return to concerned office Yes No END Attach scanned documents Transmit online and Document i d l i Monitor status of transmitted claims and receive feedback

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11.5.4 Preparation of Summary of Bills Rendered

Key Activities Key Person Key Process

Billing Staff

Head, Billing and Claims Section

Billing Staff

Collates, sorts, arranges, and encodes all Statement of Accounts of patients according to hospital bills number series and account classification as per COA RCA

Generates three (3) copies of Summary of Bills Rendered for the Month

Reviews and signs the report

Submits two (2) copies of the reports to accounting Department on or before the 5th day of the following month.

Files one (1) copy of SBR

Collate and encode
Generate Summary of Bills Rendered (SBR)

Review and sign report Submit to Accounting Department START END File copy of the report

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11.6 Reportorial and Documentary Requirements

  11.6.1 Monthly Reports

11.6.1.1 Summary of Bills Rendered
11.6.1.2 Monitoring Report of Transmitted Claims 11.6.1.3 Monitoring Report on RTH and Denied Claims - List of RTH/Denied claims within the specified period of time attached
11.6.1.4 Report on OPD and ER Quantified Free Services (QFS) 11.6.1.5 Other reports as needed by the Department of Health Central Office

11.6.2 Quarterly Reports 11.6.2.1 Report on Quantified Free Services (QFS) 11.6.2.2 No Balance Billing (NBB) compliance rate (hospital record) 11.6.2.3 Percentage of PhilHealth inpatient over total inpatient 11.6.2.4 Percentage of PhilHealth outpatient over total outpatient 11.6.2.5 Other reports as needed by the Department of Health Central Office

11.6.3 Semestral Reports

11.5.2.1 Performance Evaluation Report of Billing and Claims Staff (DPCR and IPCR) 11.5.2.2 Other reports as needed by the Department of Health Central Office

11.6.4 Annual Reports 11.5.2.3 Report on Quantified Free Services (QFS) 11.5.2.4 No Balance Billing (NBB) compliance rate 11.5.2.5 Percentage of PhilHealth inpatient over total

inpatient 11.5.2.6 Percentage of PhilHealth outpatient over total outpatient 11.6.4.5 Other reports as needed by the Department of Health Central Office

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Manual of Standards for Management of Hospital Finance Service

CHAPTER 12

FINANCIAL MANAGEMENT
SYSTEM IN GOVERNMENT- OWNED AND CONTROLLED
SPECIALTY HOSPITALS

Specialized healthcare services at par with known private hospitals in the Philippines and globally has been one of the major aims of the Department of Health. Four government-owned and controlled corporate tertiary specialty medical centers were established:  Philippine Heart Center is mandated to specialize in the prevention, diagnosis, rehabilitation and treatment of heart ailments. It focuses on service, training and research in the treatment of heart ailments. It was founded on February 14, 1975 under P.D. No. 673.  Philippine Children’s Medical Center provides the tertiary healthcare services in the prevention, diagnosis and treatment of diseases specifically for children. It focuses in the delivery of quality specialized pediatric healthcare services, training and research. It was founded on August 10, 1979 under P.D. No. 1631.  National Kidney and Transplant Institute (NKTI) is mandated to specialize in the prevention, diagnosis, rehabilitation and treatment of kidney and allied diseases through dialysis and transplantation. It focuses on service, training and research in the field of renal diseases and organ transplantation. It was founded on January 16, 1981 by virtue of P.D. No. 1892.  Lung Center of the Philippines provides the Filipino people with the state of the art specialized care for lung and other chest diseases. It focuses on service, training and research in the treatment of lung and other chest diseases. It was founded on January 16, 1981 under P.D. No. 1823.

In accordance with the Government’s commitment to accountability and effective governance, per Executive Order No. 80, dated July 20, 2012, “Directing the Adoption of a Performance-Based Incentive System for Government Employees,” the four specialty hospitals / research institutions fall under the jurisdiction of the Department of Budget and Management (DBM Memorandum Circular 2012-1, dated August 13, 2012).

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12.1 Organizational Set-up

The operations and management of these four GOCC specialty hospitals are guided by their respective decrees, and entrusted to the Board of Trustees, which the Department of Health directly oversees.

The organizational structure for government owned and controlled specialty hospitals under the approved Charter is subdivided into four major operating units, namely:  Medical Services  Nursing Services  Hospital Support Services  Education, Training and Research Services

Figure 4.1: Basic Organizational Structure for Government Owned and Controlled Specialty Hospitals

The Deputy Executive Director for Hospital Support Services is in charge of the supervision of the operations and management of the following departments:

Finance Services Department
Administrative Services Department
Ancillary Services Department

The staffing requirement is based on the approved charter of the specialty hospital.

Office of the Board of Trustees

Office of the Executive Director Office of the Deputy Executive Director for Nursing Services Office of the Deputy Executive Director for Medical Services Office of the Deputy Director for Hospital Support Services Office of the Deputy Director for Education, Training and Research

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12.2. Finance Services Department

The Finance Services Department is headed and supervised by the Department Manager who shall be responsible to the Deputy Executive Director for Hospital Support Services. Figure 4.2 shows the different divisions under the Finance Services Department.

Figure 4.2: Organizational Structure of Finance Services Department in the GOCC
Specialty Hospitals

The primary functions of the Finance Services Department shall be as follows:

Plan, supervise, direct and control the activities of the Finance Services Department and Divisions.
Manage the cash flow and ensure that enough funds are available for the day to day operations.
Establish strategies and policies for collection of hospital accounts.
Plan and prepare Corporate Operating Budget. Monitor expenses and capital expenditure utilization.
Provide technical support to the Executive committee in decision making and planning to meet the goals and objectives of the hospital.

Board of Trustees

Office of the Executive Director

Office of the Deputy Executive Director for Hospital Support Services Office of the Department Manager III
Finance Services Department

Budget Division

Cash Operations or Treasury Division

Billing and Claims Division

Accounting Division

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Government Owned and Controlled Specialty Hospitals Manual of Standards for Management of Hospital Finance Service 6. Ensure the availability of logistic requirements of the hospital in accordance with quality standards. 7. Ensure compliance to financial rules and regulations set by government regulating agencies. 8. Supervise and train staff on current related updates on finance.

12.3 Interested Parties

Headed by : Department Manager III Responsible to : Deputy Executive Director for Hospital Support Services (HSS) Expects Services/Inputs from

Divisions under Finance Services Other Departments under HSS Other Services/Units of the Hospital Management Information Services Provides Services to :
Internal Clients : Board of Trustees Top Management Executive Director Deputy Executive Directors for
 Medical Services  Nursing Services  Education, Training and Research  Hospital Support Services Chief of Departments/Divisions/Units Hospital Committees Hospital Employees External Clients : Patients and Relatives Government Agencies Legislative Bodies NGA, LGU and other government intermediaries HMO’s and other service providers Suppliers, Contractors, and Visiting Consultants Partnered agencies and other Interested parties

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Government Owned and Controlled Specialty Hospitals Manual of Standards for Management of Hospital Finance Service 12.4. Accounting Division

The Accounting Division is responsible for proper recording and accounting of government funds and properties, disbursements, transactions and status of government appropriations, contributions, income allotments and surplus in accordance with generally accepted accounting principles and practices and guided by the Philippine Public Sector Accounting Standards (PPSAS). The Division is part of the Finance Services Department under the supervision of the Department Manager III.

The Accounting Division is headed by the Chief Accountant.

The primary responsibility of Accounting Division is to prepare the following Financial Reports:

 Statement of Financial Position  Statement of Financial Performance  Statement of Cash Flows  Statement of Changes in Net Assets/Equity
 Statement of Comparison of Budget and Actual Amounts  Notes to Financial Statements  Departmentalized Hospital Income and Expenses  Schedules and Subsidiary Ledgers of Various Accounts  Other reports for submission to organization’s management and other government agencies

The Accounting Division is also responsible for the analysis and interpretation of the results of operations of the hospital. It is also responsible for the issuance of Certificate of Availability of Funds.

There are several units under the Accounting Division with specific duties and responsibilities.

12.4.1 General Accounting Section

This section maintains books such as:

12.4.1.1 Journal of Bills Rendered
12.4.1.2 Journal of Checks Issued
12.4.1.3 Journal of Collections and Deposits
12.4.1.4 General Journal
12.4.1.5
General Ledger including Subsidiary Ledgers

The section maintains the schedule for Fixed Assets as well as the corresponding accumulated depreciation.

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It also prepares the departmental income and expense report of the hospital.

12.4.2 Payables Section

This section is responsible for:

12.4.2.1 Ensuring completeness and propriety of documents to support various disbursements.
12. 4.2.2 Preparation of disbursement vouchers for various payables and expenses of the hospital. 12.4.2.3 Maintenance of subsidiary ledgers, preparation of schedule of aging of payables and other liabilities. 12.4.2.4 Preparation of Remittances of taxes withheld from suppliers and employees. 12.4.2.5 Issuance of BIR Forms for taxes withheld.

12.4.3 Receivables Section

This section is responsible for:

12.4.3.1 Maintenance of subsidiary ledgers for accounts receivable from patients including promissory notes, company sponsored, rental receivables, receivables from employees and other receivables 12.4.3.2 Preparation of schedule of aging of receivables
12.4.3.3 Preparation of statement of accounts and records transactions pertaining to funds or financial assistance to various patients. 12.4.3.4 Preparation of utilization reports for special funds and submission to concerned agencies.

12.2.4 Payroll/PhilHealth/Miscellaneous Payables Section

This section is responsible for:

12.4.4.1 Review of disbursement voucher for first salary, maternity pay, last/terminal pay and other salary adjustments.

12.4.4.2 Remittance of deductions from salaries to other government entities, such as GSIS premium, PhilHealth premium, PAG-

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Government Owned and Controlled Specialty Hospitals Manual of Standards for Management of Hospital Finance Service IBIG premium, employee compensation, various loans and withholding tax for BIR.
12.4.4.3 Maintaining individual files and earning ledgers of all employees for future reference.
12.4.4.4 Verification and processing of payment for professional fees paid from over-the-counter and from PhilHealth.

12.4.5 Cost Accounting Section

This section is responsible for:

12.4.5.1 Analysis of costs of various hospital procedures 12.4.5.2 Recommendation on the increase or maintaining existing hospital rates 12.4.5.3 Validation of costing done by Income Centers 124.5.4 Preparation of market study for the comparative hospital charges

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Government Owned and Controlled Specialty Hospitals Manual of Standards for Management of Hospital Finance Service 12.4.6 Core Process and Flowchart 12.4.6.1 Preparation of Financial Statements Key Process Key Person Responsible Key Tasks

Accounting Staff

Chief Accountant

Accounting Staff

Collects all summaries of JBR-Pay, Company & Service: JCI, JCD & GJ from Accounting Staff

Consolidates reports to include beginning balances of debit & credits, summaries of JBR, JCI, JCD & GJ for the month & ending balances

Records/posts all accounting transactions per JBR, JCI, JCD & GJ in the General Ledger

Extracts debit & credit balances & prepare monthly trial balance

Prepares the following financial reports:  Statement of Financial Performance for the month with comparative data  Statement of Financial Condition for the month with comparative data  Financial Highlights included in the Financial Reports
 Statement of Sources & application of funds
 Schedule of Receivables
 Bank Reconciliation Statement
 Aging of Cash Advances  Departmental Income & Expense  Executive Summary

Reviews & Certifies the Financial Reports

Collates & files all financial reports

Transmits financial reports to the Management, COA and other users Transmit Financial Reports Collate/File Financial Reports Prepare Financial Reports Review & sign Financial Reports Record all accounting transactions Gather Data Consolidate Reports Extract debit & credit balances & prepare trial balance START END

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12.4.7 Reportorial and Documentary Requirements:

Records/Documents 12.4.7.1 Patient's Statement of Account (SOA) 12.4.7.2 Annual Audit Report
12.4.7.3 Bank Statements 12.4.7.4 BIR Forms 12.4.7.5 Income Payees’ Sworn Declaration of Gross Receipts/Sales 12.4.7.6 Income Payor/Withholding Agent’s Sworn Declaration 12.4.7.7 Paid Disbursement Vouchers 12.4.7.8 Payroll

Monthly Reports 12.4.7.9 Journal of Bills Rendered 12.4.7.10 Journal of Collections and Deposits 12.4.7.11 Journal of Checks Issued 12.4.7.12 General Journal 12.4.7.13 Financial Statements 12.4.7.14 Accomplishment Reports
12.24.7.15 Fund Utilization Reports (MAIP and other trust funds) 12.4.7.16 Value Added Tax Declaration (monthly) 12.4.7.17 Other Reports as needed by the Department of Health Central Office

Quarterly Reports 12.4.7.18 Quarterly Income Tax Return 12.4.7.19 Value Added Tax Declaration (quarterly) 12.4.7.20 Balanced Scorecard 12.4.7.21 Budget and Financial Accountability Report

Annual Reports 12.4.7.22 Year-end Financial Statements 12.4.7.23 Schedule of Various Accounts 12.4.7.24 Annual Income Tax Return 12.4.7.25 Balanced Scorecard 12.4.7.26 Compliance with Audit Findings 12.4.7.27 Other Reports as needed by the Department of Health Central Office

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12.5 Billing and Claims Division

The Billing and Claims Division is headed by the Chief Administrative Officer (CAO) and shall be reporting to the Department Manager III, Finance Services Department.

The Billing and Claims Division serves as the “center for business operations” of the hospital. Its primary function is the preparation of bills for all patients (confined patients, out patients, ER patients and short stay unit patients).

The preparation of bills includes:  Capturing data for confined patients from the Hospital Information System (HIS)  Capturing charges for supplies, medicines and procedures provided to patients  Application of PhilHealth benefits, processing and filing of said claims  Computation of discounts as government employees or dependent, persons with disabilities (PWD) and senior citizen  Checking of payments and deposits, guaranty letters and financial assistance from various sources  Computation of amount covered by Letter of Authorization (LOA) from companies and health insurance  Computation of bills of check-up, service and surgical package patients  Printing of statement of accounts (SOA)  Discharging of patients from the HIS

The Billing and Claims Division is also responsible for generating daily balance summary for patients admitted, filling-up of patients' claims for insurance, generation of discharge summary, monthly inventory of in-patients, generation and preparation of partial billings of patients. It is also responsible for providing information on PhilHealth benefits, discounts and hospital policies on discharging of patients.

The Billing and Claims Division has sub-units with specific responsibilities.

12.5.1 Billing Section

The unit is responsible for:
12.5.1.1 Preparation of statement of account of patients for discharge, which includes computation of mandated discounts, PhilHealth benefits and other applicable deductions 12.5.1.2 Validation of patient’s deposits, guaranty letters and other financial assistance 12.5.1.3 Printing of statement of account

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12.3.1.4 Entertaining queries of hospital clients pertaining to patients’ bills 12.3.1.5 Preparation of Report of Bills Rendered (RBR)

12.5.2 Claims Section

The section is responsible for the: 12.5.2.1 Processing of PhilHealth claims which includes validation of completeness of documents, data and filling up of PhilHealth forms 12.5.2.2 Scanning of documents for e-claims 12.5.2.3 Encoding of patient’s data in the PhilHealth web service 12.5.2.4 Transmitting of scanned documents thru e-filing 12.5.2.5 Compliance to requirements for Return to Hospital (RTH) claims

12.5.3
Credit and Collection Section

This section is responsible for:
12.5.3.1 Attending to and evaluating requests for credit arrangement/ promissory notes 12.5.3.2 Monitoring outstanding accounts of in-patients 12.5.3.3 Monitoring outstanding receivables – Promissory Notes, Company Sponsored and other receivables 12.5.3.4 Coordinating with the Office of the Government Corporate Counsel for legal actions against delinquent debtors 12.5.3.5 Preparation of collection letters 12.5.3.6 Processing application for hospital accreditation of companies for credit arrangement 12.5.3.7 Preparation of transmittal letter for company sponsored accounts

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Government Owned and Controlled Specialty Hospitals Manual of Standards for Management of Hospital Finance Service 12.5.4 Core Process and Flowchart

12.5.4.1 Preparation of Statement of Account
Key Process Key Person Responsible Key Tasks

Billing Staff

Chief Administrative Officer/ Supervisor

Receives the following:  Notice of Discharge  Complete PHIC documents  Certificate of Employment for Gov’t Employees (for discount purposes)  Photocopy of Senior Citizen’s ID, PWD ID (for discount purposes)  Letter of Authorization (LOA) for company-sponsored patients  Guaranty Letter (GL) for patients with financial assistance.

Computes the following:  PHIC benefits  Discount as Gov’t Employee or dependent  Discount as Senior Citizen/PWD  Amount covered by LOA or GL Checks the following:  Optional procedures for Executive Check-Up & Surgical Package Deal Patients

Posts the following for:

Pay/Company-Sponsored Patients  PHIC benefits  Discounts  Amount guaranteed by company, health insurance or funding agencies  Other adjustments
Executive Check-up Patients  Package availed  Optional procedure Assigns Bill Number Prints the SOA

Deny Discounts/ Philhealth benefits

Receive required documents Compute Philhealth benefits and mandatory deduction Encode Deductions/ Printing Yes B No

Checking A START Complete docs?

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Chief Administrative Officer/Supervisor

Billing Staff

Checks and verifies the printed bill

Releases the bill to the patient’s representative

B SOA/Bill Correct? Yes No

Release Bill END A

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Government Owned and Controlled Specialty Hospitals Manual of Standards for Management of Hospital Finance Service 12.5.4.2 Processing of PhilHealth Claims Key Process Key Person Responsible Key Tasks

Billing Staff

Chief Administrative Officer/Supervisor

Billing Staff

Checks discharged patients with PhilHealth deduction and validate if documents were submitted

Fills out PhilHealth forms

Checks and completes attachments like OR/anesthesia records, angio record, clinical abstract, etc. Forwards to Executive Director/doctors those claims, which are for signature.

Checks completeness of data on the forms, attachments, ICD 10 Codes. Puts marks on the discharge list to avoid multiple filing Signs Part V of CSF.

Scans and arranges in proper order:  Claim Signature Form  PBEF  SOA  PMRF  Other documents

Encodes patient's data in the PHIC claims eligibility web service

Transmits all scanned documents to PHIC thru e-filing

Process PHIC claim Documents Complete? Check patients with PHIC claims Transmit documents Yes

Scan all claims documents

Review /Sign Claim No

Encode patient's Data A START

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Government Owned and Controlled Specialty Hospitals Manual of Standards for Management of Hospital Finance Service Key Process Key Person Responsible Key Tasks

Billing Staff

Verifies transmitted documents thru the e-claims processed claims module

Prints and files transmittal list of Philhealth claims

12.5.5
Billing and Claims Reportorial and Documentary Requirements

Records/Documents 12.5.5.1 Promissory Notes (individual folders of patients) 12.5.5.2 Duplicate copies of collection letters 12.5.5.3 Contracts of Companies with credit line agreement

Daily Reports 12.5.5.4 Discharge List of Patients 12.5.5.5 List of Current In-patients with Outstanding Balance (Balance Summary)

Monthly Reports 12.5.5.6 Inventory of Undischarged Patients 12.5.5.7 Accomplishment Report
12.5.5.8 Reports of Bills Rendered

Quarterly Report 12.5.5.9 Balanced Scorecard

END A

Verify Transmitted Print & File Transmittal

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12.6 Budget Division

Budget Division is headed by the Chief Administrative Officer (CAO) and directly reports to the Department Manager III, Finance Services Department.

The Budget Division is responsible for the preparation and control of budget, financial planning and management. It is also responsible for the analysis of the budget
submitted by the different divisions in order to prepare a practical Corporate Operating Budget (COB) for the year and Budget Estimates for the succeeding year. The Division also analyzes expense and income patterns of the Hospital. These will be the basis for the preparation of the annual budget.

The Division evaluates and recommends implementation of budgetary policies, plans and programs proposed by various units of the Hospital. It is responsible for the approval of the requested subsidy by attending the different budget hearings to be conducted by the Department of Budget and Management (DBM), House of Representatives and the Senate together with the Director and other senior officials of the Hospital.

The Division is also in-charge for the follow-up of monthly/quarterly fund releases from the Department of Budget and Management and the submission of all pertinent requirements/documents.

The Division is also in charge of the following:
 Posting required reports in the transparency seal  Monitoring, review and evaluation of budget utilization  Monitoring and collation of the requirements for the Performance Based Bonus  Request for the release of Special Funds if applicable
 Preparation of physical and financial reports for the utilization of Special funds  Ensuring that all units of the hospital have submitted approved Project Procurement Management Plan (PPMP) based on the approved Corporate Budget  Evaluation of the PPMP, and if warranted, will be included in the hospital’s proposal for approval of the Head of the Procuring Entity (HOPE)

12.6.1 The following are observed in the preparation of annual budget:

12.6.1.1 At the beginning of the year, the Executive Director will issue a memorandum for the submission of Projected Income and Expenses by each division together with the justification for each item and the Capital Outlay.

12.6.1.2 The Deputy Executive Directors for each service will review and evaluate collated budget estimates and transmit to Budget Division.

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12.6.1.3 The Budget Division, together with the Finance Manager, the Deputy Executive Director for each Service, the Executive Director and other officers of the hospital, will conduct Budget Hearings to evaluate and validate the submitted actual figures and proposals.

12.6.1.4 The Budget Division will prepare the Corporate Operating Budget (COB) of the Center for the current and Budget Estimates (BE) for the next fiscal year based on the submitted budget estimates and the actual financial statements of the previous year. The COB and BE will contain the following information:

5.1. Receipts/Income 5.1.1 Hospital Income

5.1.1.1 Less: Charity Hospital Expense

5.1.1.2 Less: Charity Research Expense

5.1.1.3 Less: Patients' Discounts

5.1.1.4 Net Hospital Income 5.1.2. Other Income, which consists of rental income, cafeteria sales, interest income and other income

5.1.3. Government Subsidy – the approved subsidy for the year

1.2.1. EXPENDITURES ITEMS

1.2.1 Personnel Services – consist of basic salaries of permanent and contractual employees, all allowances, fringe benefits, government share to GSIS, Pag-ibig, Philhealth contributions and Employee compensation, honorarium of all consultants, terminal leave and gratuity pay of retiring employees.

5.2.2 Maintenance and Other Operating Expenses - amount of expenses to be incurred by the Center such as supplies and materials, security services, janitorial, repairs and maintenance, water, light and power, communication laundry and other expenses.

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Government Owned and Controlled Specialty Hospitals Manual of Standards for Management of Hospital Finance Service 5.2.3 Capital Outlay – consists of land, building improvements and acquisition of all kinds of equipment.

12.6.2 The following are the assumptions used for computing the estimated income and expenses:

12.6.2.1 Hospital income - growth rate from previous year will be used and other assumptions like increase in bed capacity or increase in hospital rates and additional services

12.6.2.2 Quantified free services - the percentage of the previous year will also be used or the amount of Government Subsidy plus hospital share from operating income

12.6.2.3 Other income – previous year level will also be used

12.6.2.4 Government subsidy –the approved subsidy by the government will be used

12.6.2.5 Personnel Services - the actual basic salaries of all personnel including all approved allowances and benefits will be used

12.6.2.6 Maintenance and Other Operating Expenses – the actual expenses of prior year plus certain percentage of increase, inflation rate, increase in bed capacity and expansion of services

12.6.2.7 Capital Outlay – priority schedule of equipment and infrastructure projects as discussed in the hospital's budget hearings will be included in the Operating Budget based on the following criteria:  Income-generating or expense-reducing project  Improvement of quality of care  For patient and client safety  Strengthening “Best Practices and Accountability”

12.6.3 The hospital shall ensure that all its units submit their PPMPs. Updating of the PPMPs and the consolidated APP shall be undertaken as necessary. In case of any changes in the plans, concerned units shall request for re alignment of the budget for projects/activities.

Standard DBM Forms used in the preparation of the Corporate Operating Budget are included in the appendices

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Government Owned and Controlled Specialty Hospitals Manual of Standards for Management of Hospital Finance Service 12.6.4 Core Process and Flowchart

12.6.4.1 Preparation of the Corporate Operating Budget (COB) Key Process Key Person Responsible Key Tasks

Executive Director

Executive Director Deputy Executive Directors Finance Services Budget Division Other Officers

Budget Division

Executive Director DED-HSS DM III, Finance Services

Board of Trustees (BOT)

Dept. of Budget & Management (DBM)

Budget Division

DBM

Issues memorandum for the submission of budget proposals by different department, which includes projected income, expenses, and capital outlay.

Evaluates submitted proposals. Conducts budget deliberation to evaluate & validate actual figures & proposals Approves proposals

Prepares COB based on submitted proposals & actual financial statements of previous years Prepares the required budget forms.

Evaluates and approves the COB

Executive Director, DED-HSS & other Finance Officers presents the COB to the BOT BOT evaluates, approves and issues Board Resolution PHC submits COB to DBM

Conducts consultation meetings.

Submits required documents and justifications.

Approves the COB

Budget Deliberation Issue Memorandum for submission of budget proposal Evaluate and approve the COB

Preparation of COB

Present the COB. Evaluate, approve and issue BR

Conduct Consultation

Approve the COB START END Submit documents and justification

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12.6.5 Reportorial and Documentary Requirements:

      Monthly Reports

12.6.5.1 Financial Accountability Report –Monthly Report of Disbursements
12.6.5.2 Physical and Financial Report – Infrastructure and Equipment for special funds 12.6.5.3 Monthly Utilization Report – Both for Hospital and by Department 12.6.5.4 Other reports as needed by the Department of Health Central Office

     Quarterly Reports

12.6.5.5 Budget Accountability Report – Quarterly Physical Report of Operation
12.6.5.6 Financial Accountability Report - Summary of Appropriations, Allotments, Obligations, Disbursements and Balances 12.6.5.7 Status and Assessment of Projects, Programs and Activities (Transparency Seal)  Physical Performance  Financial Performance 12.6.5.8 Summary Reports of Unutilized Subsidy and Interest Earned
12.6.5.9 Balanced Scorecard
 Budget Utilization Rate  CAPEX Utilization Rate

        Annual Reports

12.6.5.10 Corporate Operating Budget 12.6.5.11 Budget Execution Documents
 Financial Plan - Estimated Obligation Program of the Budget Year by quarter  Physical Plan - Physical Targets of the Budget Year by the Quarter  Monthly Disbursement Program - Projected Monthly Disbursement Requirements by Type of Disbursement Authority

12.6.5.12 Project Procurement Management Plan (PPMP)  Common Use Supplies and Equipment
 MOOE, Equipment, Building Improvement and Infrastructure

12.6.5.13 Other reports as needed by the Department of Health Central Office

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12.7 Cash Operation or Treasury Division

Cash Operation or Treasury Division is headed by the Chief, Administrative Officer and shall report directly to the Department Manager III, Finance Services Department.

The Cash Operation or Treasury Division is the custodian of the hospital's cash, securities, and other negotiable instruments. It is responsible for providing an efficient and effective fund management, which includes collection, disbursement and investment. It also coordinates with concerned agencies regarding the hospital's fund releases.

The Cash Operation or Treasury Division is composed of two (2) Sections, namely: -

   12.7.1  Cashier Section  

                  This section is responsible for:

12.7.1.1 Receipt of payments 12.7.1.2 Issuance of official receipts to payers for various transactions of the hospital 12.7.1.3 Preparation of report of collections 12.7.1.4 Reconciliation of collection against issued official receipts 12.7.1.5 Preparation of deposit slips 12.7.1.6 Deposit of collections in the bank 12.7.1.7 Preparation of daily cash position report 12.7.1.8 Preparation of check payment to suppliers, creditors and other disbursements 12.7.1.9 Maintenance of Petty Cash Fund

12.7.2 Investment Section

This section is responsible for:

12.7.2.1 Transacting and communicating with authorized depository banks for attractive interest offer on investment 12.7.2.2 Monitoring daily cash position 12.7.2.3 Preparation of projected cash position to determine excess funds 12.7.2.4 Recommending placement of investment 12.7.2.5 Monitoring maturing investments

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Government Owned and Controlled Specialty Hospitals Manual of Standards for Management of Hospital Finance Service 12.7.3 Core Process and Flowchart 12.7.3.1 Receiving Payment (Out Patient)

Key Process Key Person Responsible Key Tasks

Cashier

Receives Charge Slips or Request Slip from the patient

Locates the patient’s hospital/ transaction number in the cashier module system for encoding & preparation of official receipt.

Locate the discount menu in the cashier module system and deduct the appropriate amount

If patient will not avail discount, proceeds to payment

If Credit Card payment, waits for the approval/confirmation from credit card company

If the Credit Card was declined, cash payment will be required

Prepares Official Receipt for cash payment.

Issues Official Receipt and approval slip for credit card payment

No Decline Credit Card Issue O.R./ Approval Slip Credit Card Locate for Patient Number with Discount Verify Credit Card

Receive Charge Slips Apply the Discount Proceed to payment No Yes Yes Credit Card No Yes A A Cash Payment? START END

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12.7.3.2 Receiving Payment (Pharmacy Sales) Key Process Key Person Responsible Key Tasks

Cashier

Receives charge slip/order of payment to Pharmacist on duty.

Locates the Purchase Order Slip Number in the cashier module system to determine the total amount to be collected from the customer.

Receives cash payment

Issues Official Receipt & informs the customer to wait until be called for the issuance of medicines

Checks and Reconciles total cash collections with the official receipts issued

Print Report of Collection and submit to Supervisor

Locate the Purchase Order Slip Receive Order of Payment

Issue Official Receipt Receive Cash Payment Reconcile Cash and issued OR Print and submit Collection Report START END

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12.7.3.3 Receiving Payment (In Patient) Key Process Key Person Responsible Key Tasks

Cashier

Supervisor

Cashier

Receives Hospital Bill (SOA) from the client & check the total amount to be paid

Locates the patient's hospital/ transaction number in the cashier module system for encoding of amount to be paid

Accepts payment & issues OR

Refers to Credit & Collection Section for the credit arrangement if the client cannot make full payment

Makes a request for P.N and submits for approval of the DED-HSS

Waits for approval of the credit card company

If credit card payment is declined, cash payment will be required

Prepares & issues O.R. for the cash payment.

Prepares OR and issues approval slip for credit card payment

Issues approved Notice of Discharge

Encode amount of payment Credit Approved? Receiving of Hospital Bill (SOA) Credit Arrangement Request and Submit PN for approval Verify Credit Card Issue Approval Slip Issue approved Notice of Discharge No Accept Payment Yes Full payment? Cash payment? Yes Yes No No Prepare and Issue O.R. Decline payment A A START END

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12.7.4 Reportorial and Documentary Requirements

       Records/Documents

12.7.4.1 Official Receipts (3rd copy) 12.7.4.2 Report of Collections (2nd copy) 12.7.4.3 Deposit Slips (2nd copy) 12.7.4.4 Debit Advice for the bank for various transactions (photocopy) 12.7.4.5 Daily Cash Position Report 12.7.4.6 Warrant Register (Cash Book) 12.7.4.7 Cash Book of Accountable Officer (Petty Cash Book) 12.7.4.8 Report of Disbursements (Petty Cash) 12.7.4.9 Disbursement Vouchers for paid transactions

      Monthly Reports

12.7.4.10 Report of Checks Issued 12.7.4.11 Accomplishment Reports
12.7.4.12 Report of Accountability for Accountable Forms 12.7.4.13 Other reports as needed by the Department of Health Central Office

Quarterly Reports

12.7.4.14 Balanced Scorecard 12.7.4.15 Other reports as needed by the Department of Health Central Office

143 Manual of Standards for Management of Hospital Finance Service

CHAPTER 13

FINANCIAL MANAGEMENT
SYSTEM IN LOCAL
GOVERNMENT HOSPITALS

The 1973 Constitution, as subsequently amended, guaranteed as State policy the autonomy of the local government units “to ensure their fullest development as
self-reliant communities.” (Article 2, Section 10). Then under the succeeding 1987 Constitution, Article X, general provisions were laid down for the enjoyment of local autonomy among the country’s territorial and political subdivisions (i.e., provinces, cities, municipalities, barangays, autonomous regions). This constitutional mandate led to the enactment of R.A. No. 7160, the Local Government Code of 1991, which provided for the establishment of a more responsive and accountable government structure through a system of decentralization.

Effective sharing of political and administrative powers between the national and local governments, on the other hand, is anchored, in part, on the equitable diffusion of national internal revenues among the different levels of government as well as the sharing of proceeds from the development of national wealth and from other special shares with the inhabitants of a particular community by the way of direct benefits.

The Local Government Code (LGC) of 1991 introduced a paradigm shift in relations between the national government and local government units by declaring it the policy of the State "that the territorial and political subdivisions of the State shall enjoy genuine and meaningful local autonomy to enable them to attain their fullest development as self- reliant communities and make them more effective partners in the attainment of national goals. Toward this end, the State shall provide for a more responsive and accountable local government structure instituted through a system of decentralization whereby local government units shall be given more powers, authority, responsibilities, and resources. The process of decentralization shall proceed from the national government to the local government units". [Book I, Title One, Chapter 1, Section 2(a)]

The Local Government Units (LGUs) were given responsibility for the provision of basic services such as health care, social welfare and agricultural extension. To operationalize the principle of decentralization, the national government was to provide funding support and technical assistance to LGUs so that they may carry out their newly devolved duties and responsibilities and participate more actively in national development.

144 FMS in Local Government Hospitals Manual of Standards for Management of Hospital Finance Service

“The vesting of duty, responsibility, and accountability in local government units shall be accompanied with provision for reasonably adequate resources to discharge their powers and effectively carry out their functions; hence, they shall have the power to create and broaden their own sources of revenues and the right to a just share in national taxes and equitable share in the proceeds of the utilization and development of the national wealth within their respective areas." [Section 3(d)] “The capabilities of local government units, especially the municipalities and barangays, shall be enhanced by providing them with opportunities to participate actively in the implementation of national programs and projects.” [Section 3 (g)]

13.1 Organizational Set-up

The hospitals under the supervision of Local Government unit still follows the standard organizational structure per level provided under the Joint DBM-DOH Circular discussed in Chapter 4 of this Manual. The only difference is the authority and supervision of the management and operation of the hospital, which is vested in the mandated function of the designated provincial, city and/or municipal health board.

The Provincial/City Health Board shall oversee and coordinate the integration of health services for province-wide and city-wide health systems. The Chief of Hospital/Hospital Director, as appointed by the Local Chief Executive (LCE) shall be in charge of the management and operation of the hospital activities. He/She shall be guided by the policies determined by the Provincial/City Health Board and shall coordinate effectively the medical, nursing and administrative services, in order to attain the objectives or goals of the hospitals.

The organizational structure of the hospital shall depend on its classification: its licensing category, functional capabilities, authorized bed capacity, and scope of services.

13.2 Financial Management Systems (Source: Local Health System, National Objectives for 2011-2016) In the DOH’s National Objectives for Health, under Local Health Systems, it was discussed that the implementation of the Local Government Code resulted in the devolution of health, which included among others, the provision, management and maintenance of health services at different levels of LGUs. The scarce resources were used optimally, and necessary controls were established. Among the crucial processes involved in LGU hospital’s financial management includes financial planning, budget formulation, budget execution, accounting, financial reporting, and internal control.

In spite of the devolution, the DOH remains the institutional steward of the nation’s health system. The organizational structure and staffing of LGU health facilities are still

145 FMS in Local Government Hospitals Manual of Standards for Management of Hospital Finance Service

governed by the Hospital Licensure Act and Joint DOH-DBM Circular No. 2013-1 as discussed and illustrated in Chapter 4.

13.3 Interested Parties

Headed by : Chief of Hospital/ Medical Center Chief
Responsible to : Local Health Board /Provincial/City LCE Expects Services/Inputs from

Different Departments (Medical, Nursing. HOPSS, Finance, Ancillary Departments

Provides Services to :
Internal Clients : Local Health Board/Provincial/City LCE Chief of Departments/Divisions/Units Hospital Committees Hospital Employees External Clients : Patients and Relatives Government Agencies LGU and other government intermediaries HMO’s and other service providers Suppliers, Contractors, and Visiting Consultants Partnered agencies and other Interested parties

13.4 Core Processes and Process Flow

The supervision of the finance services – Accounting, Budget, Cash Operation and Billing and Claims is still under the designated Chief Administrative Officer. The process flow as illustrated in the following flowchart showed that the central Finance Service of the local government unit is in charge of all the financial transaction, and the role of the hospital units is to process and complete all the supporting documents for submission to the LGU Finance Service.

146 FMS in Local Government Hospitals Manual of Standards for Management of Hospital Finance Service

13.4.1 Budget Process

13.4.1.1 Budget Formulation. The LGU hospital prepares and submits its budget proposal to the Provincial/City/Municipal Budget Office to be subjected to review by the Local Finance Committee and subsequently endorsed to Provincial/City/Municipal Council for deliberation. The same shall be submitted to the LCE for approval.

13.4.1.2 Budget Authorization. On or before the end of the current fiscal year, the Sanggunian concerned shall enact, through an ordinance, the annual budget of the local government unit for the ensuing fiscal year on the basis of the estimates of income and expenditures submitted by the local chief executive.

13.4.1.3 Budget Execution. The hospital prepares the request for release of allotment for implementation of its approved budget for the year.

13.4.1.4 Budget Accountability. The hospital submits the required reports to the LGU Budget Office.

Figure No.: 5.1 Budget Process in LGU Hospital

147 FMS in Local Government Hospitals Manual of Standards for Management of Hospital Finance Service

Core Process and Flowchart

13.4.1.5 Budget Preparation in Local Government Hospital

Key Process Key Person Responsible Key Tasks

Head of the Hospital Budget Unit

Budget Staff

Hospital Budget Committee

Head of the Budget Section

Budget Staff

Facilitates the issuance of memorandum to submit Budget Proposal/PPMP.

Receives and consolidates the Budget Proposal/PPMP of each unit of the hospital and determines if it is within the budget ceiling or priority budget.

Forwards to the Hospital Budget Committee for deliberation.

Deliberates the consolidated Budget Proposal/PPMP.

Finalizes the documents of the proposed budget and forwards it to the Chief Administrative Officer for the recommending approval. Then forwards to the hospital director for approval of the Hospital Proposed Budget.

Submits the proposal to the Local Government Budget Office

START

Facilitate issuance of memorandum Receive and Consolidate Budget Proposal/PPMP

Forward to Hospital Budget Committee Finalize documents and forward to approving authority Submit to Local Government Budget Office END Deliberate the consolidated Budget Proposal/PPMP

148 FMS in Local Government Hospitals Manual of Standards for Management of Hospital Finance Service 13.4.2 Accounting Processes

13.4.2.1. Processing of Disbursement Voucher (DV) in LGU Hospital

Key Process Key Person Responsible Key Tasks

Accounting Staff

Head of Accounting

Accounting Staff

Prepares/Receives DV and supporting documents. Indicates source of fund based on the attached Obligation and requests Budget Obligation Request.

Records the DV on the corresponding receiving logbook.

Reviews and checks as to the completeness and propriety of the DV & supporting documents.

If complete, affixes his/her initial on Box A.

If incomplete, returns to originating office with noted deficiencies

Forwards to the Budget Section START Prepare/Receive DV & Supporting Documents. Indicate fund source and request Budget Obligation Request Review and Check Yes No Complete? Head of Accounting affix his/her initial
Return the DV to the concerned office Forward to Budget Section Record DV in the logbook END

149 FMS in Local Government Hospitals Manual of Standards for Management of Hospital Finance Service

13.4.3 Billing and PhilHealth Claims Processing

13.4.3.1 Processing of Hospital bills and charges and Issuance of Statement of
Accounts Key Process Key Person Responsible Key Tasks

Billing Clerk

ICD-10 Coder

Billing Clerk

Receives the notice of Discharge & the Discharges clearance slips and PhilHealth requirements from the Patient/Relatives/Guardians

1.Checks & verifies if all charges are reflected on the patient’s account 2. Checks the completeness of the discharge clearance slips. 3. Checks the completeness of the PhilHealth Requirements

If incomplete, returns documents to the Patient/Relative/Guardian’s for completion

If complete, forwards to the ICD-10 coder for appropriate code/s

Fillings and printings of CF2 for Patient/Relative/Guardian’s signature

Prepares the final bill and prints the Statement of Account for the Patient/Relative/Guardian’s signature

START Receive Notice of Discharge & Discharge Clearance Slips Check & Verify all charges and completeness of documents Complete? Forward to the ICD 10 Coder Return to the Patient/ Relative/ Guardian

Filling and printing CF2 for signature Prepare the Final Bill and print the SOA Yes No END

150 FMS in Local Government Hospitals Manual of Standards for Management of Hospital Finance Service

13.4.4 Processing of PhilHealth Claims 13.4.4.1 Initial Process

Key Process Key Person Responsible Key Tasks

Claims Processor

Authorized signatories

Claims Processor

Receives PhilHealth claim forms & supporting documents

Reviews & Checks Philhealth claim forms & supporting documents

If complete, forwards PhilHealth claim forms & supporting documents to the Authorized Signatories

If incomplete, returns documents to the concerned office for completion

START Receive PhilHealth claim forms & supporting documents Review and Check Philhealth claim form and supporting Complete?

Sign documents
Return to the concerned office A B Yes No

151 FMS in Local Government Hospitals Manual of Standards for Management of Hospital Finance Service

13.4.4.2 Final Process

Process Flow Key Person Responsible Key Tasks

Claims Processor

Authorized Hospital Representative

Claims Processor

Receives Doctors-signed Philhealth claim forms & supporting documents

Signs Philhealth claim forms

Prepares and scans Philhealth claims and supporting Documents for transmittal

Transmits claims to Philhealth Office via e-Claims

Receive Signed Philhealth claim forms & supporting documents Prepare and Scan all documents END

Transmit Claims Sign document B A

152 FMS in Local Government Hospitals Manual of Standards for Management of Hospital Finance Service

13.5 Reportorial and Documentary Requirements

13.5.1 Reports submitted to the Chief Administrative Office by Hospital Billing and PhilHealth Section:

13.5.1.1 Report on Return-to-Hospital and Denied Claims 13.5.1.2 Report of Claims Processed

13.5.2 Report on Discharged Patients 13.5.3 Patient’s Demographic Profile According to Age and Sex 13.5.4 Patient’s Profile According to Hospital Service Rendered 13.5.5 Patient’s Profile According to Medical Disposition 13.5.6 Patient’s Profile According to PhilHealth Membership 13.5.7 Patient’s Profile According to Medical Social Service Classification

153 Manual of Standards and Procedures for Hospital Finance Service

CHAPTER 14

GOOD GOVERNANCE AND SOCIAL RESPONSIBILITY
IN HOSPITAL FINANCE
SERVICE

14.1 Concepts and Principles

The Department of Health recognizes an emerging paradigm in health facility governance. The health care delivery system and its reforms continue to evolve in big part to dynamics in the world arena, which in turn are driven by several factors – economic, political and cultural globalization, scientific and technological progress, expanding access to information through non-traditional and social media, and even the increasing intensity of calls to action on patients’ rights.

Much emphasis is placed on the relevance of good governance and social responsibility as the DOH pursues its vision in becoming “a global leader for attaining better health outcomes, competitive and responsive health care system, and equitable health financing.” UNESCO’s International Bio-Ethics Committee came out with a Report on Social Responsibility and Health (2009), which delved into social responsibility in the context of health care delivery. Accordingly, the right to access health care should be in accordance with universal ethical principles, respect for the human being and their fundamental rights. (1)

Accordingly, with accessibility of basic health care services being one of the major goals set by the DOH, health care facilities nationwide including the DOH-retained hospitals constitute a very significant part in provisions for the people’s development that are essential to the sustainability of human life.

154 Good Governance and Social Responsibility in Hospital Finance Service Manual of Standards and Procedures for Hospital Finance Service

Good governance in health care facilities shall then entail the assurance of providing safe, high-quality, accessible, equitable and ethically sound health care services to the people, especially those who are in most need of medical attention.

This also means that in social responsibility, it is not enough for a health care organization to bet just on its menu of services, or its competitive prices, or its advanced technology. It is important for the health care provider to be respected by their customers, fellow professionals, and the society at large.3 What this constitutes may include the provider’s genuine respect for patients’ rights, guaranteed equitable access to quality and affordable goods and services, assured safety in the facility’s environment, and even in proper health care waste management.

At the issuance of Executive Order No. 605 series of 2007, the government embarked in improving the quality of its management systems through the adoption of the ISO 9001 standards for all agencies, the DOH included. This adoption primarily aimed for the improvement, promotion and enhancement of public sector performance. Since then, government hospitals and health facilities have been continually improving the quality of services they provide to customers.

Under ISO 9001:2015, there are seven quality management principles:

 Customer Focus  Leadership  Engagement of People  Process Approach  Continual Improvement  Evidence-based Decision Making  Relationship Management

Good governance in a health care organization is implemented through the continual improvement of its Quality Management System (QMS), and is further enhanced by undertaking the Performance Governance System (PGS).

A well-functioning, harmonious health system is built on trained and motivated health workers, well-maintained infrastructure, and reliable supply of medicines and technologies, and then backed by adequate funding, strong health plans, and evidence-based policies.5

155 Good Governance and Social Responsibility in Hospital Finance Service Manual of Standards and Procedures for Hospital Finance Service

It is imperative that good governance in health entails the enhancement of stewardship functions and the improvement of management and internal support systems at the national and local levels to better respond to the needs of the health delivery system.

In his message on the 2017-2022 National Objectives for Health, Secretary Francisco Duque III noted that good governance and performance accountability principles should guide national and local health care institutions when they carry out their mandates to judiciously manage financial, capital and human resources, and to strategize the increase of their financial capabilities to effectively and efficiently provide quality services that are compliant with statutory and regulatory standards.

The DOH launched its flagship program FOURmula One Plus for Health (F1 Plus) to steer the continuing improvements in the health system for better health outcomes with Universal Health Care (UHC) for all Filipinos as medium and long term end in sight. With UHC as national policy, F1 Plus focused on three major strategic goals, by which all health care institutions are enjoined to orient towards while carrying on with their mandated functions:

Strategic Goal 1 - Better Health Outcomes Strategic Goal 2 - More Responsive Health System Strategic Goal 3 - More Equitable Health Financing

The significant consequences of good governance in health care organizations lie with the patients and families served, the general public, and even the facility’s workforce. However, health services in the public sector face the challenge that health facilities need to stretch their capacities to provide good standard of care while limited resources remain primordial and perennial concerns.

In view of the above, the Finance Service then gains a vital role in the stewardship of resources and the management of gaps while the hospital strives for effective and efficient governance. By stewardship, it is taken to mean that the Finance Service partakes in the management process that involves responsible planning and management of resources. (derived from Wikipedia)

This portion of the manual shall provide insights on the Finance Service as steward of resources as in providing the required support towards good governance and social responsibility functions of the health care organization.

156 Good Governance and Social Responsibility in Hospital Finance Service Manual of Standards and Procedures for Hospital Finance Service

14.2 Good Governance in the Hospital Finance Service

The delivery of the Finance Service as it performs its function as steward of resources is very important to good governance. This stewardship covers human resources, physical resources or the physical plant inclusive of buildings, land property and equipment, and current assets such as cash, receivables and inventories.

Core to good governance is the principle that all sectors working in public health care must act in the public interest at all times, consistent with the requirements of legislation and government policies, avoiding self-interest, and in accordance with standard ethical conduct as expected of public sector workers. 8

The Finance Service day-to-day operations shall be guided with good governance principles 9 as follows:

14.2.1 Accountability – is the tenet of good governance in which all the finance staff shall be held accountable in the performance of their duties and responsibilities.

14.2.2 Rule of Law – in good governance requires fair legal frameworks that govern the performance of regular functions, duties and responsibilities such as in COA rules and regulations, DBM issuances and guidelines, legislated laws and hospital internal policies.

14.2.3 Transparency – as conforming to Executive Order No. 2, series of 2016 pertaining to enhanced transparency and accountability in government official transactions. Its implementation include publication and posting of financial transactions, such as budget allotment and activities, in conspicuous places like the website of the hospital, bulletin board, and other means.

14.2.4 Privacy – as conforming to the Data Privacy Act of 2012 (R.A. 10173) and its IRR, which have specific guidelines to strengthen the fundamental human right of privacy and communication while ensuring the free flow of information.

14.2.5 Responsiveness – as in the regular updating of processes and flow of transactions with the intent to provide timeliness in responding to the clients’ needs. This includes the Citizen’s Charter being posted in conspicuous places in the hospital for public information. This is also being measured by looking into the results of customer satisfaction surveys. For frontline services – i.e., Cash Operations and Billing and Claims – providing a queuing system to eliminate long lines is aligned with responsiveness.

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14.2.6 Effectiveness and Efficiency – as pertinent to good governance entail the processes implemented in the hospital being able to meet the needs of its clients and stakeholders while making the best use of resources. Effectiveness is doing the right tasks as what are needed, and efficiency is doing the tasks the right way at the least cost possible. Finance Service shall assure that all resources are appropriately and properly used through the continual monitoring of its utilization.

14.2.7 Participation – means the vital role that Finance Service plays in the strategic planning of current and future directions and aspirations of the hospital. Submission of accurate and timely financial reports to Top Management shall facilitate effective decision making towards this end.

14.2.8 Sustainability – is desired in the continual improvement of the quality management system in the Finance Service, which include addressing identified risks to ensure the development of capability and capacity as well as to take a long-term approach in the utilization of resources and its outcomes. Sustainability will refer to the organization’s capacity to continue to survive successfully by meeting its intended outcomes within its limited resources.

14.2.9 Leadership –particularly one that is strong and effective can provide clear vision and strategic directions to secure effective and efficient approaches for yielding high performance results. The qualification and competence of the leader is necessary to face the challenges and bridge the gaps in effective and efficient delivery of finance services.

Strong financial management is necessary to ensure that public funds and resources are safeguarded at all times and used appropriately, economically, efficiently and effectively. For strong financial management, public sector entities should involve activities such as the following: (Good Governance in Public Sector, IFAC, June, 2012)

14.2.10 Provision, analysis, and interpretation of financial and non-financial information to the governing body and managers, supporting them in understanding the financial health of the entity and progress in delivering financial objectives, and providing the information and analysis needed for organizational objective setting, strategy formulation, execution, and control;

14.2.11 Funding and allocation for the delivery of public services, including establishing financial objectives, policies and strategies, capital planning

158 Good Governance and Social Responsibility in Hospital Finance Service Manual of Standards and Procedures for Hospital Finance Service and budgeting, raising finances, tax planning, and managing working capital, cash flow, and financial risk; and

14.2.12 Performance management through developing and implementing a financial strategy, cost determination, budgeting, forecasting, and financial control.

Good governance practices, therefore, shall be responsive to the current and future needs of the institutions. It shall exercise prudence in policy-setting and decision- making, and that the best interests of all the stakeholders shall be taken into account.

14.3 Social Responsibility in the Hospital Finance Service

In social responsibility, health care facilities, particularly hospitals, have an ethical obligation to do something beneficial to all while they continue delivering services to any person is entitled to them. Hospitals and other facilities are responsible to other “interested parties” including the environment and the communities they serve.

Figure 6.1: Drivers of Social Responsibility

The figure above describes the drivers of social responsibility wherein the health care organizations that try to act in socially responsible ways should do what is right, as well as minimize potential damage to their stakeholders. (3)

The practice of social responsibility embraces the responsibility of the health care institutions over their mandated functions, and then to cover programs that enhance the positive impact of health care provision to the environment, patients, consumers, employees, communities, stakeholders, other interested parties and even the general public. Social responsibility implies a shared vision that is universally accepted among health care professionals, hospital employees, governing agencies, other stakeholders and interested parties.

Social
Values

Social Responsibility B

Hospital Performance

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In the same UNESCO International Bioethics Committee report1 the following is explained:

“Social responsibility should be understood as being part of what has traditionally been called moral obligations. These obligations cannot be imposed by others or by the State. The difference between legal and moral obligations does not imply that the latter are less important. It simply implies that there is no legal coercion to fulfil them. Nonetheless, the more significant the consequences for failure to conform to these norms, the greater is the moral obligation to do so. This is especially so when we consider the duties deriving from a fundamental right. Thus, the concept of social responsibility is widened, both within and between States: it is not just about beneficence.”

Social responsibility resonates well with the DOH vision in Stewardship of the Health of the People, obliging the lead agency to dutifully respond to the challenges of improving health outcomes and the health system. Along this line, the DOH pursues FOURmula One Plus (F1 Plus) for Health, its flagship program aimed to realize Universal Health Care (UHC) for all Filipinos in the medium to long term. Shown below are the three strategic goals of F1 Plus.

Better Health Outcomes More Responsive Health System More Equitable Health Care Financing The health sector will sustain gains and address new challenges especially in maternal, newborn and child health, nutrition, communicable disease elimination, and NCD prevention and treatment. Improvements in health outcomes will be measured through sentinel indicators such as life expectancy, maternal and infant mortalities, NCD mortalities, TB incidence, and stunting among under- five-year-olds The quality of health goods and services as well as the manner in which they are delivered to the population will be improved to ensure people-centered healthcare provision. This may be done through instruments that routinely monitor and evaluate client feedback on health goods used and services received. Access of Filipinos, especially the poor and underserved, to affordable and quality health goods and services will be expanded through mechanisms that provide them with adequate financial risk protection from the high and unpredictable cost of healthcare. These may include efforts to reduce catastrophic OOP payments, such as through public subsidies targeted towards the poor.

Figure 6.2: The DOH Strategy Map as illustrated in the NOH 2017-2022

160 Good Governance and Social Responsibility in Hospital Finance Service Manual of Standards and Procedures for Hospital Finance Service In the NOH 2017-2022, the DOH sets a general objective focused on “Sustainable investments for health secured, efficiently used and equitably allocated for improved health outcomes.” (Objectives and Targets, NOH for Health 2017-2022)

Specifically, the sources of funds identified are as follows:

14.3.1 Establish more resources for health efficiently mobilized and equitably distributed

14.3.1.1 Revenues from National Health Insurance Program (NHIP) and innovative taxes. – This entails higher NHIP premium collection and earmarked funds from innovative taxes, such as sin taxes.
PhilHealth will sustain the initiatives (e.g. Point of Service Care or POS and Point of Care (POC) to capture those who are not yet enrolled in the NHIP.

14.3.1.2 Fiscal autonomy of government owned health facilities - DOH will support the transition of all government hospitals at national and local levels into fiscally autonomous units that can provide quality care for all, especially the poor, even without heavy central office subsidies. Policies on hospital income-retention will have to be reviewed and government facility financial performance (i.e. revenue and expenditure) will be assessed. The DOH will develop facility performance benchmarks to facilitate assessment of overall hospital efficiency in providing and sustaining care. Technical assistance will likewise be provided to capacitate concerned personnel on hospital management and accounting, including costing of health services, design of socialized user fees, computation of quantified free service, and monitoring of hospital operations including financial status.

14.3.1.3 Government and private sector complementation in health insurance coverage – Financial coverage from HMOs and private health insurance shall complement the NHIP. Implementing this strategy requires research and multi-stakeholder dialogues on the specific health services that the DOH, PhilHealth, private health insurance and HMOs will be exclusively covering to avoid overlapping subsidies (e.g. DOH to fund public health or population-based programs and activities, and PhilHealth as well as HMOs to cover personal or individual-based care).

14.3.2 Rationalize health spending

14.3.2.1 Financing for population-based and individual-based health interventions

161 Good Governance and Social Responsibility in Hospital Finance Service Manual of Standards and Procedures for Hospital Finance Service 14.3.2.2 Fixed co-payment for selected health packages

14.3.3 Focus financial resources towards high impact interventions

14.3.3.1 Identification of priority health programs

14.3.3.2 Link between financing of health service and performance

In assessing the DOH’s general and specific objectives, it was recognized that the right to health care as a positive social right emphasizes a need to set a perspective active social responsibility among the hospitals. It implies organizations to contribute its resources or skills to serve the common good such as the implementation of ethical conduct codes, afﬁrmative action policies at the workplace (or reverse discrimination of minority groups), or the active contribution in promoting the environment.

14.4 Implementation of the Universal Health Care Law

The DOH acknowledges that universal access to health care, irrespective of one’s ability to pay, is a fulfillment of the basic human right to health. Thus, the DOH has strongly advocated for the enactment of the Universal Health Care Act. Republic Act No. 11223, “An Act Instituting Universal Health Care for All Filipinos, Prescribing Reforms in the Health Care System, and Appropriating Funds Therefor” was approved and signed on February 20, 2019.

In Section 3 of the law, the primary objectives are stated: (1) to progressively realize universal healthcare in the country through a systemic clear delineation of roles of key agencies and stakeholders towards better performance in health systems; and (2) to ensure that all Filipinos are guaranteed equitable access to quality and affordable health care goods and services and protected against financial risks.

In its Implementing Rules and Regulations (IRR), Section 2, Rule 1 provides the general policies and principles that will guide all the healthcare institutions and practitioners. This part of the IRR reiterates the policy of the State to protect and promote the right of all Filipinos and instill health consciousness among them.
Provisions in the IRR that are pertinent to the Finance Service include the following:

162 Good Governance and Social Responsibility in Hospital Finance Service Manual of Standards and Procedures for Hospital Finance Service 14.4.1 Section 7, Rule II provides the financial coverage of the law:

14.4.1.1 Population-based health services shall be financed by the national government through the DOH and provided free of charge at point of service for all Filipinos (Section 7.1)

14.4.1.2 The National Government shall support LGUs in the financing of capital investments and provision of population-based health services (Section 7.2)

14.4.1.3 Individual-based health services shall be financed through prepayment mechanisms such as social health insurance, private health insurance, and HMO plans to ensure predictability of health expenditures. (Section 7.3)

14.4.1.4 Province-wide and city-wide health systems shall ensure funding for effective health operations and conduct of activities such as but not limited to capacity building, research, and health promotion consistent with national guidelines and with support from the DOH. (Section 7.4)

14.4.2 Section 17.6, Rule IV provides that the DOH shall finance population-based health services and provide supporting financing capital investments, human resources for health capacity building, health systems development, among others, to complement local government resources for health.

14.4.3 Section 27.2, Rule VII provides that the Philhealth Rating System shall include, but not limited to the following measures on provision of complete and appropriate care, health outcomes, patient satisfaction, fund utilization and allocation of resources across health care providers and different level of care; compliance to standards of clinical practice as approved by the DOH; submission of price information of health goods and services; compliance to guidelines and standards as prescribed by DOH and PhilHealth and other applicable laws; and other measures or indicators as deemed necessary.

14.4.4 Section 28, Rule VII addresses the prescribed mark-up for drugs, medical devices and supplies as follows:

14.4.4.1 The DOH shall prescribe uniform rules and structures in setting mark-ups for drugs, medical devices and supplies that shall be applied by DOH-owned health facilities on top of the price reference indices to protect patients from excessive and unnecessary charges. (Section 28.8)

163 Good Governance and Social Responsibility in Hospital Finance Service Manual of Standards and Procedures for Hospital Finance Service 14.4.4.2 All DOH-owned health care facilities shall submit to the DOH all relevant costs and information necessary for the creation of a mark- up structure for drugs, medical devices and supplies. (Section 28.9)

14.4.4.3 All DOH-owned health care facilities shall adhere to the price structure and shall not go beyond the prescribed mark-up for drugs, medical devices and supplies (Section 28.10)

14.4.4.4 Non-compliance to the prescribed mark-up structure shall be subject to existing rules and administrative sanctions as stipulated in the IRR and other relevant laws such as R.A. No. 9184 (Government Procurement Act), R.A. No. 9502 (Cheaper Medicine Act of 2008), and R.A. No. 7394 (Consumer Act of the Philippines), among others. (Section 28.12)

14.4.5 Section 35.4 (a, b), Rule VIII provides the guidelines on tracking financial relationships between health and health-related commodity manufacturers, healthcare providers, and health professionals.

14.4.6 Section 37, Rule IX discusses the different provisions on appropriations.

14.5 Institutionalization of Malasakit Centers and Programs in the Hospitals

R.A. No. 11463, the Malasakit Centers Act approved and signed on December 2, 2019. A Malasakit Center is a one-stop shop for all government medical and financial assistance for all Filipinos particularly the poor, the indigent and less fortunate patients. It is intended to be a non-partisan, convenient, free of charge, accessible service that sets a standard system of availment of assistance.

The principle behind “Malasakit” benefits the patients with personalized and optimum health care. When visiting a hospital or any health care facility for treatment, patients are in a vulnerable state physically and emotionally, and some come from the lower socio-economic status. It is very important for patients to know of their fundamental rights as patients, and to have the ability for active involvement in their care as intended for safe and quality outcomes be it diagnostic, clinical or therapeutic in nature.

Every person is entitled to certain rights mandated by law, and within the law, some additional legal regulations are designed to extend further protection to them. The following are salient provisions of the Malasakit Centers Act:

164 Good Governance and Social Responsibility in Hospital Finance Service Manual of Standards and Procedures for Hospital Finance Service 14.5.1 Section 2 provides the general policies and principles in establishing the Malasakit Centers.

14.5.1.1 Adopt a multi-sectoral and streamlined approach in addressing health issues and affirm the inherently integrated and indivisible linkage between health and social services consistent with the
whole-of-government, whole-of-society and whole-of-system framework of RA 11223, the Universal Health Care (UHC) Act

14.5.1.2 Ensure that the patients experience compassion and empathy or Malasakit, and receive respect and dignity in the availment of health services

14.5.1.3 Provide medical and financial assistance through a one-stop shop

14.5.2 Section 4 defines the objectives in establishing and implementing the Malasakit Programs in the health care facilities

14.5.2.1 Provide a policy framework for integrated people-centered health services that shall (1) ensure and promote an organizational culture geared towards responsiveness; (2) ensure appropriate infrastructure and processes; and (3) promote client engagement and empowerment

14.5.2.2 Ensure financial risk protection and alleviate the financial burden of indigent and financially incapacitated patients and families who avail of health services in public hospitals through financial and medical assistance provided by the national government agencies, local government, non-governmental organizations, private corporations and individuals.

14.5.3 Section 6 lists the functions that Malasakit Centers are to be established.

14.5.3.1 Serve as a one-stop shop for medical and financial assistance

14.5.3.2 Provide patient navigation and referral to the health care provider networks

14.5.3.3 Provide information with regard to membership, coverage and benefit package in the National Health Insurance Program (NHIP)

14.5.3.4 Document, process and utilize data from patient experience through a standardized form to shape institutional changes in the hospital

14.5.3.5 Provide capacity-building and performance evaluation to ensure good client interaction

165 Good Governance and Social Responsibility in Hospital Finance Service Manual of Standards and Procedures for Hospital Finance Service 14.5.3.6 Provide critical information on healthy behaviors and conduct health promotion activities in the hospital

The following terminology are provided in the law, which are relevant in the operations of Malasakit Centers:

14.5.4 Financial Assistance refers to monetary aid, in the form of guaranty letter, cash or check, which covers burial, transportation, and other allied assistance or physical aid, such as food, clothing, general assistive devices, given by agencies and mandated by existing laws, rules and regulations to provide such assistance.

14.5.5 Financially Incapacitated Patient refers to a patient who is not classified as indigent but who demonstrate clear inability to pay or spend for necessary expenditures for one’s medical treatment, as assessed and certified by the medical social worker.

14.5.6 Indigent Patients refer to patient who has no visible means of income, or whose income is insufficient for the subsistence of his/her family, as assessed by the DSWD, local government social worker or medical social worker of the health facility.

14.5.7 Medical Assistance refers to assistance for out-of-pocket expense in the form of coupon, stub, guaranty letter, promissory note or beneficiaries to be used for the purchase of drugs and medicines, goods or other services prescribed by the physician of a health facility for in- and out-patients.

14.5.8 One-Stop Shop refers to common site or location designated to receive and process requests for medical and financial assistance for indigent and financially incapacitated patients.

14.5.9 Out-of-Pocket Expenses refer to the amount paid by the patient for medical and surgical services not sufficiently covered by PhilHealth benefits, insurance coverage, discounts, or other sources of similar nature.

14.6 Declaration of the Rights of Patients

For better understanding of the UHC and Malasakit, the following lists and discusses 15 primary rights of patients that form the Declaration of the Rights of the Patient by the World Medical Association.

166 Good Governance and Social Responsibility in Hospital Finance Service Manual of Standards and Procedures for Hospital Finance Service 14.6.1 The Right to Good Quality Health Care and Humane Treatment

Every person shall be given due medical care that corresponds to her or his state of health, within the limits of resources, manpower, and competence. No form of discrimination should hinder a patient from receiving quality health care. As for patients needing emergency or urgent attention, they shall be given immediate medical care and treatment without being asked to provide advance payment in any form until she/he is stable.

14.6.2 The Right to Dignity

The patient’s dignity, culture, and values shall be respected at all times. As such, terminally ill patients shall be entitled to humane end-of-life care to make dying as dignified and comfortable as possible.

14.6.3 The Right to Choose Health Care Provider and Facility

Every patient has the freedom to choose which physician and health care institution to serve her or him, unless the patient has waived this right in writing, is under a service facility's care, or the safety and health of the public are involved. Consulting with a specialist and seeking a second opinion from another medical professional is also allowed at her or his expense and request, if appropriate.

14.6.4 The Right to Informed Consent

All patients are granted the right to an honest and adequate explanation of the proposed medical procedures, in a suitable language and manner that is understood by the patient. Furthermore, the medical professionals tasked with performing the procedure must provide her or his name and credentials, as well as details of possible risks and probability for success. Accordingly, without written informed consent, no patient shall be subjected to any kind of procedure, except for some special cases.

14.6.4.1 Unconscious Patients: Informed consent will be sought from a legal representative or next of kin. If a representative is not available, and medical or surgical intervention is urgent, then the patient’s consent is presumed.

14.6.4.2 Legally Incompetent Patients: If the patient is a minor or is considered legally incompetent, the consent of a legal representative is needed.

14.6.4.3 Procedures Against the Patient’s Will: Medical procedures and treatment against the patient’s will can only be carried out under

167 Good Governance and Social Responsibility in Hospital Finance Service Manual of Standards and Procedures for Hospital Finance Service exceptional circumstances. In such cases, consent is sought from the next-of-kin.

14.6.5 The Right to Refuse Diagnostic and Medical Treatment

For as long as her or his refusal will not jeopardize public health and safety, any patient who is of legal age and mentally competent has the right to refuse diagnostic and medical treatment. Upon refusal, the patient releases her or his health care providers from any obligation relative to the consequences of the decision.

14.6.6 The Right to Refuse Participation in Medical Research

The patient shall be advised if there are plans to involve her or him in any form of medical research. Moreover, she or he can refuse involvement or may not be subjected to scientific study without written consent.

14.6.7 The Right to Religious Belief and Assistance

Any patient may refuse treatment and procedures which may contradict with her or his religious beliefs. However, this right may not be imposed by guardians upon minor children in life-threatening circumstances. Furthermore, the patient has the right to receive spiritual and moral support, including that from a priest, minister, or representative from her or his chosen religion.

14.6.8 The Right to Privacy and Confidentiality

Patients have the right to evade any form of unwarranted private or public exposure and demand that all information and records regarding their health care be treated strictly confidential. Without a patient's consent, no health care practitioner shall divulge any sort of information, except for certain circumstances.

14.6.9 The Right to Disclosure of and Access to Information

Throughout her or his hospital care, the patient shall be provided with information regarding her or his disease, as well as the treatment administered, medications prescribed, etc. In addition, a patient, given that she or he is of legal age and sound mental state, is entitled to receive an itemized bill of the healthcare services rendered. Lastly, after confinement, the patient has the right to request a written summary of the treatment course, as well as a medical certificate.

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14.6.10 The Right to Health Education

The patient has the right to health education that will help in making informed decisions surrounding their condition and the health services available to them. This includes methods of prevention, early detection, and healthy lifestyle choices.

14.6.11 The Right to Correspondence and to Receive Visitors

A patient can communicate with and receive visitors under the reasonable restrictions prescribed by a medical establishment's rules and regulations.

14.6.12 The Right to Medical Records

A patient is entitled to receive a summary of her or his condition and medical history. Provided that an attending physician is present, she or he may access and view her or his medical records, subject to some reasonable limits. Upon discharge and at the expense of a patient, she or he may obtain record reproductions, regardless of whether she or he has completely settled monetary obligations or not.

14.6.13 The Right to Leave Against Medical Advice

Patients are allowed to leave any healthcare establishment, regardless of her or his physical state, given that she or he is adequately informed of consequences, has released involved parties of obligations, and her or his decision to leave will not affect the health and safety of the public.

14.6.14 The Right to Express Grievances

Every patient has the right to express and file complaints about the services received from a medical institution, without fear of being reprised or discriminated.

14.6.15 The Right to be Informed of Her or His Rights and Obligations as a Patient

Every individual shall be informed of her or his rights and obligations as a patient. Additionally, it's the duty of institutions to inform patients of their rights with regards to its rules and regulations.

The Finance Service in its vital roles in the stewardship of the health care facility’s resources and maintenance of good governance, with due regard of the facility’s social responsibility, must assure the uninterrupted flow of resources that in turn assures the continuity of the delivery of quality health care services.

169 Good Governance and Social Responsibility in Hospital Finance Service Manual of Standards and Procedures for Hospital Finance Service

REFERENCES

1 UNESCO. (2010). Report of the International Bioethics Committee of UNESCO on Social Responsibility and Health. Paris: UNESCO.

2 RA 11223 Otherwise known as the Universal Health Care Act

3 Social Responsibility: A New Paradigm of Health Governance (Brandao, Rego, Duarte, Nunes) published April 6, 2012

4 ISO 9001:2015 Principles

5 WHO notes on Stewardship

6 A Review of Health Governance Status and Achievement 12th National health Sector Meeting, November 4-5, 2009

7 National Objectives for Health 2017-2022

8 Section 2, RA 6713 – Code of Conduct and Ethical Standards for Public Officials and Employees

9 Governance in Public Sector by International Federations of Accountants (IFAC), June 2013

RA 11463 Otherwise known as the Malasakit Center Act

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Manual of Standards for Management of Hospital Finance Service

CHAPTER 15

REVENUE AND COST
MANAGEMENT

Hospital Administrators are involved in varied strategic decisions and operational decisions of which financial issues play a key role. Decisions in financial management are largely controlled by the economic, political, social and legal environment in which the healthcare facilities operate. Availability and use of financial resources in health care are influenced by the following critical dimensions:

 Institutional context in which the healthcare organization operates (whether under direct supervision and control by the government, government-owned and controlled corporation, or private)  Method of financing health care (Subsidized by government, retained income, foundation, etc.)  Methods of payment (service, PhilHealth, pay, etc.)

Thus, revenue and cost management is one of the critical roles of Finance Service in coordination with all the department heads and other interested parties in any healthcare facilities.

The resources used in hospital operation include human resources, physical plant such as land and building, equipment, devices, supplies and consumables that are needed to provide uninterrupted quality services to patients and its clients. All these resources have monetary value and each process requires financial resources to meet its objectives. Thus, financial system can be seen as vital subsystem of the health system.

To illustrate the relationship underlying healthcare process:

Figure No. 7.1: Process flow

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Thus –

o Input means all resources used to produce health care outcomes such as human resources, equipment, facilities, and supplies. All these inputs can be measured and valued in terms of money. Thus, the monetary value of the inputs allows analysis of the use of resources within the organizations.

o Process describes the activities carried out to achieve the desired outcome. Financial processes involve budgeting, utilization of funds, collecting revenue, payment for personnel and creditors, procuring drugs and medical supplies, and investing capital in equipment and infrastructure. To be able to perform these processes, the ﬁnancial information needs to be accurate, timely and relevant. Example of health care processes are the number of cases of patients treated, number of diagnostic procedures conducted, number of vaccinations/ immunization, and other medical, nursing and patient support services provided.

o Output measures the changes to a patient’s health status that can be attributed to the health care management of the patient that implicitly utilizing ﬁnancial resources. Outcome measures, such as discharge improved, quality of life, play an important role in economic evaluation of increasing the quality of life of the patient.

15.1 Sources of Healthcare Funds

Healthcare financing may be sourced from:

15.1.1 Government Subsidy – public funds generated through general taxation.
Government act as the principal financial agent to subsidize patients admitted in government and government owned hospitals both in local and national level. Health care expenses are planned and appropriated based on the priority programs, activities, and projects of the Department of Health.

15.1.2 National Health Insurance Services (PHIC, GSIS & SSS) – based on premium paid by individual members.

15.1.3 Private Health Insurance and Health Maintenance Organization (HMO).

Out of Pocket – Patients have co-payment or shared payments for services rendered not covered by the above-mentioned sources of funds.

15.1.4 Hospital Retained Income - proceeds from user’s fee, sale of pharmaceutical products, and revenues from use of facilities and services other than patient related.

172 Revenue and Cost Management Manual of Standards for Management of Hospital Finance Service 15.1.5 Financial assistance from other government agencies (PCSO, PAGCOR, DSWD, LGUs, etc.)

15.1.6 Donations by NGOs, private individuals and entities.

15.1.7 Foreign grants and aid.

15.2 Cost Accounting and Management

Cost Accounting is the process of determining and accumulating the cost of product or activity. It is a process of accounting for the incurrence and the control of cost. It also covers classification, analysis, and interpretation of cost. In other words, it is a system of accounting, which provides the information about the ascertainment, and control of costs of products, or services. It measures the operating efficiency of the enterprise.

Cost Accounting is aimed at providing cost data, statements and reports for managerial decision making. The process involves the preparation of statistical data, application of cost control methods and the ascertainment of profitability of activities carried out or planned.

Costing involves the classifying, recording and appropriate allocation of expenditure for the determination of costs of products or services; the relation of these costs to sales value; and the ascertainment of profitability. (Chapter 27, Introduction to Cost Accounting, Robert Kabwe)

15.2.1 Cost Determination and Rate Setting

Determining the proper cost of health services is an essential component of health systems. It strengthens the efficiency in health system, ensures equitable and efficient resource allocation, improves planning and budgeting, advocates funding and determines user fees, insurance premiums and contract prices. Costing of hospital services and commodities has several variables which include direct costs, indirect costs and full costs.
The following are the objectives of Cost Determination and Rate Setting:

15.2.1.1 Set the rates for selected services/procedures of hospitals at a level that allows adequate cost recovery and financial sustainability, without prejudice to the patient. Determine the accurate cost of tests, procedures, modalities and services provided to patients.

15.2.1.2 Set the appropriate hospital rates that should be charged to the patient or the third party payor for all tests, procedures, modalities and services rendered.

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Manual of Standards for Management of Hospital Finance Service Revenue and Cost Management 15.2.1.3 Standardize the costing and rate setting process for uniform implementation.

15.2.1.4 Establish a monitoring system that will evaluate the effectiveness of the new rates in recovering costs and providing financial sustainability.

15.2.1.5 Provide information for decision making relating to the following matters:
15.2.1.5.1 Determination of cost-volume-profit relationship.
15.2.1.5.2 Buy or lease equipment 15.2.1.5.3 Shut down or continue operation at a loss 15.2.1.5.4 Continue using the existing machinery or replace them with new equipment

15.2.1.6 Ascertain profit or loss.

15.2.1.7 Review production, generated income and operating results.

A Hospital Costing and Rate Setting Committee is necessary to oversee implementation of cost determination and rate setting activities in the Hospital. The Hospital Rates Committee is recommended to be composed of the following personnel:

DESIGNATION LEVEL 1 and LEVEL 2 LEVEL 3 Chairperson
Chief Administrative Officer FMO/CAO Vice Chair Chief Accountant Chief Accountant Member Chief Medical Professional Staff or authorized representative Chief Medical Professional Staff or Authorized Representative

Nursing Officer or authorized representative Procurement Officer Procurement Officer

Planning Officer Billing and Claims Head Billing and Claims Head Provisional Members Representative from cost and revenue centers Secretariat

Encoder HIMD/HOMIS Statistician/HIMD/HOMIS

Provisional Members: Cost and Revenue Center representative Department/Unit/Section Head concerned End-user representative/s

174 Revenue and Cost Management Manual of Standards for Management of Hospital Finance Service

The duties of the Hospital Rates Committee shall be as follows:

15.2.1.8 The Committee shall be the primary oversight over the hospital rates in each Hospital and other health facilities.

15.2.1.9 The Committee shall determine the appropriate hospital rates and recommend the same to the Chief of Hospital or appropriate LGU authorities for approval.

15.2.1.10 The Committee shall review current rates and initiate updating of rates if there are new modalities introduced in the market.

15.2.1.11 The Committee shall monitor and evaluate effectiveness of the costing and rate setting activities.

The determination of rates for hospital services shall follow a methodology of activity-based costing. Activity-based costing will identify the actual cost of patient services, as well as other associated financial requirements to deliver these services. The process follows the aggregation of the following inputs needed to produce the services:  Direct Labor Cost  Direct Material Cost  Equipment Cost  Overhead Cost  Mark-up

For each hospital service identified, the following steps for activity-based costing shall be implemented:

Step 1. Define each of the activities involved to perform the hospital service. Activities should include all steps and tasks relevant to perform the identified hospital service. The list of activities for each service should be comprehensive, and be specific to the completion of the service.

Step 2. Gather relevant information to determine the total direct material costs for the hospital service.

Material Cost shall be computed as follows:

Direct Material Cost = quantity of materials used x unit cost of materials

         The Total Direct Material Cost shall be computed as the sum of all direct

material costs needed for the hospital service.

Step 3. Gather relevant information to determine the total direct labor costs for the hospital service/procedure. For each activity, identify the hospital personnel in charge of performing the activity. Indicate the position title,

175
Manual of Standards for Management of Hospital Finance Service Revenue and Cost Management not the individual staff name. Determine the working time required to perform the activity. The working time per activity refers to the number of minutes used in performing the activity. Compute the total personnel cost on a per minute basis. The basis shall be basic salary plus all allowances (including the government share on GSIS, Pag-ibig, ECC and PhilHealth).
The labor cost (specified in pesos) shall be computed as follows:

Personnel rate/month = Annual Basic Salary & Allowances divided by 12
Personnel cost/day = Personnel Rate per Month divided by 22 (average Working days) Personnel cost/hour = Personnel Cost per day divided by 8 Personnel cost/minute = Personnel cost per hour divided by 60 Direct Labor Cost = Personnel cost per minute multiplied by the
Required working time (expressed in minutes)

The Total Direct Labor Cost shall be computed as the sum of all direct labor costs, expressed in man-minutes, needed for the hospital service/procedure.

Step 4. Gather relevant information on equipment cost for the hospital service/procedure. For each activity, identify the specific equipment needed to perform each activity then, compute for the equipment cost. The equipment cost is based on the estimated time needed to recover the costs of acquiring the equipment. Acquisition costs should include the cost of bidding, transportation, setting up, and other associated installation costs. Costs for acquiring equipment should be recovered within five years of equipment utilization. Equipment utilization can be estimated on either: a) volume of utilization basis; or b) per minute use basis.

Step 5. Compute the annual depreciation cost based on the following formula:

Equipment Depreciation Cost = Total Acquisition Cost of the Equipment
Divided by estimated useful life in years Depreciation cost/month = Equipment Depreciation cost divided by 12

Step 6. Compute for the equipment utilization cost based on volume of utilization or equipment hours

a. Based on volume of utilization: Equipment Cost = Depreciation per month divided by the
average volume of utilization per month

b. Based on equipment hours:

176 Revenue and Cost Management Manual of Standards for Management of Hospital Finance Service Daily Depreciation = Depreciation per month divided by
number of days running per month Hourly Depreciation = Daily Depreciation divided by number of
hours running per day Per Minute Depreciation = Hourly Depreciation divided by 60

Equipment Cost per minute = Depreciation multiplied by the number
of minutes per utilization per month

Step 7. Gather relevant information to determine the overhead costs for the hospital service/ procedure. The overhead costs are determined through discussion with the hospital engineer. The following bases can be used:

o Working hours can be used to compute for the power consumption per kilowatt per hour. Water consumption per cubic meter can similarly be determined. o Total working hours of the equipment o Rental costs for the floor area of the equipment

Step 8. Determine the appropriate mark-up rate for hospital services. The mark-up rate is computed with the hospital accountant/finance officer. This is based on the proportion of administrative and non-clinical costs to the total hospital operating budget. This includes costs for non-clinical services, such as janitorial, security, laundry, and dietary services.

Step 9. Determine the appropriate hospital rate.

      The computed cost is determined by getting the sum of the following:

 Direct Labor Cost  Direct Material Cost
 Equipment Cost  Overhead Cost

The appropriate hospital rate is calculated using either of the formula stated below:

a. Hospital Rate = Computed Cost multiplied by 1+ mark-up rate (decimal place)

Note: If the approved mark-up rate is 30%, the computed cost will be multiplied by 1.30

   b. Hospital Rate = Computed Cost / (1 - mark-up rate (decimal place)

Note: If the approved mark-up rate is 30%, the computed cost will be divided by 70%

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Manual of Standards for Management of Hospital Finance Service Revenue and Cost Management

The computed hospital rate shall be used as a guide to determine the charging structure of the service.

Step 10. Determine other factors relative to the recommended rate. The demand for the service and the fee charged by other hospitals or organizations providing the same service varies. Some charges may have to be set higher than the computed rate while some are lower than the computed rate. For example, if the computed rate for x-ray is P150 and result of the comparative rates with other hospitals show that the lowest fee charge by other hospital is P200, fees may be set at a higher rate than the computed rate.

However, if the computed rate is higher than the fees set by other hospitals, the recommended rate should either be the same as the lowest fee or to the fee charged by a healthcare institution of the same level with your hospital. This is to make the rate competitive with the market. In cases like this, the hospital must review the reason for a higher computed rate and come-up with strategies to reduce cost.

The fees should be able to recover expected additional cost in the future.
The charges should be enough to cover these additional costs. In setting up the fees for the service, consider the budgeted figures of various expenses like salary and supplies since these rates will be used on a longer period of time, unless amended. The computed rate may be suitably adjusted to estimate the variation in the cost.

Step 11. Monitor and evaluate the effectiveness of the costing and rate setting activities. The activity-based costing shall be reviewed every year (or as deemed necessary) by the Hospital. The Hospital Rates Committee shall ensure compliance to this schedule. The Medical Center Chief/Chief of Hospital, or equivalent position, of the Hospital shall be held responsible for compliance to the annual activity-based costing.

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Manual of Standards for Management of Hospital Finance Service CHAPTER 16

QUANTIFIED FREE
SERVICES AND DISCOUNTS

Chapter 15 discusses Revenue and Cost Management which emphasizes the need to recognize revenue to ensure a more effective cost-recovery program based on proper cost computation of hospital services. While the hospital rates include margins to provide for the reasonable financial sustainability of hospital operations, it is also acknowledged that there are occasions when hospital charges are not fully covered by PhilHealth benefits and that the balance are not paid for by the patients specifically those who have been classified as service or indigent patients. As such, the hospital services to duly qualified patients are provided without co-payment or free of any charges. In all government hospitals, approximately 80% to 90% of patients belong to this category. Under this scenario where the total hospital bill is not fully covered by PHIC benefits and patients are not able to pay, the hospital absorbs the losses. Hospital services provided for free to patients are therefore classified as Quantified Free Services.

16.1 Quantified Free Service Defined

Quantified Free Service (QFS) is the unpaid portion of patient’s hospital bill subsidized by the MOOE of the hospital, as follows:

16.1.1 The portion of the total hospital bill after deducting mandatory discounts like Senior Citizen, PWD, PhilHealth Benefits and financial assistance including Medical Assistance to Indigent Patients Program (MAIP), PCSO, DSWD, LGU Support and
out-of-pocket payments from patient.

The cost of the treatment that was waived through the Medical Social Work Unit Classification System.

16.1.2 The excess portion of the NBB Policy, after deducting the PhilHealth Benefits and medical assistance.

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Manual of Standards for Management of Hospital Finance Service

16.1.3 The cost of the treatment, subsistence and accommodation of institutional patients that were not covered by any third party and out of pocket schemes.

16.1.4 The QFS includes ER, OPD, Institutional or Custodial and Inpatient subsidies.

The Cost of free services given to indigent patients, senior Citizens’ discounts and privileges granted to elderly Filipinos aged 60 and above like 20% discount on medicines and medical supplies, restaurants, hotels and other applicable goods and services.

16.1.5 The cost of discounts granted to Persons with Disability (PWD) and government employees still active in the service who are entitled to the same discount of 20% given to senior citizens

16.2 Purpose of Setting up the QFS

Provision of quality health care is the primary objective of DOH hospitals and other healthcare facilities. However, financial survival or sustainability is equally important to hospital operations in order to ensure continued delivery of quality services. The QFS data is useful in assessing financial performance of the hospital since it represents how much services were being provided to patients free of charge. The QFS should be able to inform the hospital in the following ways:

16.2.1 Validate the effectiveness of the government subsidy received by the hospital, or whether this subsidy adequately provides funding support for the services given free of charge.

The government subsidy proves its effectiveness if it adequately supports for the operational needs of the DOH-retained hospitals and ensures the continuous provision of services. However, the amount of subsidy varies depending on parameters primarily dictated by the DBM and based on DOH’s assessment. To help rationalize the adequacy of subsidy for hospital operations (i.e., standardize the computation), the DOH can use the QFS as its point of reference. At present, the DBM provides the government subsidy for GOCC hospitals equivalent to the QFS values as reflected in their audited financial report.

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Manual of Standards for Management of Hospital Finance Service

16.2.2 Monitor the appropriateness of the rate structure used by the hospital to support its cost recovery, or whether these rates can recover the direct cost of hospital operations.

Hospital rates charged by DOH hospitals for services rendered including medicines and supplies dispensed should be based in a costing methodology that will ensure recovery of full cost. While indigent patients are not required to provide for out-of-pocket payments, the hospital charges should still be presented at gross amount to reflect the actual cost of services provided.

16.2.3 Provide relevant data to monitor the UHC implementation, including for the assessment on the extent of the PhilHealth benefit programs and the support value of the case rates provided to patients.

Cost Recovery for hospital services: Hospital rates charged by DOH hospitals for services rendered and drugs, medicines & supplies dispensed should be based on a costing methodology that will ensure recovery of full cost. While indigent patients are not required to provide for out-of-pocket payments, the hospital charges should be presented at gross amount to reflect actual cost of hospital services provided.

DOH Department Memorandum No. 2019-0101 dated February 26, 2019 explained that gathering QFS data from the DOH hospitals is vital in analyzing the impact of the UHC Act’s implementation, particularly on the expansion of the National Health Insurance Program (NHIP), the implementation of the No Balance Billing Policy, and the current payment scheme all PhilHealth case rates. The assessment of the PhilHealth benefit programs and case rates together with utilizing QFS data can generate the evidence needed to facilitate a more appropriate, responsive, and equitable distribution of resources among the DOH Hospitals.

16.3 Computation of Quantified Free Services

The cost of medicines, supplies and services provided to qualified patients are quantified based on actual charges the hospital bills to patients. The patients’ bills use appropriate hospital rates for the drugs and supplies provided and service rendered. These rates are developed based on actual cost incurred in providing

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Quantified Free Services and Discounts
Manual of Standards for Management of Hospital Finance Service the service with imputed reasonable margin. This margin helps provide the funds for the hospital’s indirect costs and expenses as well as capital expenditure programs such as equipment replacements and upgrades.

Hospital bills are settled or paid through PhilHealth benefits coverage, institutional government guarantees, private insurance coverage, and
out-of-pocket payments by the patients. To quantify the cost of free services, all settlements to the actual hospital charges shall be deducted accordingly and then the unsettled difference shall be reflected as QFS.

To ensure uniformity of QFS computation, the following formula shall be followed:

QFS

= THB less PHIC and TPP

Where:

To illustrate: Actual Hospital Bill (Gross) ₱100,000.00 Less:

PhilHealth Benefits ₱30,000.00 DOH Guarantee
₱20,000.00 Patient’s Co-pay ₱5,000.00 Net - To be set as QFS ₱45,000.00

16.4 Recording of Quantified Free Services QFS shall be recorded as a contra-income account similar in nature to the Hospital Discounts provided to senior citizens, PWDs and government employees.

QFS Refers to Quantified Free Services as a result of the net balance THB Total Hospital Bill (Cost of Services from ER, Admission (In- patient), Ward, and OPD) PHIC
PhilHealth Availment TPP
Third Party Payers (PCSO, DSWD, LGU, MAIP and other HMO)

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Manual of Standards for Management of Hospital Finance Service Using the above example, the accounting entry shall be:

Account Title Account Code Debit Credit Cash Collecting Officers 10101010 5,000.00

Due from National Government Agencies (add sub- object code for DOH) 10303010 20,000.00

Due from Government- Owned or Controlled Corporations (add sub- object code for PHIC) 10303020 30,000.00

Hospital Discounts, Allowances and Free Services 40202171 45,000.00

Hospital Fees 40202170

100,000.00

16.5 Policy Recommendations

16.5.1 Integrate Quantified Free Services as criteria for MOOE budget

appropriation for DOH Hospitals;

16.5.2 Expedite the approval of the policy on Costing and Rate

setting; and

16.5.3 Review and request from Philhealth the following:

16.5.3.1 In Patient Benefits: Adjustment of Philhealth case rates to ensure full coverage for all hospital services provided including drugs, medicines and supplies dispensed.

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Quantified Free Services and Discounts
Manual of Standards for Management of Hospital Finance Service 16.5.3.2 Out Patient Benefits:

Development and/or enhancement of existing Philhealth out-patient benefits to ensure full coverage for all hospital expenses including drugs, medicines and supplies dispensed.

16.6 Goals

16.6.1 To promote efficiency in hospital operations and management;

16.6.2 Attain financial flexibility while maintaining the government’s social responsibility for the indigent patients.

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Manual of Standards for Management of Hospital Finance Service

CHAPTER 17

FINANCIAL
RISK MANAGEMENT

Managing hospital financial operations entails complex and diverse skills considering the nature of service it provides to its clients and other interested parties. The primordial thrust is to provide continuous and uninterrupted logistic supports in order to save lives. The complexity entailed in handling the financial resources requirements of the hospital is protected by (and can also be caused by) the stringent rules and regulations that governs government financial transactions.

Broadly defined, risk management includes any activity, process or policy to reduce liability exposure1. (ISO 9001:2015 white paper: www.iso.org/tc176/sc02/public). It is also defined as the culture, capabilities, and practices, integrated with strategy-setting and performance, that organizations rely on to manage risk in creating, preserving and realizing value (COSO-ERM:2017)

Managing risk is a proactive function. It is taking action to reduce the frequency and severity of unexpected incidents, reduce the impact of legal claims, and promote high reliability performance, system design and the uniqueness of all the interested parties expose the organization to the potential for liability. Thus, managing risk in any healthcare facilities will involve all aspects of any healthcare facilities’ infrastructures and services, including financial matters, facility maintenance, fire safety, compliance with applicable laws, rules and regulations, and clinical care management.

The challenge is in facing the increased financial risk which may result to low performance or even non-performance of targeted strategic programs and activities.

In this chapter, the manual will identify common financial risks in healthcare facilities, which if left unattended or uncontrolled, may result to penalties or sanctions due to non- compliance to regulatory requirements, or even legal implications for possible break from patient safety protocols resulting to medical malpractice claims.

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17.1 Importance of Risk Management in Finance Service

Institutionalization of risk management in healthcare facilities is a means to implement effective risk governance, which in turn aims to prevent and/or control the occurrence of possible risks which will put the hospital’s status and reputation at stake2. From both patient and employees’ safety and a financial perspective, it is vital that all healthcare facilities conduct risk management activities. Risk management can be beneficial in:

17.1.1 Patient and employees’ safety 17.1.2 Competent and qualified human resources 17.1.3 Cost benefit and cost effectiveness analysis 17.1.4 Effective financial management of resources 17.1.5 Facility Management and safety 17.1.6 Statutory and Regulatory compliance

In ISO 9001:2015 Standards implementation, (Clause 6.1), an effective risk management approach provides the organizational resilience, confidence and benefits, including:

17.1.7 Provides an effective decision-making and planning process 17.1.8 Provides flexibility to respond to unexpected threats 17.1.9 Takes advantage of opportunities and provides competitive advantage 17.1.10 Equips the managers and leaders the tools to anticipate changes and threats and to allocate appropriate resources 17.1.11 Provides assurance to Top Management and stakeholders that critical risks are being managed appropriately 17.1.12 Enables better operation resilience and compliance management. 17.1.13 Improves customer confidence and satisfaction 17.1.14 Assures consistency of quality of services being provided 17.1.15 Establishes a proactive culture of prevention

Risk is inherent in all aspects of quality management system. There are risks in all systems, processes and functions. Risk-based thinking ensures that these risks are identified, considered and controlled throughout the design and use of the quality management system.

2 Risk management in Healthcare by Ali Yawar Alam 2016, published research

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Financial Risk Management Manual of Standards for Management of Hospital Finance Service 17.2 Basic Steps in Risk Management
The main responsibility of risk management is lodged in the top management, heads of division and key officers in the hospital. Thus, the management is responsible for: 17.2.1 Setting of Strategic Direction, objectives, policies and procedures to institute programs and activities consistent with the targeted goals. 17.2.2 Communicating the policies relating to risk management to all the interested parties. 17.2.3 Ensuring that risk taking remains within the limits set in its risk management plan. Any deviation must be reported and appropriate corrective measures be implemented. 17.2.4 Creating a Risk Committee who will be responsible in identifying key risk, connecting them with the risk management process and delegating them to risk owners who evaluate the adequacy of the risk management activities, and establish monitoring processes to ensure that risk activities are operating as designed. The diagram shows the risk management process in ISO 31000:2018 standards

Source: Steps in the Process of Risk Management in Healthcare by Ali Yawar Alam 2016

According to the above diagram, based on ISO 31000:2018, risk management has five basic steps: establishing the context, risk identification, risk analysis, risk evaluation, and risk treatment. Step 1. Establish the Context. Context is very important in risk identification and management. Figure 6.1: Basic Steps in Risk Management (ISO 31000:2018 Standards)

187 Financial Risk Management Manual of Standards for Management of Hospital Finance Service Step 2. Identify Risks. Risk identification is the process whereby the healthcare professional and employees become aware of the risks in the healthcare services and environment. The risk identified are entered in the Risk Management Tool known as the Risk Register. How to identify risk? o Discussion with department heads and staff o Executive Committee reports o Facility management and safety report o Patients complaints and customers’ satisfaction survey results o COA audit memorandum and observation reports o QMS Internal Audit reports o Hospital quality control report

After the identification of possible risks, the risk register is established. Risk register contains the list of all the risks of the organization, containing the related explanations.
To illustrate, here are samples of the common identified risks in the Finance Service: Objective Establish and implement effectively and efficiently the works in finance service Description To establish and implement activities designed to ensure the safety, effectiveness and quality of the company’s financial management system. Risk Names Explanation Risk Score 1 No Policies Lack of written policies to effectively and efficiently implement and monitor the works in all the departments under the Finance service 25 2 FS Staff not aware
Policies are not properly disseminated and explained to all the staff. FS staff is unaware of what is expected of them to deliver. 25 3 Inadequate Personnel
Competence of the HR assigned in the different FS department is a mismatch with the job description of the positions and personnel required to do the job
24 4 Inadequate Fund Allotments Inadequate funds/resources to effectively implement the approved programs and activities of the hospital 22 5 Lack of Funds Lack of funds/resource to implement the automation/computerization of the Finance services transactions and control system like installation of surveillance system
20

In discussing the Enterprise Risk Management Framework, four typical risks were identified in the conduct of business: operational, financial, hazard, and strategic as illustrated in the figure below.

Figure 6.2: List of Common Identified Risks in Finance Service

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Common Risks identified in Finance Service

There are common risks identified in the conduct of business of the Hospital Finance Service. The risk exposure without mitigating action may affect the quality of services provided for its internal and external clients. These risks are classified into four types in the following table.

Operational Risk Financial Risk Hazard Risk Strategic Risk Organizational – bureaucracy, culture Liquidity – inadequate cash flow Natural hazard – typhoon, earthquake

Resetting Strategic goals and objectives based on DOH Thrust People – behavior, skills, competence Credit – non collection of accounts receivable from PhilHealth/other HMO Man-made hazards – Fire, theft, property loss, spillage Changes in Administration (New Heads) Legal and compliance – regulatory, standards (COA, PPSAS, DOH, DBM) Market Risk – viability of services, return of investments for equipment investments Accidents- third party liability Competition – patient’s choice hospital Security – Loss, theft, fraud High inflation rate Employees‘ injury/illness Exhausted PhilHealth coverage
Processes & controls – gaps, glitzes, non- conformities

Decrease in Budget allocations/government subsidy

Client/Customer satisfaction – complaints

Figure 6.4: Identified Common Financial Risks Using the Four Quadrants Figure 6.3: Four Quadrants of Risk (COSO-ERM:2017)

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Step 3. Analyze Risks: Risk analysis is about developing an understanding of the risks identified. Management can assess the risk by determining two main factors: probability of occurrence («likelihood») and significance of effects («Impact»). So that management can distinguish between the high-risk, which needs immediate action, medium risk, which needs action with lesser priority, and low-risk, which needs much less intensive actions.
Looking at underlying causes of adverse occurrences furthers one’s capacity for risk analysis. Root Cause Analysis (RCA) represents a systematic approach to identifying the underlying causes of adverse occurrences so that effective steps can be taken to modify processes and prevent future losses. Brain storming with a team of relevant and informed people is the best method to do RCA. There are other methods, the most common in use include Five Whys Method, Pareto Chart, Fish Bone Diagram, Scatter Diagram and Failure Mode and Effect Analysis (FMEA).

When examining the existing control measures, consideration should be given to their adequacy, method of implementation and level of effectiveness in minimizing risk to the lowest reasonably practicable level. These include all measures put in place to eliminate or reduce the risk and may include: o Policies, procedures, protocols, guidelines o Alarms and beeps o Engineering controls o Insurance coverage programs o Code teams o Trainings o Emergency arrangements o Preventative maintenance controls

Step 4. Evaluate Risk: The purpose of risk evaluation is to prioritize the risks based on risk analysis score and to decide which risks require treatment and the appropriate mode of treatment.

Step 5. Risk Treatment: (Also known as Risk reduction, Risk mitigation): The decisions in risk treatment should be consistent with the defined internal, external and risk management contexts and taking account of the service objectives and goals. Risk treatment plan should have: o Proposed actions o Resource requirements o Person/s responsible for action o Timeframes (Dates for actions to be completed and date for review)

Risk will influence every aspect of the hospital’s operations in particular the Finance Service operation. Understanding the risks and managing them appropriately will enhance the ability to make a better decision, safeguard assets and enhance the ability to provide quality service and achieve the set mission and goals.

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17.3 Risk Management Plan (Action Plan)

The Risk Management Plan is the summary of the steps that the organization will undertake to address a risk that was identified and given a priority based on the results of the risk assessment. (ISO 31000:2018). The table below is an example of a Risk Management Plan applicable to the Finance Service.

Objective Establish and implement effectively and efficiently the works in financial service

Risk: No Policies Action Plan Target Date Person/Dept Responsible 1 Identify issues and concerns affecting the process in effectively and efficiently implement the works in Finance Service January, 2020 FMO/ FS Department Heads
2 Conduct Completed Staff Work training among all the senior/mid-level supervisors February, 2020 FMO/ FS Department Heads in coordination with HRD 3 Prepare the Issuances indicating the instructions on what, who, when, how and why (Work instructions) February, 2020 FMO/FS Department Heads 4 Disseminate the approved work instruction, policies and standards to all the FS staff and other interested parties February, 2020 FMO/FS Department Heads

17.4 Challenges/Barriers of Risk Management

Implementation of risk management program in the healthcare facilities is challenging and takes a period of time to institutionalize, considering the following factors:

o Leadership commitment for ensuring risk management o Risk identification and prioritization o Involvement of risk management team with the employees and processes o Availability of competent team in handling risk management o Availability of resources for risk treatment/mitigation
o Acceptance of changes in the process/system o Presence of monitoring and control systems

Figure 6.5: Sample Risk Management Plan for Finance Service

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CHAPTER 18

FINANCE SERVICE
CONTINUOUS
QUALITY IMPROVEMENT

The standards of the Hospital Finance Service are geared towards Continuous Quality Improvement (CQI), a cyclical process of assessing performance, implementing improvement plans, and reassessing results.

18.1 Framework

18.1.1 Continuous Quality Improvement in the Finance Service

CQI in the FS intends to evaluate the optimal financing, allocation and control of all resources of the health care organization and implement corrective measures to improve the financial management of the hospital. The ten (10) steps of the CQI process are:

18.1.1.1
Development of criteria for optimum care- Every improvement is based on benchmarking with a standard of quality and this Manual provided the standards for a well performing Finance Service that is a requirement to enable the hospital achieve optimum care for the patients. The Self-Assessment Tool provided in Appendix B.3 shall be used by the Finance Service to identify areas for improvement. 18.1.1.2
Assignment of responsibilities- Quality improvement shall start with the assignment of a quality circle in the Finance Service that would initiate the establishment of the Continuing Quality Improvement program. This could be headed by a staff knowledgeable in CQI, statistical process control and other CQI tools and measurements. Members shall be a representation of the different departments in the service.

18.1.1.3 Delineation of the scope and care- Each member of the quality circle have identified responsibilities not only because each department in the service have respective

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FS Continuous Quality Improvement Manual of Standards for Management of Hospital Finance Service standards to follow but the work on quality improvement requires team effort and series of steps.
18.1.1.4 Identification of indicators - Performance measurement indicators for Finance Management is provided in this Manual. The Finance Self-Assessment Tool has summarized the indicators according to input, process and output.
18.1.1.5 Establishment of thresholds for evaluation- Thresholds help establish if a thorough evaluation of a key function or process is necessary. Each threshold is associated to an indicator. This will show an acceptable level of performance. However, since the Manual is a First Edition, the thresholds are more descriptive such as presence of a plan rather than measurable such as 80% to 90% budget utilization. Other thresholds were taken from published references like 3 months of liquidity. The Self-Assessment Tool provided a scoring mechanism to determine the level of compliance to the standards and evaluation of the performance of the Finance Service.
18.1.1.6 Collection and organization of data- Data are collected from monitoring efforts. These data shall be used to identify opportunities for improvement in each department. Action items are developed when current practices do not meet standards. Action items are implemented to close gap between ideal and existing practice. An example is the provision of Customer Satisfaction Survey (CSS) boxes in area of Finance Service usually frontline services such as Billing and Claims and Cash Operations. 18.1.1.7 Evaluation of data related to quality of care- Performing well in Financial Management leads to a higher quality care in hospitals according to the study on “Performing Well in Financial Management: evidence from hospital process measures for treatment of cardio vascular disease”, Gang Nathan Dong, BMC Health Services Research, 2015. The financial indicators they used included profitability, debt level, asset liquidity, labor costs, charity care costs and operating efficiency. Using the tools in problem analysis of CQI such as flow chart, check sheets, pareto diagrams, root cause analysis, histograms, scatter diagrams and control charts, opportunities for improvement are identified.
Hopefully, through this Manual, more financial indicators that can be linked to quality care, can be identified and monitored.
18.1.1.8 Taking action to improve care- After the root causes have been identified, a plan of action is generated to improve the quality of services. Following the above

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example in #6 any complaint received in the Finance Service will be discussed in the Division Management Review for appropriate action. A particular example of a complaint in Billing and Claims Department: A significant number of clients/patients who feedback that most staff are arrogant in dealing with them. The FS will now conduct a training for them on customer service to address the problem and improve their performance towards clients/patients.
18.1.1.9 Assessing action and documentation of improvements- This step will determine if the corrective action succeeded in improving the system or if actions taken produced the desired effect and if the effect of the actions can be maintained. Following the example in #8, the Quality Circle conducted a training on customer service, an assessment shall be administered to determine if the corrective action done was effective in the improvement of customer service in the department.
18.1.1.10 Communication of findings or outcomes- After assessing action and documentation of improvements, a report should be made and this consists of conclusions, suggestions/recommendations, actions, and follow-ups and it shall be made available to all employees involved.
The FS will now inform the Billing and Claims Department of the outcome of the findings, if they have improved or not in their service towards clients/patients. CQI is the responsibility of every employee.

18.1.2 Creating a Culture of Quality in Finance Service

Quality of care is one of the central themes of the Universal Health Care (UHC) Act. It is also one of the main reasons why the CQI program was institutionalized through Administrative Order No. 2020-0034, and became a requirement for licensing and accreditation for all health facilities in the country. Moreover, hospitals even apply for international certification to achieve quality (ISO).

More than compliance to the standards in this Manual, the aim of FS should not only to “follow” CQI because it is a requirement but FS should aim to instill a culture of quality, "an environment in which employees not only follow quality guidelines, but also consistently see others talking about quality and feel quality around them" (Kathy lyall, Culture of Quality, Quality Magazine August 3, 2020). More specifically Quality is performed even without being monitored.

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FS Continuous Quality Improvement Manual of Standards for Management of Hospital Finance Service Below are some elements for creating a culture of quality:

 Clearly communicated vision, mission, objectives, core values, guidelines and policies – These are well stated in Chapters 2 and 3.

An organization with culture of quality will not only see these merely as standards written on walls or manuals for all to see and follow but rather it should be instilled to every employee and they should be committed to it.

It should serve as a guide and a compelling force on what the organization believes in, where it is headed, how these aspirations can be realized and what can they contribute in improving the quality in Finance Service.

Leadership emphasis on quality- A leader that lives and breathes quality is essential for the development of culture of quality. She/He must be a model and must resonate this mindset to each personnel under her/his department.

 Employee ownership and empowerment - One of the defining traits of an organization with a true culture of quality is that employees are free to apply judgment to situations that fall outside the rules. (Source: Harvard Business Review: Creating a Culture of Quality).

Empowering employees on the other hand, such as providing them trainings, involving them in brainstorming sessions to further improve quality in their respective departments and the like, will give them a sense of pride in their work and realize that what they do impacts quality. They must be involved in the process of identifying deficiencies and contributing to the solution.

 Peer-involvement- An organization is made up of group of people, therefore teamwork is necessary in creating a culture of quality. Culture of quality should be seen, heard, felt and ultimately passed on to every employee within the organization for the culture to develop and be sustainable.

Developing a culture of quality has the following benefits:  Produces more efficient planning  Lesser mistakes done by employees therefore organizations spend less time and money correcting mistakes  Increased profits through a reduction in costs and an increase in revenues.  Employees are motivated  Quality will be a way of life

Embedding a culture of continuous quality improvement in Finance Service, the FMO shall be abreast with the latest trends, issuances and

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technologies that will enhance the capacity in implementing CQI and instilling the culture of quality in the organization.

18.1.3 Total Quality Management

As a holistic, organization-wide approach in maintaining and improving quality service, total quality management (TQM) requires a highly proactive, highly participative style of management. It is a philosophy that gives major emphasis on the continuous process of quality improvement with the effective use of resources and sustained patients and clients satisfaction as ultimate goals.

The very purpose of managing quality is to establish a system that measures and manages care in a way to provide the best care for all clients/patients. To achieve this would require a deliberate effort for managers at every level of the organization to initiate and maintain quality.

TQM acts as a valuable management tool that assist health care professionals in achieving and maintaining the highest possible level of quality care for all patients of the facility. The common guiding principles in TQM practice can be summarized by the ACCEPT acrostic:

A – Aim for patient satisfaction C – Communicate and coordinate all activities C – Cooperate towards continuous improvement E – Empower the employees P – Promote usage of problem-solving tools T – Train for quality

The above principles can only take root if there is a well-uniformed quality leadership that sustains the continuous improvement process.

The Finance Service is an essential part of the hospital operation, thus the quality improvement in this service shall achieve the goals of the hospital in total quality management.

18.2 Performance Management

Performance management1 is a systematic process aimed at helping achieve an organization’s mission and strategic goals by improving effectiveness, empowering employees, and streamlining the decision-making process. It actively uses data to improve performance, including the strategic use of performance standards, measures,

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FS Continuous Quality Improvement Manual of Standards for Management of Hospital Finance Service progress reports, and ongoing quality improvement efforts to ensure an agency achieves desired results. (Public Health Foundation, 2020)

Managing and measuring performance are necessary in FS to determine its contribution in the achievement of the goals of the Hospital. It shall also provide critical and key indicators necessary for the top management for decision making.

There are a number of published performance indicators for the Finance Services in nonprofit organizations and government agencies. Some of these are monitored by DBM and COA like the Budget Utilization Rate and Disbursement Rate. These are measured to see how hospital funds are being utilized effectively.

We have reviewed some performance management indicators for Finance Service in line with the goals of Universal Health Care and included it in the Self-Assessment Tool.

Hospital performance management bridges the gap between conceptual planning of organizational goals and the actual monitoring of the status of accomplishments. It also provides decision maker whether to revise or improve the strategic objectives set.

An effective performance management aims to:  Define the goals clearly;  Provide real-time feedback;  Enhance employee’s performance;  Determine learning development and training needs;  Improve the employee’s engagement and commitment;
 Align the individual employee’s performance with the hospitals vision and mission; and  Transform the human resource into a strategic partner in attaining its goals.

18.3 Performance Management: Strategies, Tools and Approaches

Performance Management covers the monitoring, analysis and evaluation of set goals, objectives and plans. The following are some of the strategies, tools and approach which can be used to measure performance:

18.3.1 Strategic Performance Management System (SPMS)

According to the Civil Service Commission’s “Guidebook on the Strategic Performance Management System”, the SPMS is a mechanism that links employee performance with organizational performance to enhance the performance orientation of the compensation system. It ensures that the employee achieves the objectives set by the organization and the organization, on the other hand, achieves the objectives that it has set as its strategic plan. It has the following basic elements:  Goals that are aligned to agency mandate and organizational priorities;  System that is outputs/outcomes-oriented;  A team approach to performance management;

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 Forms that are user-friendly and shows alignment of individual and organizational goals;  Information systems that support monitoring and evaluation; and  A communication plan.

More importantly, the SPMS complements the Results-Based Performance Management System that is implemented by the Office of the President and that links organizational performance to societal goals. It is also linked to the Performance-Based Incentive System (PBIS) that consists of the Productivity Enhancement Incentive (PEI) and the Performance-Based Bonus (PBB).

The SPMS Process - follows a four-stage cycle, consisting of the following:  Performance planning and commitment: During this stage, success indicators are determined. Success indicators are performance level yardsticks consisting of performance measures and performance targets. These shall serve as bases in the office’s and individual employee’s preparation of their performance contract and rating form.  Performance monitoring and coaching: The performance of the office and every individual shall be regularly monitored at various levels. Monitoring and evaluation mechanisms ensure that timely and appropriate steps can be taken to keep a program on track, and that its objectives or goals are met in the most effective manner. Managers and supervisors act as coaches and mentors to provide an enabling environment/intervention to improve team performance, and to manage and develop individual potentials.  Performance review and evaluation: This phase aims to assess both office’s and individual employee’s performance level based on performance targets and measures as approved in the office and individual performance commitment contracts. Part of the individual employee’s evaluation is the competency assessment vis-à-vis the competency requirements of the job. The assessment shall focus on the strengths, competency-related performance gaps and the opportunities to address these gaps, career paths, and alternatives.  Performance rewarding and development planning: The results of the performance evaluation/assessment shall serve as inputs for the agency’s HR Plan, which includes identification and provision of developmental interventions, and conferment of rewards and incentives.

The SPMS Rating Scale uses a five-point rating scale, described in Table 4.

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FS Continuous Quality Improvement Manual of Standards for Management of Hospital Finance Service Table 4: SPMS five-point rating scale

Numerical Rating Adjectival Equivalent Description 5 Outstanding Performance represents an extraordinary level of achievement and commitment in terms of quality and time, technical skills and knowledge, ingenuity, creativity, and initiative. Employees at this performance level should have demonstrated exceptional job mastery in all major areas of responsibility. Employee achievement and contributions to the organization are of marked excellence. 4 Very Satisfactory Performance exceeded expectations. All goals, objectives, and targets were achieved above the established standards. 3 Satisfactory Performance met expectations in terms of quality of work, efficiency, and timeliness. The most critical annual goals were met. 2 Unsatisfactory Performance failed to meet expectations, and/or one or more of the most critical goals were not met. 1 Poor Performance was consistently below expectations, and/or reasonable progress toward critical goals was not made. Significant improvement is needed in one or more important

18.3.2 Performance Commitment and Review

Office Performance Commitment and Review (OPCR) Form is accomplished by Agency Directors. The OPCR consists of seven (7) columns:  Column 1: Major Final Outputs  Column 2: Success Indicators  Column 3: Allotted Budget  Column 4: Divisions Accountable  Column 5: Actual Accomplishments  Column 6, further divided into four (4) sub-columns: Rating for Quality (Q), Efficiency (E) and Timeliness (T), and the Average (Ave)  Column 7: Remarks

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The Department Memorandum No. 2021-0103 provides an update on the implementation of the OPCR for CY 2021.

Division Performance Commitment and Review (DPCR) Form is accomplished by Division Chiefs. The DPCR consists of 7 columns:  Column 1: Major Final Outputs  Column 2: Success Indicators  Column 3: Allotted Budget  Column 4: Individuals Accountable  Column 5: Actual Accomplishments  Column 6, further divided into 4 sub-columns: Rating for Quality (Q), Efficiency (E) and Timeliness (T), and the Average (Ave)  Column 7: Remarks

Individual Performance Commitment and Review (IPCR) Form is accomplished by individual staff in all the units of the organization. The IPCR consists of five (5) columns:  Column 1: Major Final Outputs  Column 2: Success Indicators  Column 3: Actual Accomplishments  Column 4, further divided into 4 sub-columns: Rating for Quality (Q), Efficiency (E) and Timeliness (T), and the Average (Ave)  Column 5: Remarks The lower portion of the forms is signed by the Supervisor and/or Rater at the beginning and the ending of the rating period. 18.3.3 Hospital Scorecard - As stated in the Department Memorandum 2021- 0040, the Hospital Scorecard is a performance and reporting tool that is used to measure and track the performance of all the DOH hospitals, consistent with the commitment and goals of the DOH’s platform to boost Universal Health Care, the FOURmula One (F1 Plus) for Health. Indicators in the scorecard are part of the core functions of the hospital’s Office Performance Commitment Report.

18.3.4 Reporting Tool of Financial Data on Revenues and Expenses- As stipulated in Department Memorandum No. 2020-0041, “All DOH Hospitals are hereby directed to submit the financial reports using the provided template on or before 28th day of February of the year starting 2020.

This reporting tool is used to determine the efficiency and accuracy of the data submitted through the Online Health Facility Statistical Report System (OHSRS) and the data gathered in this tool shall be used to ensure full accountability in the reporting of financial data, and serve as one of the bases for proposals of appropriations in Maintenance and Other Operating Expenses of DOH Hospitals. The details of this memorandum is provided in Appendix C.6.

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FS Continuous Quality Improvement Manual of Standards for Management of Hospital Finance Service 18.4 Accreditation

With the issuance of Executive Order No. 605 on February 23, 2007 by the President of the Philippines, all government (both National and Local) and government owned and controlled corporations has been mandated to institutionalize the structure, mechanics and standards to implement government quality management program in recognition of the International Organization for Standardization (ISO) 9000 series which ensures consistency of products and services through quality processes.

The importance of accreditation is the recognition that the organization achieved the quality standards of the said accreditation body. Sometimes recognition provides access to certain financing like international health insurances.

18.4.1 Performance Governance System (PGS)

The PGS is based on the performance management system that uses the “balanced scorecard” technology. Through the PGS, the organization gets closer to attaining its vision through the efficient execution of its strategies that leads to results. Instead of measuring and monitoring only the organizational output, the PGS, will more importantly measure the impact of the programs, projects, and activities of the health facility to its employees, customers, stakeholders, the Philippine government, and the country. The PGS consists of four stages - Initiation, Compliance, Proficiency, and Institutionalization – described as follows:  Initiation Stage focuses on the setting of the overall direction of the organization including its strategies, outcomes, and key success indicators. In this stage, the organization goes through defining its value chain, performs environmental scanning, identifies its inefficiencies and vulnerabilities to corruption, and think of ways to improve the facility’s governance system to give breakthrough results to its stakeholders.  Compliance Stage focuses on the alignment of the facility’s resources to its strategies. The facility’s enterprise scorecard will be cascaded to the different levels of the organization. In addition, the facility shall create a multi-sector governance body composed of internal and external stakeholders who will be part of the governance process, formally integrate the roles and responsibilities of offices on strategy management and policy and planning management, and craft a communication plan.  Proficiency and Institutionalization Stages focus on assessing the readiness of the facility to undergo the Proficiency Evaluation Process, which involves a third party audit and impact assessment. Here, the facility’s systems and processes, which were established, refined, and streamlined during the first two stages of the PGS will be assessed if these correspond to the PGS elements. An assessment of the results of the enterprise scorecard will also be conducted as

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well as the impact of the facility’s programs, projects, and activities to the different levels of society.

The facility shall undergo a “revalida” at the end of each stage. The revalida is a public presentation to a chosen panel group where it will be determined whether the facility has complied with the PGS elements and passed the stage.

18.4.2 International Organization for Standardization (ISO)

Quality per International Organization for Standardization (ISO) is the “totality of features and characteristics of a product or service that bear on its ability to satisfy stated or implied needs.” A federation of national standards bodies, the ISO’s aims to promote the development of standardization to facilitate international exchange of goods and services.

The ISO 9000 series of standards define what is required of a quality- oriented system. Principles involved in quality management include:
 Customer Focus  Leadership  Engagement of people  Process approach  Improvement  Evidenced-based decision making  Relationship management

ISO 9001:2015 provides the requirements for a quality management system (QMS). The adoption of an ISO 9001:2015 compliant QMS is a strategic decision for an organization such as a health facility to improve its overall performance and provide a sound basis for sustainable development initiatives. The potential benefits to an organization of implementing an ISO 9001:2015 QMS are:  The ability to consistently provide products and services that meet customer and applicable statutory and regulatory requirements;  Facilitating opportunities to enhance customer satisfaction;  Addressing risks and opportunities associated with its context and objectives;  The ability to demonstrate conformity to specified quality management system requirements.

18.4.2.1 The Process Approach

The ISO 9001:2015 employs the process approach, which incorporates the Plan-Do-Check-Act (PDCA) cycle. The process approach enables an organization to plan its processes and their interactions to enhance customer satisfaction by meeting customer requirements.

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FS Continuous Quality Improvement Manual of Standards for Management of Hospital Finance Service Understanding and managing interrelated processes as a system contributes to the organization’s effectiveness and efficiency in achieving its intended results. This approach enables the organization to control the interrelationships and interdependencies among processes of the system, so that the overall performance of the organization can be enhanced.

The PDCA Cycle enables an organization to ensure that its processes are adequately resourced and managed, and that opportunities for improvement are determined and acted on. The cycle can be briefly described as follows:  Plan: establish the objectives of the system and its processes, and the resources needed to deliver results in accordance with customers’ requirements and the organization’s policies, and identify and address risks and opportunities;  Do: implement what was planned;  Check: monitor and (where applicable) measure processes and the resulting products and services against policies, objectives, requirements and planned activities, and report the results;  Act: take actions to improve performance, as necessary.

Figure_7.1: Repetitive four-stage PDCA cycle model for continuous improvement

18.4.2.2 Risk-Based Thinking

ISO in its guide on risk management defines risk as the “effect of uncertainty of objectives.” Further, it clarifies

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that effect is “[a] deviation from the expected” whether positive and/or negative, and that risk is “often characterized by reference to potential events and consequences, or a combination of these.” Uncertainty surrounding objectives may be due to lack of information, understanding or knowledge on the likelihood of these potential events and consequence.

ISO 9001:2015 employs a risk-based thinking approach because a QMS is established as a tool to prevent risks. The standard requires that in establishing the organization’s context, it shall determine risks (and opportunities) as basis for planning, implementing and documenting the QMS. The organization is required to apply risk-based thinking, to formulate actions to address risks, and may keep documents as evidence how it determined risks.

18.4.2.3 ISO 9001:2015 QMS Requirements

Table 5 summarizes the requirements in establishing a QMS as defined by ISO 9001:2015.

Table 5:
Main clauses and requirements under ISO 9001:2015 Main Clauses Titles of Clauses Specific Clauses Requirements 4.0 Context of the Organization 4.1 Understanding the organization and its context 4.2 Understanding the needs and expectations of interested parties 4.3 Determining the scope of the QMS 4.4 QMS and its processes 5.0 Leadership 5.1 Leadership and commitment
(includes 5.1.2, “Customer Focus”)

5.2 Policy (i.e. “Quality Policy”)

5.3 Organizational roles, responsibilities and authorities 6.0 Planning 6.1 Actions to address risks and opportunities

6.2 Quality objectives and planning to achieve them

6.3. Planning of changes 7.0 Support 7.1 Resources
(includes 7.1.2, “People”; 7.1.3, “Infrastructure”; 7.1.4, “Environment”; 7.1.5, “Monitoring and measuring resources”; 7.1.6, “Organizational knowledge”)

7.2 Competence

7.3 Awareness

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FS Continuous Quality Improvement Manual of Standards for Management of Hospital Finance Service Main Clauses Titles of Clauses Specific Clauses Requirements

7.4 Communication

7.5 Documented information 8.0 Operation 8.1 Operational planning and control 8.2 Requirements for products and services
(includes 8.2.1, “Customer communication”, 8.2.2, “Determining the requirements”, 8.2.3, “Review of the requirements”, 8.2.4, “Changes to requirements”) 8.3 Design and development of products and services
(includes 8.3.2, “Planning”; 8.3.3, “Inputs”; 8.3.4, “Controls”; 8.3.5, “Outputs”; 8.3.6, “Changes”)
8.4 Control of externally provided processes, products and services 8.5 Production and service provision 8.6 Release of products and services 8.7 Control of nonconforming outputs 9.0 Performance Evaluation 9.1 Monitoring, measurement, analysis and evaluation (includes 9.1.2, “Customer satisfaction”) 9.2 Internal audit 9.3 Management review 10.0 Improvement 10.2 Nonconformity and corrective action 10.3 Continual improvement

Performance management in Finance Service is important to hospitals more than ever. Certainly, high performance is reflected with the quality of care provided and in terms of organizational outcomes. However, there are no shortcuts to changing or improving performance management systems. It will require hard work from everyone and smarter management choices.

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Manual of Standards for Management of Hospital Finance Service GLOSSARY OF TERMS

The terms indicated herein are commonly referred to by Finance Service. These definitions were lifted from the Glossary of Terms in the GAM for NGAs and Department of Budget and Management Manual.

TERM DESCRIPTION A

Accounting System The total structure of records and procedures, which discover, record, classify, and report information on the financial position and operations of a governmental unit or any of its funds, balanced account groups, and organizational components. Accounts Payable Refers to valid and legal obligations of NGAs/OUs, for which, goods/services/projects have been delivered/rendered/completed and accepted, regardless of the year when these obligations were incurred. Accrue To record revenues when earned and to record expenditures as soon as they result in liabilities for benefits received, notwithstanding that the receipt of cash or payment of cash may take place, in whole or in part, in another accounting period. Activity A recurring work process that contributes to the implementation of a program or sub-program Advice/Authority to debit account Refers to an authorization issued by the NGA/OU appearing in the lower portion of the List of Due and Demandable Accounts Payable- Advice to Debit Account (LDDAP-ADA). It serves as instruction to the Modified Disbursement System, Government Servicing Banks (MDS-GSBs) to debit a specified amount from its available NCA balance under regular MDS sub-account for payment of creditors/payees through Expanded Modified Direct Payment Scheme (ExMDPS)
Agency Fund A fund consisting of resources received and maintained by the hospital, such as subsidy from government, sub-allotment from DOH or other agencies, donations, retained income. Agency Heads Refer to the heads of departments, attached agencies and Other Executive Offices under the Executive Branch, State Universities and Colleges, Constitutional Commissions, and Government-Owned and/or-Controlled Corporations and other similar entities and instrumentalities concerned. Agency Performance Review The process of determining the level of accomplishment of each agency in terms of outputs, income generated, and actual expenditures incurred in the production/delivery of goods and services Allotment An authorization issued by the DBM to NGAs to incur obligations for specified amounts contained in a legislative appropriation in the form of budget release documents. It is also referred to as Obligational Authority. Appropriation An authorization pursuant to laws or other legislative enactment, hence, required Congressional action, directing the spending of public funds for a specific purpose, up to a specified amount under specified conditions.
Assets Financial representations of economic resources owned by the

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Glossary of Terms Manual of Standards for Management of Hospital Finance Service hospital such as physical plants, equipment, human resource, supplies, materials, vehicles, etc. Assumed Liabilities Domestic or foreign loans originally contracted or liabilities on securities issued by Government Financial Institutions (GFIs) or Government Owned or Controlled Corporations (GOCCs) which by law, have been transferred to and form part of the liabilities of the National Government.
Audit The examination of documents, records, reports, systems of internal control, accounting and financial procedures, and other evidence for one or more of the following purposes: a. To ascertain whether the statements prepared from the accounts present fairly the financial position and the results of financial operations of the constituent funds and account groups of the governmental unit in accordance with generally accepted accounting principles and on a basis consistent with that of the preceding year. b. To determine the compliance with applicable laws and regulations of a governmental unit's financial transactions. c. To review the efficiency and economy with which operations were carried out. d. To review effectiveness in achieving program results. Automatic Appropriations These are authorizations programmed annually or for some other period prescribed by law, by virtue of outstanding legislation, which does not require periodic action by Congress. B

Balance of Payments Balance of Payments (BOP). A summary of the economic transactions of a country with the rest of the world for a specific period. It serves as an accounting statement on economic dealings between residents of the country and nonresidents.
Balance Sheet A statement which discloses the assets, liabilities, reserves, and equities of a fund or governmental unit at a specified date, properly classified to exhibit financial position of the fund or unit at that date. Borrowings Borrowings. Funds obtained from repayable sources, including loans secured by the government from financial institutions and other sources internal and external, to finance development projects and/or budget support.
Budget The budget is the government’s plan for a year. It is a table/schedule of expenditures, based on either obligations or cash concepts and the corresponding sources of financing, either from revenues, borrowings, or cash drawdown. Ultimately, it is a tool that enables government to achieve its development agenda. Budgetary Accounts

Those accounts which reflect budgetary operations and condition, such as estimated revenues, appropriations, and encumbrances, as distinguished from proprietary accounts. Budget Call A budget document issued by the DBM at the start of the budget preparation phase, which contains the following:  Budget Priorities Framework, which sets budget priorities, macroeconomic assumptions, and fiscal parameters for the Proposed Budget; and  Guidelines, procedures, and prescribed forms in formulating budget proposals. A separate Corporate Budget Call is issued for government corporations and Local Budget Memorandum for LGUs. Budgeting Allocation of revenues/ borrowed funds among agency programs and projects to attain socio-economic goals and within the bounds of fiscal sustainability/prudence. Budget and Financial Accountability Reports (BFARs) Budget and Financial Accountability Reports (BFARs). Harmonized reports on the agencies’ actual financial and physical

207 Glossary of Terms Manual of Standards for Management of Hospital Finance Service accomplishment/ performance for a given period prescribed by the oversight agencies. Build-Operate-and Transfer (BOT) A contractual arrangement between the NG and the private sector whereby the project proponent undertakes the construction or operation, including the financing, of a given government infrastructure or operation for which it is allowed by government to collect toll fees and/or lease payments over a number of years as amortization of its costs. It has several variants such as Build- Operate-and-Own, Build-Lease-and-Transfer, Build-and Transfer, Build Transfer-and-Operate, etc.

Capital Outlays or Capital Expenditures Refer to an expenditure category/expense class for the purchase of goods and services, the benefits of which extend beyond the fiscal year and which add to the assets of the Government, including investments in the capital stock of GOCCs and their subsidiaries. Capital Revenues Proceeds from the sale of fixed or capital assets such as land, buildings, machinery, stocks and intangibles, including receipts of unrequited transfers for capital purposes from non-governmental sources. Cash Advances Advances granted to officers and employees which may be classified into:
a) Regular Cash Advance – those granted to cashiers, disbursing officers, paymasters and/or property/ supply officers for salaries and wages, commutable allowances, honoraria and other similar payments and petty cash operating expenses; and

b) Special Cash Advances – those granted on the explicit authority of the agency heads to duly designated disbursing officers or employees for other legally authorized purposes. Commitment An obligation incurred by government agencies for which items have not been delivered and services not yet rendered. This is also called “Obligations Not Yet Due and Demandable”. Current Account Covers trade in goods, services, income and current transfers. Trade in goods refers to exports and imports. Among others, Trade in services includes travel receipts in service exports while transportation (payments to foreign carriers for freight of the country’s imported goods) top service imports. Income records as receipts of a portion of the earnings of overseas Filipinos (earnings of those whose job contracts do not exceed one year), as well as the profit of Philippine investments abroad. Current transfers include the rest of remittances [from Overseas Filipino Workers (OFWs) with work contracts of at least one year and from migrants], gifts, grants and donations to and from abroad. Current Year’s Accounts Payable Those accounts payable, which have been incurred during the current year and remain unpaid before the end of the current year. D

Disbursement Refers to the actual amounts spent or paid out of the budgeted amounts.

Constitute all cash paid out during a given period in currency (cash) or by check/ADA. It may also mean the settlement of government payables /obligations by cash, check or ADA. It shall be covered by DV/Petty Cash Voucher (PCV)/Payroll

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Glossary of Terms Manual of Standards for Management of Hospital Finance Service E

Earmarked Revenues These identified revenues are required by statute to be used for designated activities, benefits, or purposes, and must be accounted for separately from government’s general revenues. Extended Payment Period (EPP) Three-month period in the following fiscal year when payments, chargeable against the Appropriations Law of the previous fiscal year can be processed and disbursed for goods received and services rendered, inspected and accepted by the end of the previous fiscal year Expenditure Program The ceiling on the obligations that could be incurred by the government in a given budget year. The said ceiling is supported by estimated financial resources. Expense Refers decreases in economic benefits or service potential during the reporting period in the form of outflows or consumption of assets or incurrence of liabilities that result in decreases in net assets/equity, other than those relating to distributions to owners. Expense Class Refers to the general classification of expenditures, specifically based on economic classification or the process/inputs involved in the government’s fulfillment of its responsibilities, including but not limited to the delivery of goods/services. These are Personnel Services (PS), Maintenance and Other Operating Expenses (MOOE), Financial Expenses (FinEx), Capital Outlays (CO) and Net Lending (NL). External Client Refers to a patient, office or general public transacting business with the hospital F

Fees and Charges Amounts collected by the hospital for administrative and regulatory purposes as well as payments exacted in exchange for goods and services. Financial Expenses Expense category, which refer to management supervision/trusteeship fees, interest expenses, guarantee fees, bank charges, commitment fees and other financial charges incurred in owning or borrowing an asset property.

Financial Management Refers to the process of planning, organizing, controlling and monitoring of financial resources in order to attain organizational objectives. Financial Resource Refers to the availability of hospital resources to meet its financial obligations G

General Appropriations Act The GAA is the legislative authorization that contains the new appropriations authorized by Congress in terms of specific amounts for salaries, wages and other personnel benefits; MOOE; and CO authorized to be spent for the implementation of programs, activities and projects (P/A/Ps) of all departments, bureaus and offices of government for a given year.
General Administration and Support A cost component of the agency budget which consists of the activities and projects dealing with the provision of overall administrative management and operational support to the entire agency operations. General Fund Fund which is available for any purpose to which the Congress may choose to apply, and is composed of all receipts or revenues which are not otherwise accruing to other funds.

209 Glossary of Terms Manual of Standards for Management of Hospital Finance Service Government Owned or Controlled Corporation (GOCC) A stock or a nonstock corporation, whether performing government or proprietary functions, which is directly chartered by special law or, if organized under the general corporation law, is owned or controlled by the government directly or indirectly, through a parent corporation, to the extent of at least a majority of its outstanding capital stock of the outstanding voting capital stock. Government Servicing Banks Financial institutions authorized, upon accreditation by the Monetary Board, to accept government deposits and perform banking services on behalf of government agencies. Grants All non-repayable transfers received from other levels of government, or from private individuals, or institutions, foreign or domestic, including reparations and gifts given for particular projects or programs, or for general budget support Guaranteed Letter (GL) Letter authority issued by any sponsoring individual/agency relative to the funds allotment for patient’s medical assistance referred to hospitals. H

Hospital Finance Service Refers to the provision of financial resources to cover a budget deficit or allocates financial resources arising from budget surplus. I

Imports Corresponding to import arrivals which essentially include all goods entering any of the seaports or airports of entry of the Philippines properly cleared through customs or remaining under customs control. Import duties and Taxes Taxes and levies, generally in ad valorem form, imposed on goods that enter the country, for the purpose of protecting locally manufactured goods of similar nature, or for the purpose of generating revenues under the Tariff and Custom Code. Includes specific taxes on imported goods, advance sales tax and compensating tax on imported goods. Indirect Tax Tax levied on the sale of, use of or expenditure on goods and services, such as excise tax, sales tax, VAT, import duties, export tax, documentary and stamp taxes, forest charges, and others. Internal Revenue Allotment (IRA) Automatically appropriated and released share of local government units, aggregately corresponding to 40% of the national internal revenue taxes based on the collection of the third fiscal year preceding the current fiscal year, with the share of each local government unit determined pursuant to the provisions of the Local Government Code, by share for each LGU level, and in terms of population/land area/equal sharing. Interest Charges imposed as a consequence in the use of money. It is deemed synonymous with discount when applied to government securities Internal Client Refers to the employees or official transacting business within the hospital Itemized Positions Approved positions in the regular personnel plantilla of all agencies of the national government. L

Legal Framework Refers to laws, rules and policies that governs and regulates financial decision making.
Local Development Council (LDC) The main advisory arm of the local chief executive in setting the direction and coordinating development efforts in their respective territorial jurisdictions. It includes the Provincial Development Councils (PDC), City Development Councils (CDC), Municipal

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Glossary of Terms Manual of Standards for Management of Hospital Finance Service Development Councils (MDC) and the Barangay Development Councils (BDC) Local Government Units (LGU) Refer to provinces, cities, municipalities and barangays. Locally Funded Projects (LFP) Projects financed out of revenue collections and domestic borrowings. M

Maintenance and Other Operating Expenses (MOOE) Refer to an expenditure category/expense class for support to the operations of government agencies such as expenses for supplies and materials; transportation and travel; utilities (water, power, etc.) and the repairs, etc. Mandate Is defined as the authorization given to hospital or agency to carry out or perform particular task as public servant. Manual of Standards Refers to the Statements of principles, procedures and guidelines that assist professionals in ensuring quality financial health services. Miscellaneous Income Non-tax revenues not elsewhere classified such as proceeds from the sale of goods or confiscated merchandise, inventory adjustments, and waste materials. Modified Disbursement system (MDS) A disbursement system implemented to facilitate effective management of the national government’s cash resources, whereby national government agencies/GOCCs settle their payable through issuance of checks or through direct crediting to bank accounts, chargeable against the account of the Treasurer of the Philippines (TOP/Bureau of the Treasury) being maintained with government servicing banks (GSBs). Monthly Disbursement Program (MDP) The estimated monthly disbursement requirements of the operating units (OUs) of departments/ agencies. Multi-year Obligation and Authority (MYOA) A document issued by DBM, for locally funded projects (LFPs), foreign-assisted projects (FAPs) implemented by agencies, including regular/recurring services in order to authorize the recipient entity to enter into Multi-Year contracts for the full project cost of multi-year programs/projects. A MYOA, which contains an annual breakdown of the full project cost, obligate the agencies to include in their budget proposal for the ensuing years, the amount programmed for the said year(s). Multi-year Contracting Authority (MYCA) The authority issued by the DBM to agencies, covering the full contract cost, for the procurement of multiyear projects. This shall be used as basis in the certification of availability of funds required prior to contract execution. N

National Expenditure Program (NEP) Budget proposal submitted by the President to Congress in accordance with Section 22, Article VII of the 1987 Philippine Constitution, serving as the basis of the General Appropriations Bill (GAB), which upon enactment becomes the General Appropriations Act (GAA). National Government Agencies (NGAs) Entities which perform functions not normally undertaken by the private sector, wholly dependent on the government for their budgetary requirements. Negotiated Checks MDS checks already paid/encashed by government servicing banks. Net Income (loss) The difference between revenues and expenses, reflecting the results of operations of corporations for a given period. A positive balance indicates a net income while a negative balance, a net loss.

211 Glossary of Terms Manual of Standards for Management of Hospital Finance Service New General Appropriations These are annual authorizations for incurring obligations during a specified budget year, as listed in the General Appropriations Act (GAA).
Non-Budgetary Accounts Trust liabilities, securities unloaded or purchased, sinking fund, and other accounts not included in the NG budget, i.e., the government’s estimated income and expenditures for a particular year. Non-Governmental Organization (NGO) Refers to private, non-profit voluntary organization, including schools, that is committed to the task of socio-economic development and established primarily for service which may include giving assistance to citizens or people’s organizations in various ways as by educating, training or giving financial assistance to them Non-NCA Expenditures Budgetary accounts which are paid without requiring the issuance of notices of cash allocation (NCAs) during the budget year in consideration. Non-Tax Revenues Revenues collected from sources other than compulsory tax levies. Includes those collected in exchange for direct services rendered by government agencies to the public, e.g. fees and charges, or those arising from the government's regulatory and investment activities. O

Object of Expenditures Refers to a classification under an allotment class, based on type of goods or services consistent with COA Government Accounting Manual for National Government Agencies (GAM for NGAs) and Unified Accounts Code Structure (UACS) Manual Obligation It is an act of a duly authorized official which binds the government to the immediate or eventual payment of a sum of money. Obligation maybe referred to as a commitment that encompasses possible future liabilities based on current contractual agreement.
Obligation Authority Document issued to an agency authorizing the agency to incur obligations or enter into a contract. These documents include the following:

GAA-as-Allotment-Order (GAAAO). Serves as an authority wherein appropriations in the GAA are considered released, excluding those identified in the pertinent issuance as “For Later Release”.
General Allotment Release Order (GARO). A comprehensive authority issued to all national government agencies, in general, to incur obligations, i.e. Retirement and Life Insurance Premium (RLIP), except RLIP for the departments/agencies chargeable against Special Accounts in the General Funds (SAGFs) and those covered by special arrangements.
Special Allotment Release Order (SARO). A specific authority issued by DBM to identified agencies to incur obligations not exceeding a given amount during a specified period for the purpose indicated. It shall cover expenditures the release of which is subject to compliance with specific laws or regulations, or is subject to separate approval or clearance by competent authority. Off-Budget Item Any expenditure item which is not part of the National Expenditure Program. Principal repayments are considered off-budget items. Off-budgetary Funds Receipts which are authorized to be deposited with government financial institutions for expenditure items which are not part of the National Expenditure Program. These are categorized into: a) Retained Income/Receipts; b) Revolving Funds; and c) Receipts from borrowing by BTr

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Glossary of Terms Manual of Standards for Management of Hospital Finance Service Operating and Service Income Nontax revenues generated in the exercise of the administrative and regulatory functions by the national government. Includes hospital income, tuition fees of government schools and admission fees to government museums and parks. Also includes revenues realized by government agencies from their business undertakings called for by the nature of their functions, and those income generated by social security agencies in the form of premiums earned from life and non- life insurance. Operating Expenditures Costs incurred by Government in the exercise of its administrative, regulatory, or service functions. Operating Program The portion of the expenditure program for a given fiscal year used for the delivery of goods and services. This includes PS, MOOE, FinEx and CO. Operating Revenue Receipts from the conduct of regular business operations. Operating Units Refer to organizational units carrying out specific substantive functions and directly implementing the program/activities/projects of a department or agency. 1) Implementing Units (IUs). Refer to operating units directly receiving cash allocations, capable of administering its own funds. 2) Non-Implementing Units (NonIUs). Refer to operating units not yet capable of administering its own funds, hence, not directly receiving cash allocations. Operations Cost structure which consist of programs and corresponding expenditures that relate to the main purpose for which an agency has been created. Involves direct production of goods or delivery of services or direct engagement in regulations. Organizational Outcome (OO) A short to medium-term result produced by an agency that contributes to the 805 achievement of its legislated mandate and is achieved through the delivery of its programs. Organizational Structure A hierarchy of positions that defines functions, roles and responsibilities in finance service. Outcome Any change, effect, or result brought about by an agency's programs or strategies upon individuals, social structures, or the physical environment.

Output Any good or service that an agency delivers to a target population or client group external to the agency. Outstanding Checks/Checks Floats Checks the agency/entity has issued and recognized but which have not been presented to the bank for payment.
P

Performance Indicator (PI) A characteristic or evidence that measures and illustrates the standard of performance by which an agency delivers its programs or outputs. Performance Indicators can measure the quantity, quality or timeliness of outputs and outcomes of an agency or a program and provide evidence that describes results such as economy, efficiency, and effectiveness. Output indicators are mostly within the control of an agency and are strongly linked to the budget. An outcome indicator measures how well a program has achieved its stated objective. Performance Target A predetermined level of either quantity, quality, timeliness and cost of outputs. Performance-Based Bonus (PBB) An incentive given to personnel of bureaus or delivery units in accordance with their contribution to the accomplishment of their department’s overall targets and commitments.

213 Glossary of Terms Manual of Standards for Management of Hospital Finance Service Performance-Informed Budgeting (PIB) A set of integrated processes that aims to improve the efficiency and effectiveness of public expenditure by linking the funding to results, making systematic use of performance information, although not solely, in resource allocation and management. Personnel Services (PS) Refer to an expenditure category/expense class for the payment of salaries, wages and other compensation (e.g., merit, salary increase, personnel economic relief allowance, honoraria and commutable allowances, etc.) of permanent, temporary, contractual, and casual employees of the government Peso-Denominated Transactions Involves cash obligations and receipts expressed in the local currency Philippine Government electronic Procurement System (PhilGEPS) The single, centralized electronic portal that serves as the primary and definitive source of information on government procurement.
Prior Year’s Accounts Payable Those accounts payable which have been incurred and remained unpaid as of the end of the preceding year. Private Sector Refers to any person, entity or organization who or that is not part of government. It includes, among others, non-government organizations (NGOs), people’s organizations (POs), members of the business community or business groups, cooperatives, schools, professional organizations, civic clubs and plain citizens or individuals who are not members of any organization. Program A group of activities and projects that contribute to a common particular outcome. A program should have the following: 1) unique expected results or outcomes; 2) a clear target population or client group external to the agency; 3) a defined method of intervention to achieve the desired result; and 4) a clear management structure that defines accountabilities. Program/Project Assessment A review of accomplishments against target objectives. Program Expenditure Classification (PREXC) A form of structuring the budget into programs and outcomes. In comparison to the MFO-based budget, classifying expenditures by program.

An expenditure classification by program will contribute to improved transparency and accountability, and help better link inputs to objectives or outcomes. Program/Activity/Project (PAP) Any work process or group of work processes undertaken to realize the outputs and outcomes of an agency. This is represented by an item of appropriation in the national budget. Project Refers to the undertaking, whether construction work, research or training program, computer engagement or other authorized activities which an agency shall prosecute or implement in favor or in behalf of another agency.
Project Cost The total amount necessary to implement and complete a project over a given period of time. Projection Data which approximates future event, derived from statistics/econometric tool. Property Taxes or Taxes on Property Taxes on the ownership of wealth or immovable properties levied at a regular intervals and on transfer of real or personal properties. Public Expenditure Management (PEM) A budgeting approach oriented towards achieving socially desired outcomes. It focuses on outcomes and sees expenditures as a means to produce outputs which are needed to achieve desired outcomes, highlights the importance of having the right processes. Public Financial Management (PFM Deals with all aspects of resource mobilization and expenditure management in government. It is about the way government raises its

214
Glossary of Terms Manual of Standards for Management of Hospital Finance Service income (in the form of taxes, customs duties and other revenues) and manages its expenditures to deliver essential services to its citizens, i.e., education, health care and other social programs, roads and infrastructure, the rule of law, peace and order, and security, and those areas which generally make the lives of citizens better off. Public Sector Composed of the national government (NG), the government owned and controlled corporations (GOCCs), the social security institutions (GSIS/SSS/PHIC), the local government units (LGUs) and the Bangko Sentral ng Pilipinas (BSP). All the financial transactions of these entities are summed up to generate consolidated public sector resources, for consideration in the preparation of the fiscal program. R

Receipts The sum of revenues and gross borrowings for a given period. Receipts Automatically Appropriated Receipts from grants, donations, insurance proceeds, and other sources, which by law may be immediately used by the agency without undergoing the usual legislative process. Resources In budgeting, a term frequently used to refer to revenues, gross borrowings, and free or unencumbered cash balances. Retained Income/Funds Collections which are authorized by law to be used directly by agencies concerned for their operation or specific purposes. Retirement and Life Insurance Premiums (RLIP) The share of the national government in the premium payments to Government Service Insurance System (GSIS), for the life insurance and retirement benefit fund of government employees. Revenue Refers to the gross inflow of economic benefits or service potential during the reporting period when those inflows result in an increase in net assets/equity, other than increases relating to contributions from owners.

These are increases in economic benefits or service potential during the accounting period in the form of inflows or increases of assets or decreases of liabilities that result in increases in net assets/equity, other than those relating to contributions from owners. Revolving Funds Receipts derived from business-type activities of departments/agencies which are authorized by law to be constituted as such and deposited in an authorized government depository bank. These funds shall be self-liquidating and all obligations and expenditures incurred by virtue of said business-type activity shall be charged against said fund. S

Subsidy A grant or financial aid, usually by a government body, to some other persons or institutions for general purposes. When applied to GOCCs, it may also refer to amounts used to cover operational expenses not supported by corporate revenues or to cover corporate deficits and losses. Sub-program A program with either a more specific method of intervention or more defined target clients that is contained within a bigger program of an agency. Supplemental Appropriations Additional appropriations authorized by law to augment the original appropriations which proved to be insufficient for their intended purpose due to economic, political or social conditions supported by a Certification of Availability of Funds (CAF) from the BTr.
Support to Operations A cost component of an agency budget which consists of activities and projects which provide staff, technical, and/or substantial support to operations, but do not produce goods or deliver services

215 Glossary of Terms Manual of Standards for Management of Hospital Finance Service directed at a target population or client group external to the agency. This also includes expenditures that are indivisible across programs. T

Target Goal or specific objective of a program. Tax Revenues Compulsory charges or levies imposed by government on goods, services, transactions, individuals, entities, and others, arising from the sovereign power of state. Tax on Domestic Goods and Services Tax levied on the domestic production, sale or transfer, leasing, use or delivery of goods, and rendering of services. Treasury Single Account (TSA) A single account or a set of linked accounts, thereby centralizing government cash balances, established to improve the financial management of government funds, resulting to minimized borrowing and transaction cost Trust Funds Fund which accounts for the receipts by any agency of government or by a public officer acting as trustee, agent, or administrator for the fulfillment of some obligations. Trust Liabilities An account used to record collections, income, or receipts of agencies held in trust or guarantee for another agency and for a specific purpose. Two-Tier Budgeting Approach (2TBA) An approach to strengthen the strategic decision making process by separating the evaluation of agency proposals, i.e., the first tier covering review of Forward Estimates for ongoing/existing programs/projects and the second tier covering review of new spending proposals and the expansion of on-going/existing programs/project U

Unified Accounts Code Structure (UACS) A harmonized coding structure jointly developed by the DBM, COA, DOF and BTr which aims to facilitate financial reporting and consolidation of actual revenue collection and expenditures, enable the assessment of outturns against transparency/ accountability and improve efficiency in terms of utilization of government funds. Unified Reporting system (URS) This automated system allows online or electronic submission and encoding of the plans/targets, i.e., physical, financial and disbursement program, and actual accomplishments, i.e., budget and financial accountability reports, of departments/agencies/implementing or operating units adopting the UACS. The URS can be accessed thru urs.dbm.gov.ph.

Unprogrammed Appropriations Unprogrammed Appropriations. Appropriations under the annual GAA which provide standby authority to incur additional agency obligations for priority programs or projects when revenue collections exceed targets, or when additional foreign funds are generated.
Z

Zero-Based Budgeting (ZBB) A budgeting approach through which major agency programs and projects are evaluated to: a) determine the continued relevance of program objectives vis-à-vis current developments/directions; b) assess whether program objectives/ outcomes are being achieved; c) ascertain alternative or more viable ways of achieving the objectives, and ultimately; d) guide decision makers on whether the program/project should continue to be funded at its present level, or if funding should be increased, reduced or discontinued.

B. APPENDICES

216 Appendix B.1 Summary List of Accounting Books, Registries, Records, Forms and Reports Manual of Standards for Management of Hospital Finance Service SUMMARY LIST OF ACCOUNTING BOOKS, REGISTRIES, RECORDS, FORMS AND REPORTS

Volume 11, Government Accounting Manual (GAM) for NGAs provides the common accounting books, registries, records, forms and reports, which shall be used as reference in the financial transactions in government agencies including its attached agencies.

NO. TITLE DESCRIPTION 1 Advice of Checks Issued and Cancelled This is a report prepared and submitted at least daily by an agency/entity to the GSB to enable the payees to encash/ negotiate the issued checks. The advice shall be promptly submitted to the GSB. 2 Aging of Unpaid Obligations – FAR No. 3 This schedule shall be prepared by agencies central offices/regional offices/operating units. Adopt the UACS Code per COA-DBM-DOF Joint Circular No. 2013-1 dated 6 August 2013, JC No. 2014-1 dated 7 November 2014, and JC No. 1 dated 11 August 2017. 2. Certified correct by the Budget Officer (data on Obligation Request and Status number and amount and data on aging of Not Yet Due and Demandable Obligations) and Chief Accountant (data on the aging of Due and Demandable Obligations) and approved by the Head of Department/Agency/ Authorized Representative as recommended by the Director of FMS or Equivalent 3. Due for submission to COA, DBM and BTr within 30 days after the end of the year.

3 Budget Utilization Request and Status This form shall be used by the Requesting/ Originating Offices in the utilization of their approved budget allocations for off budgetary and custodial funds such as SAGF, Internally generated funds, Business related funds and Trust funds.

217 Appendix B.1 Summary List of Accounting Books, Registries, Records, Forms and Reports Manual of Standards for Management of Hospital Finance Service NO. TITLE DESCRIPTION 4 Cash Disbursement Journal This special journal is used by the Accounting Division/Unit to record the disbursements made by the Disbursing Officer. It shall be maintained by fund cluster.

5 Cash Disbursements Register This register shall be used by field offices without complete set of books to record, monitor and report transactions involving the cash advances/payments charged thereto, and liquidating thereof by disbursing accountable officer.

6 Cash Receipts Journal This special journal is used to record the RCD/CRReg submitted by the collecting officer/s to the Accounting Division/Unit. It shall be maintained in the Accounting Division/Unit by fund cluster.

7 Cash Receipts Record This record shall have maintained to monitor accountability. All transactions for the day shall be recorded immediately and a balance (Un-deposited Collection) shall be extracted 8 Certificate of Travel Completed This is a form used by officers/employees concerned to confirm that he/she has completed the travel or otherwise, based on the approved itinerary. It is one of the supporting documents to liquidate cash advances for travel. It shall be prepared by fund cluster.

9 Check Disbursements Journal
This special journal is used to record the disbursements through checks made by the Disbursing Officer in the Accounting Division/Unit. It shall be maintained by fund cluster.

10 Disbursement Vouchers This is a form used to pay an obligation to employees/individuals/agencies/creditors for goods purchased or services rendered. It shall be prepared by the Requesting Office/Unit. The Accounting Division/Unit shall stamp on the face of this form the date of receipt from the requesting unit.

218 Appendix B.1 Summary List of Accounting Books, Registries, Records, Forms and Reports Manual of Standards for Management of Hospital Finance Service NO. TITLE DESCRIPTION 11 General Journal This journal shall be maintained in the Accounting Division/Unit by fund cluster. Only transactions not recorded in the Special Journals shall be recorded in this journal.
12 General Ledger This ledger summarizes all transactions recorded in the GJ and special journals (e.g. CRJ, CDJ, CkDJ, etc.) maintained in the Accounting Division/Unit. The ledger sheet is arranged in the same order or sequence of the accounts appearing in the RCA. Postings to this ledger shall come directly from the General and Special Journals.

13 Inspection and Acceptance Report This is a report submitted by the Inspection Officer/Committee and the Supply and/or Property Custodian on the inspection and acceptance, respectively, of the purchased supplies/goods/equipment/property. The IAR is a report submitted by the Inspection Officer/Committee and the Supply and/or Property Custodian on the inspection and acceptance, respectively, of the purchased supplies/goods/equipment/property.

14 Inventory and Inspection Report of Unserviceable Property This is a report prepared by the Supply and/or Property Unit as basis to record dropping from the books the unserviceable properties carried in the PPE accounts. 15 Inventory Custodian Slip This is a form used by the Supply and/or Property Custodian to issue tangible items amounting to less than P15,000 to end-user to establish accountability over them.

16 Itinerary of Travel This form shall be used by the official/employee of the agency/entity making the travel to show the detailed itinerary of travel before and after the travel and shall be attached to all claims for traveling expenses (cash advance for travel and actual expenses). This shall be prepared by fund cluster.

219 Appendix B.1 Summary List of Accounting Books, Registries, Records, Forms and Reports Manual of Standards for Management of Hospital Finance Service NO. TITLE DESCRIPTION 17 Journal Entry Voucher This form shall be used to record all transactions of the NGAs, whether cash receipts, cash disbursements or non-cash transactions. Accounting journal entries shall be reflected therein and it shall serve as the basis for recording in the books of accounts.

18 Liquidation Report This form shall be used to liquidate cash advances for travel and related expenses by the employees/officers concerned of the agency/entity. It shall be supported by the required supporting documents. This shall be prepared by fund cluster. 19 Monthly Report of Disbursements – FAR No. 4 This report shall be prepared indicating all authorized disbursements of the agency/OU by type and by allotment class, showing the totals by disbursement authority issued. 2. Certified Correct by the Chief Accountant/Head of Accounting Unit and approved by Head of Agency/Authorized Representative as recommended by the Director of Financial Management Service (FMS) or Equivalent. 3. Submitted to the DBM and COA - GAS. In submitting their reports to DBM, agencies and OUs under the coverage of DBM Central Office shall submit their signed Unified Reporting System (URS)-generated reports directly to the Budget and Management Bureau (BMB) concerned. In the case however of DepEd, DOH, DPWH, TESDA, SUCs, CHED, their ROs and lowest OUs shall submit their signed URS- generated reports directly to the DBM RO concerned. The CO of these departments/agencies shall submit a signed URS-generated consolidated report to the DBM - BMB concerned. 4. Due for submission to DBM, COA and BTr within 10 days after the end of the month.

20 Notice of Budget Utilization Request and Status Adjustment This form shall be used by the Accounting Unit to adjust excess/ underutilization. The Accounting Staff-in-Charge shall put a check mark in every respective item where the adjustments are attributable to.

220 Appendix B.1 Summary List of Accounting Books, Registries, Records, Forms and Reports Manual of Standards for Management of Hospital Finance Service NO. TITLE DESCRIPTION 21 Notice of Obligation Request and Status Adjustment This form shall be used by the Accounting Division/Unit to adjust excess/under obligation. The Accounting Staff-in-Charge shall put a check mark in every respective item where the adjustments are attributable to.

22 Obligation Request and Status This form shall be used by the Requesting/ Originating Offices in the utilization of their approved budget allocations per GAARD and other budget laws/authority. It shall be maintained by fund cluster.

23 Petty Cash Fund Record This shall be maintained to record cash advance, utilization and replenishment made and to monitor the PCF balance. All transactions for the day shall be recorded immediately 24 Property Acknowledgement Receipt The PAR shall be used in the Supply and/or Property Division/Unit to record the issue of PPE to end-user. It shall be maintained by fund cluster. It shall be renewed every three years or every time there is a change in custodianship/user of the property.

25 Property Card This shall be maintained in the Supply and/or Property Division/Unit for each class of PPE. The Supply and/or Property Custodian shall record promptly the acquisition (based on the IAR and other supporting documents), issue/transfer/disposal and the description/information about the asset. It shall be maintained by fund cluster.

26 Property Transfer Report This form shall be used when there are transfers of property from one Accountable Officer/Agency/Fund Cluster to another Accountable Officer/Agency/Fund Cluster.

221 Appendix B.1 Summary List of Accounting Books, Registries, Records, Forms and Reports Manual of Standards for Management of Hospital Finance Service NO. TITLE DESCRIPTION 27 Property, Plant and Equipment Ledger Card This shall be kept in the Accounting Division/Unit for each class of PPE. The Accounting Staff in charge in maintaining the PPELC shall record promptly the acquisition, description, custody, estimated life, depreciation, impairment, issue/transfers/disposal, repair history and other information about the property. It shall be maintained by fund cluster. 28 Purchase Order This is a form/document used by the agency/entity, addressed to a supplier, to deliver specific quantities of supplies/goods/property subject to the terms and conditions contained in the PO. 29 Purchase Request This is a form used by the Supply and/or Property Custodian for purchasing goods/supplies/property if the item/s requested is/are not available on stock. It shall be 53prepared by fund cluster. 30 Quarterly Physical Report of Operation – BAR No.1 The report shall reflect the agency's/OU's actual physical accomplishments as of a given quarter, in terms of the performance measures indicated in its Physical Plan (BED No. 2). This report shall be prepared capturing all fund sources. This shall be submitted to DBM, COA not later than the 30th day following the end of the quarter.

31 Registry of Accounts Written- Off This Registry is used to record and monitor accounts that were written off by the agency/entity maintained per fund cluster. 32 Registry of Allotments and Notice of Cash Allocation This registry shall be maintained by the Accounting Division/Unit to determine the amount of allotments not covered by NCA and to monitor available NCA.

33 Registry of Allotments, Obligations and Disbursements – Capital Outlays This registry shall be maintained by the Budget Division/Unit by Appropriations Act, fund cluster, by Major Final Output (MFO) or Program/Activity/Project (PAP) for capital outlays.

34 Registry of Allotments, Obligations and Disbursements – Financial Expenses This registry shall be maintained by the Budget Division/Unit by Appropriations Act, fund cluster, by Major Final Output (MFO) or Program/Activity/Project (PAP) for financial expenses.

222 Appendix B.1 Summary List of Accounting Books, Registries, Records, Forms and Reports Manual of Standards for Management of Hospital Finance Service NO. TITLE DESCRIPTION 35 Registry of Allotments, Obligations and Disbursements – Maintenance and Other Operating Expenses This registry shall be maintained by the Budget Division/Unit by Appropriations Act, fund cluster, by Major Final Output (MFO) or Program/Activity/Project (PAP) for maintenance and other operating expenses.

36 Registry of Allotments, Obligations and Disbursements – Personnel Services
This registry shall be maintained by the Budget Division/Unit by Appropriations Act, fund cluster, by Major Final Output (MFO) or Program/Activity/Project (PAP) for personnel services.

37 Registry of Appropriations and Allotments This Registry shall be maintained by fund cluster by the Budget Division/Unit of each government entity to ensure that allotment releases are within the authorized appropriation. Separate registry shall be maintained for prior year’s appropriations.
38 Registry of Budget, Utilization and Disbursements – Maintenance and Other Operating Expenses This Registry shall be maintained by the Budget Unit of each entity by fund cluster, by MFO or PAP for maintenance and other operating expenses.
39 Registry of Budget, Utilization and Disbursements – Personnel Services
This registry shall be maintained by the Budget Division/Unit of each entity by fund cluster, by MFO or PAP for Personnel Services.
40 Registry of Budget, Utilization and Disbursements –Capital Outlays
This Registry shall be maintained by the Budget Unit of each entity by fund cluster, by MFO or PAP for capital outlays 41 Registry of Budget, Utilization and Disbursements –Financial Expenses
This Registry shall be maintained by the Budget Unit of each entity by fund cluster, by MFO or PAP for financial expenses 42 Registry of Revenue and Other Receipts – Internally Generated Funds (Off- Budgetary Funds – Retained Income Funds)/ Business Related Funds This registry shall be maintained by the Budget Division/Unit of the entity for the following fund clusters:

Internally Generated Funds (Off-Budgetary – Retained Income Funds)
Business Related Funds

223 Appendix B.1 Summary List of Accounting Books, Registries, Records, Forms and Reports Manual of Standards for Management of Hospital Finance Service NO. TITLE DESCRIPTION 43 Registry of Revenue and Other Receipts – Regular Agency and Foreign Assisted Projects Fund This registry shall be maintained by the Budget Division/Unit of the entity for the following fund clusters:

Regular Agency Fund
Foreign Assisted Projects Fund
44 Registry of Revenue and Other Receipts – Special Account Locally Funded/Domestic Grants Fund and Special Account Foreign Assisted/Foreign Grants Fund This registry shall be maintained by the Budget Division/Unit of the entity for the following fund clusters:
Special Account-Locally Funded/Domestic Grants Fund
Special Account-Foreign Assisted/Foreign Grants Fund

45 Registry of Revenue and Other Receipts – Summary This Summary shall be kept by the Budget Division/Unit for each fund cluster maintained by the entity. 46 Registry of Revenue and Other Receipts – Trust Receipts/Inter-agency Transferred Funds This registry shall be maintained by the Budget Division/Unit of the entity for the Trust Receipts/Inter-Agency Transferred Funds. 47 Reimbursement Expense Receipt The RER is used to support the expenses which cannot be conveniently issued official receipts/invoice. It shall be submitted to the Accounting Division/Unit together with the LR and other supporting documents. It shall be prepared by
fund cluster.

48 Report of Accountability for Accountable Forms This is used by each Accountable Officer to report the result of the physical count of all accountable forms, with or without face value such as checks, stamps, official receipts, LDDAP-ADA, etc., in his/her custody. It shall be prepared monthly and by fund cluster.

49 Report of Advice to Debit Account Issued This report shall be used by the Disbursing Officer to report daily or as often as necessary his/her disbursements made through ADA. It shall include cancelled ADA and be maintained by fund cluster. One (1) report shall be prepared for each bank account which shall be the basis for the preparation of JEV.

224 Appendix B.1 Summary List of Accounting Books, Registries, Records, Forms and Reports Manual of Standards for Management of Hospital Finance Service NO. TITLE DESCRIPTION 50 Report of Cash Disbursements This report shall be prepared by the Disbursing Officer to liquidate his/her cash advances for payment of salaries, wages, honoraria, allowances, and other personnel benefits, current operating expenses, and special purpose/time-bound undertakings. It shall be maintained by fund cluster. 51 Report of Collections and Deposits This report shall be prepared to record collections and deposits to an AGDB as of specific date and shall be maintained by fund cluster 52 Report of Lost, Stolen, Damaged, Destroyed Property This form shall be used by the Accountable Officer to report or notify the auditor of the COA, the Chief Accountant and all others concerned of the lost, stolen, damaged or destroyed property

53 Report of Supplies and Materials Issued This is a form prepared by the Supply and/or Property Division/Unit to report/summarize all issues of inventories (by stock number) during the day. 54 Report on the Physical Count of Inventories This is a form used to report the physical count of inventory items by type such as Office Supplies Inventory; Accountable Forms Inventory; Medical, Dental and Laboratory Supplies Inventory; Food Supplies Inventory, etc. which are owned by the agency/entity. It shall be prepared semi-annually by the Inventory Committee and by fund cluster.

55 Report on the Physical Count of Property, Plant and Equipment This is the form used to report on the physical count of PPE by type such as land, land improvements, infrastructure, building and other structures, machinery and equipment, transportation equipment, furniture, fixtures and books, etc. which are owned by the agency. It shall be prepared yearly by fund cluster 56 Requisition and Issue Slip This shall be used by the Requisitioning Division/Office to request supplies/goods/ equipment/property carried in stock and by the Supply and/or Property Division/Unit to issue the items requested.

225 Appendix B.1 Summary List of Accounting Books, Registries, Records, Forms and Reports Manual of Standards for Management of Hospital Finance Service NO. TITLE DESCRIPTION 57 Statement of Appropriations, Allotments, Obligations, Disbursements and Balances – FAR No.1
This report shall be prepared by all national government agencies’ (NGAs) Central Offices/Regional Offices (ROs)/Operating Units (OUs) in reporting the appropriations, the allotments received the obligations, the disbursements made and balances for the reporting period.

58 Statement of Approved Budget, Utilizations, Disbursements and Balances – FAR No. 2 This report shall be prepared by all national government agencies' Central Offices/ROs/OUs with authority to use their revenue in reporting the budgeted income received, the utilizations made, disbursements and balances for the reporting period.

59 Stock Card This is a form used in the Supply and/or Property Division/Unit for each type of supplies to record all receipts and issues made. It shall be maintained by fund cluster. 60 Subsidiary Ledger This ledger shows details for each control account in the GL which is maintained per account and fund cluster by the Accounting Division/Unit.
61 Summary of Appropriations, Allotments, Obligations, Disbursements and Balances by Object of Expenditures – FAR No.1-A This report shall be prepared by all agencies' Central Offices/Regional Offices/Operating units in reporting the appropriations, the allotments received, the obligations, the disbursements made and balances by object of expenditures for the reporting period.

62 Summary of Approved Budget, Utilizations, Disbursements and Balances by Object of Expenditures – FAR No. 2-A This report shall be prepared by all national government agencies' Central Offices/ROs/OUs with authority to use their revenue in reporting budgeted income received, the utilizations made, disbursements and balances for the reporting period. 63 Summary of List of Due and Demandable Accounts Payable Advice to Debit Accounts Issued and Invalidated Advice to Debit Account Entries This is used by the Cash/Treasury Unit to summarize the LDDAP-ADA issued and the invalidated ADA entries and shall serve as advance information to the BTr on the cash requirements of the agency pertaining to their AP. It shall be prepared daily and supported with copy of the LDDAP-ADAs.

226 Appendix B.1 Summary List of Accounting Books, Registries, Records, Forms and Reports Manual of Standards for Management of Hospital Finance Service NO. TITLE DESCRIPTION 64 Supplies Ledger Card This is a form used in the Accounting Division/Unit for each type of supplies to record all receipts and issues made. It shall be maintained by fund cluster 65 Waste Materials Report This shall be used by the Supply and/or Property Custodian to report all waste materials previously taken up in the books of accounts as assets or in his/her custody so that they may be properly disposed of and derecognized from the books

Certification of Expenses for P300 or less not needing official receipts This shall be used for expenses incurred by government officials and employees in the discharge of their official functions amounting to P300.00 or less need not be supported by official receipts, except for the following: a) Payment of fares in public utility vehicles issuing receipts such as bus, train, vessel/ship; and b) Purchases in business establishments issuing receipts. The official/employee concerned shall be required to submit a certification for expenses P300.00 or less as supporting document (Annex “A”)

B.2 STANDARD FORMS FOR

FINANCE SERVICE

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STANDARD FORMS USED IN FINANCE SERVICE

B.2.1: FORMS USED IN ACCOUNTING DEPARTMENT

        Common Forms as prescribed in the revised COA Government Accounting Manual

(GAM) for NGAs issued by COA

General Journal (GJ)
Cash Receipts Journal (CRJ)
Cash Disbursements Journal (CDJ)
Check Disbursements Journal (CkDJ)
General Ledger (GL)
Subsidiary Ledger (SL)
Registry of Revenue and Other Receipts – Summary (RROR-S)
Registry of Revenue and Other Receipts – Internally Generated Funds (RROR-IGF)
Notice of Obligation Request and Status of Adjustment (NORSA)
Notice of Budget Utilization Request and Status of Adjustment (NBURSA)
Monthly Report of Disbursements (MRD) – FAR No. 4
Quarterly Report of Revenue and Other Receipts (QRROR) – FAR No. 5
Order of Payment (OP)
Registry of Allotments and Notice of Cash Allocation (RANCA)
Registry of Allotments and Notice of Transfer of Allocation (RANTA)
Disbursement Voucher (DV)
Journal Entry Voucher (JEV)
Index of Payments (IP)
Liquidation Report (LR)
Itinerary of Travel (IoT)
Reimbursement Expense Receipt (RER)
Certificate of Travel Completed (CTC)
Petty Cash Voucher (PCV)
Advice to Debit Account Disbursement Journal (ADADJ)
Schedule of Accounts Payable (SAP)
Schedule of Accounts Receivable (SAR)

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Appendix 1 (GAM) GENERAL JOURNAL Month ______________ Entity Name : _____________________________ Fund Cluster : ____________________________ Sheet No. : ___________ Date JEV Particulars UACS P Amount No. Object Code Debit Credit

Totals

CERTIFIED CORRECT:

(Signature over Printed Name)

Chief Accountant/Head of Accounting Division/Unit

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GENERAL JOURNAL (GJ)

INSTRUCTIONS

A. This journal shall be maintained in the Accounting Division/Unit by fund cluster. Only transactions not recorded in the Special Journals shall be recorded in this journal.

B. This journal shall be accomplished as follows:

Month – month covered by the GJ
Entity Name – name of the agency/entity
Fund Cluster – the fund cluster name/code in accordance with the UACS
Sheet No. – sheet number of the GJ, which shall be one series for each year
Date – date of the Journal Entry Voucher (JEV)
JEV No. – number assigned to the JEV
Particulars – brief description of the transaction
UACS Object Code – account code used to record the transaction
P (Posting Reference) – put a check "√" mark to indicate completion of posting of the individual transaction in the appropriate General Ledger (GL) account
Amount Debit – amount debited corresponding to the account
Amount Credit – amount credited corresponding to the account

C. Entries to the GJ shall be made only on the bases of duly approved JEVs. Said entries shall be posted individually to the GL.

D. A new sheet shall be started at the beginning of each month. Each sheet shall be footed and the totals carried forward to the next sheet. The succeeding sheet shall start with the totals brought forward. The totals of the debit and credit columns must be equal. A check "√" mark immediately underneath the totals of the amount columns shall be made to prove the equality of the total debits and total credits.

E. Every sheet shall be certified correct by the Chief Accountant/Head of Accounting Division/Unit as follows:

“CERTIFIED CORRECT:

(Signature over Printed Name) Chief Accountant/Head of Accounting
Division/Unit”

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Entity Name : _______________________________ Fund Cluster : ______________________________ UACS Object Code P Amount UACS Object Code P Amount Totals AO 5-14-02 Recapitulation: Debit Credit Certified Correct: SUNDRY CREDIT DEBIT Amount CREDIT DEBIT SUNDRY Sheet No. : __________ (Signature over Printed Name) Name of Collecting Officer Account Code P Total Chief Accountant/Head of Accounting Division/Unit Appendix 2 (GAM) CASH RECEIPTS JOURNAL
Month _________________ COLLECTIONS DEPOSITS Date RCD/ CRReg No. JEV No.

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Appendix B.2.1 Accounting Forms Manual of Standards for Management of Hospital Finance Service CASH RECEIPTS JOURNAL (CRJ)

INSTRUCTIONS

A. This special journal is used to record the RCD/CRReg submitted by the collecting officer/s to the Accounting Division/Unit. It shall be maintained in the Accounting Division/Unit by fund cluster.

B. This journal shall be accomplished as follows:

Month – month covered by the journal
Entity Name – name of the agency/entity
Fund Cluster – the fund cluster name/code in accordance with the UACS
Sheet No. – number of sheet of the journal, which shall be one series for each year
Date – date of recording in the journal
RCD/CRReg No. – Report of Collections and Deposits or Cash Receipts Register number
JEV No. – number assigned to the JEV
Name of Collecting Officer – name of the Collecting Officer/Cashier
Collections-Debit – amount collected based on the ORs issued
Collections-Credit Columns – amount of income or other receipts collected per nature of collections/receipts
Collections-Sundry-UACS Object Code – the code of the account credited for which no column has been provided
Collections-Sundry-P (Posting Reference) – put a check "√" mark to indicate completion of posting in the appropriate GL account
Collections-Sundry-Amount – amount to be credited to the account
Deposits-Debit Columns – amount deposited based on the validated deposit slip
Deposits-Sundry-UACS Object Code – the code of the account debited for which no column has been provided
Deposits-Sundry-P (Posting Reference) – put a check "√" mark to indicate completion of posting in the appropriate GL account
Deposits-Sundry-Amount – amount to be debited to the account
Deposits Credit – amount deposited as deduction from the accountability of the Collecting Officer/Cashier

C. The sundry columns shall be summarized/recapitulated and shall be shown below the totals using the format below:
Recapitulation:

Account Code

P Amount Debit Credit

Total

E. At the end of the month, posting to the GL shall be made directly from this journal. A check "√" mark immediately underneath the total of the amount columns shall be made to indicate completion of posting to the GL.

F. Every sheet shall be certified by the Chief Accountant/Head of Accounting Division/Unit as follows:

“Certified Correct:

(Signature over Printed Name) Chief Accountant/Head of Accounting Division/Unit”

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Appendix B.2.1 Accounting Forms Manual of Standards for Management of Hospital Finance Service

Entity Name : ___________________________ Fund Cluster : __________________________ Sheet No. : __________ Account Title UACS Object Code P Amount Account Title UACS Object Code P Amount AO 5-14-02 Recapitulation: Debit Credit Total Certified Correct: Chief Accountant/Head of Accounting Division/Unit Month _________________ CASH DISBURSEMENTS JOURNAL
CREDIT DEBIT Advances for Payroll (19901020) Advances to Special Disbursing Officer (19901030) SUNDRY Office Supplies Expenses (50203010) Fuel, Oil and Lubricants Expenses (50203090) Advances for Operating Expenses (19901010) Name of Disbursing Officer RCDisb No. (Signature over Printed Name) Appendix 3 (GAM) Water Expenses (50204010) SUNDRY DATE Account Code P Amount JEV No. Transportatio n and Delivery Expenses (50299040)

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Appendix B.2.1 Accounting Forms Manual of Standards for Management of Hospital Finance Service

CASH DISBURSEMENTS JOURNAL (CDJ)

INSTRUCTIONS

A. This special journal is used by the Accounting Division/Unit to record the disbursements made by the Disbursing Officer. It shall be maintained by fund cluster.
B. This journal shall be accomplished as follows:

Month – month covered by the journal
Entity Name – name of the agency/entity
Fund Cluster – the fund cluster name/code in accordance with the UACS
Sheet No. – the sheet number which shall be one series for each year
Date – date the JEV was prepared
JEV No. – number assigned to the JEV
RCDisb No. – number assigned to the Report of Cash Disbursements
Name of Disbursing Officer – the name of the Accountable Officer whose report is being recorded
Credit columns – account name, UACS object code, and amount of cash advances subject to liquidation. Examples are Advances for Payroll, Advances for Operating Expenses, and Advances to Special Disbursing Officer.  Sundry: o Account Title – additional account credited for which no column has been provided o UACS Object Code – object code for which no column has been provided
o P (Posting Reference) – place a check mark “√” to indicate completion of posting in the appropriate GL account
o Amount – amount credited to the account
Debit columns – account name, UACS object code and amount of expenses paid out of the cash advances. Examples are Office Supplies Expenses, Transportation and Delivery Expenses, Fuel, Oil and Lubricants Expenses, and Water Expenses
 Sundry:
o Account Title – additional account debited for which no column has been provided o UACS Object Code – object code based on the UACS for which no column has been provided o P – place a check mark (√) to indicate completion of posting in the appropriate GL account
o Amount – amount debited to the account

C. The sundry columns shall be summarized/recapitulated using the format below:
Recapitulation:

Account Code P Amount Debit Credit

Total

E. At the end of the month, posting to the GL shall be made directly from this journal. A check mark immediately underneath the total of the special columns shall be made to indicate completion of posting to the GL.

F. Every sheet shall be certified by the Chief Accountant/Head of Accounting Unit as follows:

“Certified Correct:

(Signature over Printed Name) Chief Accountant/Head of Accounting Division/Unit”

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Appendix B.2.1 Accounting Forms Manual of Standards for Management of Hospital Finance Service

Appendix 4 (GAM) CHECK DISBURSEMENTS JOURNAL
Month _________________ Entity Name :

Fund Cluster :

Sheet No. :

DA TE JE V No. RCI/D V No. Serial No. of Checks
Name of Disbursing Officer CREDIT DEBIT

SUNDRY

SUNDRY Fro m T o UACS Object Code P Amount UACS Object Code P Amount

Totals

Recapitulation:

Account Code P Amount

Debit Credit

Total

Certified Correct:

(Signature over Printed Name)

Chief Accountant/Head of the Accounting Division/Unit

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Appendix B.2.1 Accounting Forms Manual of Standards for Management of Hospital Finance Service

CHECK DISBURSEMENTS JOURNAL
(CkDJ)

INSTRUCTIONS

A. This special journal is used to record the disbursements through checks made by the Disbursing Officer in the Accounting Division/Unit. It shall be maintained by fund cluster.

B. This journal shall be accomplished as follows:

Month – month covered by the journal 2. Entity Name – name of the agency/entity 3. Fund Cluster – the fund cluster name/code in accordance with the UACS 4. Sheet No. – number of the sheet which shall be one series for each year 5. Date – date of the JEV 6. JEV No. – assigned JEV number 7. RCI/DV No. – RCI/DV number 8. Serial No. of Checks – serial number of the checks shall be entered in numerical/chronological sequence 9. Name of Disbursing Officer – name of the Accountable Officer 10. Credit columns – account code covered by the payment and amount of checks issued 11. Sundry-UACS Object Code – account code for which no column has been provided 12. Sundry-P (Posting Reference) – put a check “√” mark to indicate completion of posting in the appropriate GL account 13. Sundry-Amount (Credit) – amount credited to the account 14. Debit columns – account code and amount of expenses and other recurring expenses paid 15. Sundry-UACS Object Code – account code for which no column has been provided\ 16. Sundry-P (Posting Reference) – put a check “√” mark to indicate completion of postings in the appropriate GL account 17. Sundry-Amount (Debit) – amount debited to the account

C. The sundry columns shall be summarized/recapitulated using the format below:

Recapitulation:

Account Code P Amount Debit Credit

Total

E. At the end of the month, posting to the GL shall be made directly from this journal. A check “√” mark immediately underneath the total of the amount columns shall be made to indicate completion of posting to the GL.

F. Every sheet shall be certified by the Chief Accountant/Head of Accounting Division/Unit as follows:

“Certified Correct:

(Signature over Printed Name) Chief Accountant/Head of Accounting
Division/Unit”

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Appendix B.2.1 Accounting Forms Manual of Standards for Management of Hospital Finance Service

Appendix 5 (GAM) GENERAL LEDGER Entity Name: _______________________ Fund Cluster : ____________________ Account Title: ______________________ UACS Object Code: _______________ Date Particulars Ref. Amount Debit Credit Balance

Totals

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Appendix B.2.1 Accounting Forms Manual of Standards for Management of Hospital Finance Service

GENERAL LEDGER
(GL)

INSTRUCTIONS

A. This ledger summarizes all transactions recorded in the GJ and special journal (e.g. CRJ, CDJ, CkDJ, etc.) maintained in the Accounting Division/Unit. The ledger sheet is arranged in the same order or sequence of the accounts appearing in the RCA. Postings to this ledger shall come directly from the General and Special Journals.

B. The ledger shall be accomplished as follows:

Entity Name – name of the agency/entity
Fund Cluster – the fund cluster name/code in accordance with the UACS
Account Title – account title used in accordance with the prescribed RCA
UACS Object Code – account code used in accordance with the prescribed RCA
Date – date of the source document
Particulars – other information or details pertaining to the account
Ref. – the source reference: general/special journal and sheet number
Debit Column – total/recapitulated amount or individual amount of the corresponding debit account in the general/special journal
Credit Column – total/recapitulated amount or individual amount of the corresponding credit account in the general/special journal
Balance – the difference between the Debit and Credit columns. Place parenthesis in the amount with a negative balance.

B. At the end of each month, after all journals have been posted, the debit and credit columns of each account shall be footed in pencil and the balance indicated in ink.

C. At the end of the fiscal year, each account shall be ruled and closed. All totals shall be written legibly in ink and the balance of the real account carried forward as the opening balance of the new GL for the next fiscal year.

D. Controlling accounts in the GL shall be supported by details in the SLs.

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Appendix B.2.1 Accounting Forms Manual of Standards for Management of Hospital Finance Service

Appendix 6 (GAM) SUBSIDIARY LEDGER Entity Name :

Fund Cluster :

Account of: ______________________________________________ Account Code
Office/Address: ___________________________________________ GL _______________ Contact Person:___________________________________________

SL ________________ Contact Number/Email Address:

Date Particulars Ref. Amount Debit Credit Balance

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Appendix B.2.1 Accounting Forms Manual of Standards for Management of Hospital Finance Service SUBSIDIARY LEDGER (SL)

INSTRUCTIONS

A. This ledger shows detail for each control account in the GL which is maintained per account and fund cluster by the Accounting Division/Unit.

B. It shall be accomplished as follows:

Entity Name – name of the agency/entity
Fund Cluster – the fund cluster name/code in accordance with the UACS
Account of/Office/Address/Contact Person/Number – name, office address and contact number/e-mail address of the debtor/creditor (individuals, companies, agencies). In case of an agency/company, include the name, telephone number/e-mail address of the contact person.
GL Account Code – GL account code prescribed in the RCA
SL Account Code – SL account code assigned by the agency/entity
Date – date of the source documents (i.e., JEV, OR, etc.)
Particulars – other information or details pertaining to the transaction
Ref. – reference document such as the Statement of Account/JEV/OR/DV number, etc.
Debit Column – amount being debited to the account
Credit Column – amount being credited to the account
Balance – the difference between the Debit and Credit columns. Place parentheses in the amount with a negative balance.

C. At the end of each month, after all transactions in the journals have been posted, the debit and credit columns of each account shall be footed in pencil and the balance indicated in ink. The totals of the SL balances shall be reconciled with the corresponding GL controlling account.

D. At the end of the fiscal year, each SL shall be ruled and closed. All totals shall be written legibly in ink and the balance of the account carried forward as the opening balance of the new SL for the next fiscal year.

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Entity Name : _____________________________ Date Reference UACS Object Code Estimated Revenue Revenue Collections
Non- Revenue Collections/ Other Receipts Cumulative Revenue/ Other Receipts
Variance (Estimated Revenue over Cumulative Revenue and Other Receipts) Remittance to BTr
Deposit with AGDB/ AABs
Cumulative Remittance s and Deposits
Unremitted/
Undeposited Revenue and Other Receipts (a) (b) (c) d= (b+c) e= (a-d) (f) (g) h= (f+g) i= (d-h) REGISTRY OF REVENUE AND OTHER RECEIPTS-SUMMARY For the year ___________________ Fund Cluster : ______________________ Appendix 7 (GAM)

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REGISTRY OF REVENUE AND OTHER RECEIPTS-SUMMARY
(RROR-S)

INSTRUCTIONS

A. This Summary shall be kept by the Budget Division/Unit for each fund cluster maintained by the entity.

B. This form shall be accomplished as follows:

For the year – year covered by the registry
Entity Name – the name of the agency/entity
Fund Cluster – the fund cluster name/code in accordance with the UACS:
Sheet No. – sheet number which shall be one series for each year
Date – the date of recording/posting
Reference – the report number of the RCD, the CRReg, or the JEV Number.
UACS Object Code – the object code prescribed in the RCA
Estimated Revenue – the revenue estimates/targets of the entity
Revenue Collections – the collections received from revenue transactions. In the case of collections for the Regular Agency/Foreign Assisted Fund, revenue collection is further divided to tax and non-tax.
Non-Revenue Collections/Other Receipts – the collections other than those received from revenue transactions (example is refund from overpayment of expenses)
Cumulative Revenue/Other Receipts – the sum of the revenue collections and non- revenue collections/other receipts
Variance (Estimated Revenue over Cumulative Revenue and Other Receipts) – the difference between the estimated revenue over the cumulative revenue collections and other receipts
Remittance to BTr – the collections remitted to the BTr
Deposit with AGDB/AABs – the collections deposited with the AGDBs/AABs
Cumulative Remittances and Deposits – the sum of the remittances to the BTr and the deposits with AGDBs/AABs
Unremitted/Undeposited Revenue and Other Receipts – the difference between the total revenue collections and other receipts and the total remittances to the BTr and deposits with AGDBs/AABs

01 Regular Agency Fund 02 Foreign Assisted Projects Fund 03 Special Account-Locally Funded/Domestic Grants Fund 04 Special Account-Foreign Assisted/Foreign Grants Fund 05 Internally Generated Funds (Off-Budgetary Funds – Retained Income Funds) 06 Business Related Funds 07 Trust Receipts/Inter-Agency Transferred Funds

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Entity Name: _____________________________________________________________________________________

Fund Cluster: Internally Generated Funds (Off-Budgetary Funds-Retained Income Funds)/Business Related Funds Permit Fees School Fees Seminar and Training
Fees Rent/ Lease Income Income from Grants and Donations in Cash Total Refunds of Overpayment of Expenses Total (40201010) (40202010) (40202040) (40202050) (40402010) (a) (b) (c) (d) (e) (f) (g) (h)=(b+c+d+e+f+g) (i) (j) (k)= (i+j) (l)=(h+k) (m)=(a-l) (n) (o) (p)= (n+o) (q)= (l-p) Appendix 7C (GAM) Revenue Collections
Non-Revenue Collections Sheet No. : _________________________ Date For the year _______________________ Cumulative Revenue/ Other Receipts
Variance (Estimated Revenue over Cumulative Revenue and Other Receipts) Remittance to BTr
Deposit with AGDBs/ AABs Cumulative Remittances and Deposits
Unremitted/ Undeposited Revenue and Other Receipts REGISTRY OF REVENUE AND OTHER RECEIPTS Reference Estimated Revenue

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Appendix B.2.1 Accounting Forms Manual of Standards for Management of Hospital Finance Service REGISTRY OF REVENUE AND OTHER RECEIPTS (Internally Generated Funds (Off-Budgetary Funds – Retained Income Funds)/Business Related Funds)

INSTRUCTIONS

A. This registry shall be maintained by the Budget Division/Unit of the entity for the following fund clusters:

Internally Generated Funds (Off-Budgetary – Retained Income Funds)
Business Related Funds

B. This form shall be accomplished as follows:

a. For the year – the year covered by the registry b. Entity Name – the name of the agency/entity c. Sheet No. – sheet number which shall be one series for each year d. Date – the date of recording/posting e. Reference – the report number of the RCD, the CRReg, or the JEV Number f. Estimated Revenue – the revenue estimates/targets of the entity g. Revenue Collections – the collections received from revenue transactions. Permit Fees, School Fees, Seminar and Training Fees, Rent/Lease Income, Income from Grants and Donations in Cash are examples of revenue collections for entities with internally generated funds/retained income funds and business related/revolving fund. h. Non-Revenue Collections – the collections other than the collections received from revenue transactions (example is refund from overpayment of expenses) i. Cumulative Revenue/Other Receipts – the sum of the revenue collections and non-revenue collections. j. Variance (Estimated Revenue over Cumulative Revenue and other Receipts) – the differences between the estimated revenue over the cumulative revenue collections and other receipts k. Remittance to BTr – the collections remitted to the BTr l. Deposit with AGDB/AABs – the collections deposited with the AGDBs/AABs
m. Cumulative Remittances and Deposits – the sum of the remittances to the BTr and the deposits with AGDBs/AABs n. Unremitted/Undeposited Revenue and Other Receipts – the difference between the total of the revenue collections and other receipt and the total remittances to BTr and deposits with AGDBs/AABs

C. Blank columns are intended for other types of collections where no columns were specifically provided

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Appendix B.2.1 Accounting Forms Manual of Standards for Management of Hospital Finance Service Appendix 12 (GAM) Serial No. : _________ Date : _____________ Fund Cluster : ______ For: The Budget Officer: Budget Division/Unit Please adjust ORS No. ___________________dated ___________________ due to the following changes: Responsibility Center to ___________________________ Particulars to ___________________________ MFO/PAP to ___________________________ Account Code to ___________________________ Amount to P ___________________________ Please adjust RAOD for excess/under obligation per attached
JEV No. ___________dated ____________. Prepared by: Approved by: Certified Correct: Verified by: NOTICE OF OBLIGATION REQUEST AND STATUS ADJUSTMENT Entity Name

Head of Budget Division/Unit/

Accounting Staff-in-Charge

Head of Requesting Office/
Chief Accountant/Head of Accounting

Authorized Representative Division/Unit Authorized Representative A. C. D. B.

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NOTICE OF OBLIGATION REQUEST AND STATUS ADJUSTMENT
(NORSA)

INSTRUCTIONS

A. This form shall be used by the Accounting Division/Unit to adjust excess/under obligation. The Accounting Staff-in-Charge shall put a check mark in every respective item where the adjustments are attributable to.

B. This form shall be accomplished as follows:

Entity Name – the name of the agency/entity
Serial No. – the number assigned by the Accounting Division/Unit to the NORSA
Date – date of the receipt
Fund Cluster – the fund cluster name/code in accordance with the UACS in which the budget obligated is to be charged
ORS No. – the ORS number that needs to be adjusted
Dated – the date of the ORS that is to be adjusted
Responsibility Center to – the new/adjusted responsibility center of the ORS
Particulars to – the change in the nature of the expenditures indicated in the ORS to be adjusted
MFO/PAP to – the new/adjusted MFO/PAP account code based on the UACS
Account Code to – the object code attributable to the change in the particulars in the ORS to be adjusted
Amount to P – the amount of the adjustment of the expenditure
JEV No. – the number of the JEV of the expenditure based on the obligation incurred
Dated – date of the JEV

C. It shall be approved by the Chief Accountant/Head of Accounting Division/Unit.

D. The Head of the Requesting Office or his/her Authorized Representative shall certify that the adjustment is necessary to correct the charges in the ORS in the section C of the NORSA.

E. The Head of Budget Division/Unit or his/her Authorized Representative shall affix his/her signature over printed name to conform to the adjustment made.

F. This form shall be prepared in three (3) copies to be distributed as follows:

Original – Budget Division/Unit Copy 2 – COA Auditor, through the Accounting Division/ Unit, to be attached to the DV Copy 3 – Accounting Division/Unit

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NOTICE OF BUDGET UTILIZATION REQUEST AND STATUS ADJUSTMENT
(NBURSA)

INSTRUCTIONS

A. This form shall be used by the Accounting Unit to adjust excess/underutilization. The Accounting Staff-in-Charge shall put a check mark in every respective item where the adjustments are attributable to.

B. This form shall be accomplished as follows:

a. Entity Name – the name of the agency/entity b. NBURSA No. – the number assigned by the Accounting Division/Unit to the NBURSA
c. Date – date of the receipt
d. Fund Cluster – the fund cluster name/code in accordance with the UACS in which the budget utilization is to be charged e. BURS No. – the BURS number that needs to be adjusted f. Dated – the date of the BURS that is to be adjusted g. Responsibility Center to – the new/adjusted responsibility center of the BURS h. Particulars to – the change in the nature of the expenditures indicated in the BURS to be adjusted i. MFO/PAP to – the new/adjusted MFO/PAP account code based on the Unified Accounts Code Structure j. Account Code to – the object code attributable to the change in the particulars in the BURS to be adjusted k. Amount to P – the amount of the adjustment of the expenditure
l. JEV No. – the serial number of the journal entry voucher of the expenditure based on the obligation incurred m. Dated – date of the JEV

C. It shall be approved by the Chief Accountant/Head of Accounting Division/Unit.

D. The Head of the Requesting Office or his/her Authorized Representative shall affix his/her signature over printed name to certify that the adjustment is necessary to correct the charges in the ORS in the section C of the NBURSA.

E. The Head of Budget Division/Unit or his/her Authorized Representative shall affix his/her signature over printed name to conform to the adjustment made.

F. This form shall be prepared in three (3) copies to be distributed as follows:

Original – Budget Division/Unit (as SL) Copy 2 – COA Auditor, through the Accounting Division/ Unit, to be attached to the DV Copy 3 – Accounting Division/Unit

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Appendix B.2.1 Accounting Forms Manual of Standards for Management of Hospital Finance Service MONTHLY REPORT OF DISBURSEMENTS
(MRD) FAR No. 4

INSTRUCTIONS

The MRD shall be:

Prepared indicating all authorized disbursements of the national government agency/OU by type and by allotment class, showing the totals by disbursement authority issued. Certified Correct by the Chief Accountant/Head of Accounting Division/Unit and approved by Head of Agency/Authorized Representative.
Submitted to the DBM and COA-GAS. In submitting their reports to DBM, agencies and OUs under the coverage of DBM Central Office shall submit their signed Unified Reporting System (URS)-generated reports directly to the Budget and Management Bureau (BMB) concerned. In the case however of DepEd, DOH, DPWH, TESDA, SUCs, CHED, their ROs and lowest OUs shall submit their signed URS-generated reports directly to the DBM RO concerned. The CO of these departments/agencies shall also submit a signed URS-generated consolidated report to the DBM - BMB concerned. Due for submission to DBM COA and BTr within 10 days after the end of the month.

Columns 1 to 28 shall reflect the following information:

Column 1 type of disbursement authorities used during the month covered by the report.

Disbursements against the NCAs/NTAs made through MDS Checks or ADA; Working Fund for NCA's issued to the BTr; TRAs for remittance of taxes withheld; CDC for authorized disbursements charged against income collected and retained by the foreign service posts of DFA and DOLE; NCAA for cost of goods and services paid directly by lending institutions to creditors of the agency implementing a foreign-assisted project;
Disbursements effected through outright deductions from claims of any amount due to the Government (e.g., overpayment of expenses, restitution for loss of government property, liquidated damages and similar claims and Others for Tax Expenditure Fund, BTr Documentary Stamp Tax, etc. Columns 2 to 6 total disbursements made for obligations/expenditures incurred and charged against the current year budget i.e., allotments received during the year chargeable against the current year GAA Columns 7 to 11 total disbursements for obligations incurred in prior years chargeable against prior years’ budget
Columns 12 to 16 total disbursements for obligations incurred in the current year chargeable against prior years’ budget Column 17 total disbursements made for prior years’ budget Column 18 sub total,of Columns 6 and 17 (i.e., all disbursements for regular operating requirements) Columns 19 to 22 total disbursements made for trust liabilities covered by E.O. 338 / DOF-DBM Joint Circular No. 1-97. Columns 23-27 grand total, i.e., Columns 6, 17 & 22 for all types of disbursements by allotment class during the month covered by the report. Column 28 any additional information relevant to this report.

Summary of Total Disbursement Authority received and actual disbursements shall be indicated. List of disbursements authorities shall be presented on a separate sheet by Disbursement Authorities received indicating the number, date and amount.

Likewise, the over or under spending shall be determined by deducting the actual disbursements from the disbursements program. The reasons for over or under spending and the catch-up plan shall be stated in the remarks.

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Appendix B.2.1 Accounting Forms Manual of Standards for Management of Hospital Finance Service

QUARTERLY REPORT OF REVENUE AND OTHER RECEIPTS (QRROR) FAR No. 5

INSTRUCTIONS

A. This QRROR shall reflect the agency's/OUs actual revenue and other receipts collections from all sources remitted with the BTr and deposited in other AGDB, for the budget year, broken down by quarter. This shall be submitted to COA, DBM and BTr within 30 days after the end of each quarter. It shall be presented by Fund Cluster Code (UACS Fund Cluster: 01-Regular Agency Fund, 02- Foreign Assisted Projects Fund, 03-Special Account-Locally Funded/Domestic Grants Fund, 04- Special Account-Foreign Assisted/Foreign Grants Fund), 05 (Internally Generated Funds) 06 (Business Related Funds) and 07 (Trust Receipts).

B. Column 1 shall reflect the classification/sources of revenue and other receipts: (1) as to revenue collections or non-revenue collections; (2) as to cash revenue or non-cash revenue; and (3) as to tax or non-tax, if applicable. It should identify the specific source (Tax Income: e.g., Tax on Domestic Goods and Services, Tax on Net Profits, etc.; Non-tax Income: e.g. Permits and Licenses, Service, Income, Business Income, etc.) consistent with the Revised Chart of Accounts prescribed by COA. These shall include constructive receipts of income employees, government which were deducted from claims of and other receipts representing the amounts due the suppliers, contractors and other creditors, such as overpayment of personnel benefits or expenses, restitution for loss of government property, liquidated damages, fines and penalties.
C. Column 2 shall reflect the UACS Code per COA-DBM-DOF Joint Circular No. 2013-1 dated 6 August 2013, JC No. 2014-1 dated 7 November 2014, and JC No. 1 dated 11 August 2017.

D. Column 3 shall reflect the revenue targets for the year. This should be consistent with the amounts indicated in the BESF tables for the budget year. E. Columns 4 to 8 shall reflect the actual quarterly revenue and other receipts/collections for the year covered by the report. F. Columns 9 to 11 shall reflect the cumulative revenue and other receipts deposited by the agency with the BTr/AGDB as of date (from January 1 of the current year). G. Columns 12 and 13 shall reflect the variance between the annual targeted collection and the actual revenue and other receipts/collection as of the period covered by the report. H. Column 14 shall reflect any additional information i.e., reasons for any variance between targeted and actual collections; new fees imposed; increase in fees and charges; or implementation of new programs; or adjustments in the revenue.

I. This form shall be certified correct by the Chief Accountant/Head of Accounting Division/Unit and approved by the Head of Agency or his/her Authorized Representative as recommended by the Director of Financial Management Service (FMS) or Equivalent.

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                              Appendix 28 (GAM)

Entity Name : ________________________ Serial No. : _______________ Fund Cluster : _______________________ Date : __________________

ORDER OF PAYMENT The Collecting Officer

Cash/Treasury Unit

          Please issue Official Receipt in favor of

(Name of Payor)

(Address/Office of Payor) in the amount of ________________________(P) for payment of

(Purpose) per Bill No. ________________ dated __________________.

Please deposit the collections under Bank Account/s: No. Name of Bank Amount

Total P

Signature over Printed Name Head of Accounting Division/Unit/Authorized Official

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Appendix B.2.1 Accounting Forms Manual of Standards for Management of Hospital Finance Service Year of issue

ORDER OF PAYMENT
(OP)

INSTRUCTIONS

A. The Accounting Division/Unit shall prepare this form based on a Bill and it shall be prepared for each payor.

B. The OP shall be accomplished as follows:

Entity Name – name of the agency/entity
Fund Cluster – the fund cluster name/code in accordance with the UACS
Serial No. – number assigned to the OP which shall be as follows: 0000-00-0000

Serial number (one series for each year)

          Month of issue

4. Date – date of the preparation of the OP 5. Name/Address/Office – name and address/office of the Payor 6. Amount in words – total amount of the Bill in words which should agree with the amount in figures 7. Purpose – brief explanation of the transaction as appearing in the Bill
8. Bill No. and Date – Bill No. and Date as appearing in the Bill 9. Bank Account No. – Bank account number where the collection shall be deposited 10. Name of Bank – the name of the depository bank of the agency/entity 11. Amount – amount to be deposited per bank account 12. Total – total of the amount column

C. The person who prepared the OP shall initial below the name of the Authorized Signatory.

D. The Head of Accounting Division/Unit or authorized official shall affix his/her signature.

E. This form shall be prepared in three (3) copies to be distributed as follows:

Original – Payee Copy 2 – Collecting Officer or Cash/Treasury Unit Copy 3 – Accounting Division/Unit

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Appendix 30 (GAM)

REGISTRY OF ALLOTMENTS AND NOTICE OF CASH ALLOCATION
For the period ________________ Entity Name : ______________________________ Fund Cluster : ___________________ Sheet Number : __________________ Date Reference AMOUNT Allotment
Received Notice of Cash Allocation Balance Received Utilized Unutilized
NCA Unfunded
Allotment (a) (b) ( c) (b - c)
(a - b)

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Appendix B.2.1 Accounting Forms Manual of Standards for Management of Hospital Finance Service

REGISTRY OF ALLOTMENTS AND NOTICE OF CASH ALLOCATION (RANCA)

INSTRUCTIONS

A. The RANCA shall be maintained by the Accounting Division/Unit to determine the amount of allotments not covered by NCA and to monitor available NCA.

B. This form shall be accomplished as follows:

For the period – the year covered by the registry
Entity Name – name of the agency/entity
Fund Cluster – the fund cluster name/code in accordance with the UACS in which the Allotments and NCA are attributable to.
Sheet No. – the sheet number which shall be one series per year
Date – date of the reference document
Reference – the reference document such as GAARD/SARO/GARO/NCA/JEV/ DV/Payroll number
Allotment Received – amount of allotment received per GAARD/SARO/GARO
Notice of Cash Allocation (NCA):

a. Received – amount of NCA received b. Utilized – amount of NCA utilized (based on processed DV/Payroll)

Balance:

a. Unutilized NCA – running balance of unutilized NCA b. Unfunded Allotment – running balance of allotment not covered by NCA

C. At the end of the year, the amount columns for allotment received, NCA received and utilized shall be totaled and ruled.

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Appendix 31 (GAM) REGISTRY OF ALLOTMENTS AND NOTICE OF TRANSFER OF ALLOCATION
For the year ___________________ Entity Name (RO/OU) :____________________ Fund Cluster : _________ Sheet Number : ________ Date Reference AMOUNT Allotment
Received Notice of Transfer of Allocation Balance Received Utilized Unutilized
NTA Unfunded
Allotment (a) (b) ( c) (b - c)
(a - b)

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REGISTRY OF ALLOTMENTS AND NOTICE OF TRANSFER OF ALLOCATION (RANTA)

INSTRUCTIONS

D. The RANTA shall be maintained by the Accounting Division/Unit to determine the amount of allotments not covered by NTA and to monitor available NTA.

E. This form shall be accomplished as follows:

For the year – the year covered by the registry
Entity Name – name of the agency/entity
Fund Cluster – the fund cluster name/code in accordance with the UACS in which the Allotments and NTA are attributable to.
Sheet No. – the sheet number which shall be one series per year
Date – date of the reference document
Reference – the reference document such as GAARD/SARO/GARO/NTA/JEV/DV/ Payroll number
Allotment Received – amount of allotment received per GAARD/SARO/GARO
Notice of Transfer of Allocation (NTA):

a. Received – amount of NTA received b. Utilized – amount of NTA utilized (based on processed DV/Payroll)

Balance:

a. Unutilized NTA – running balance of unutilized NTA b. Unfunded Allotment – running balance of allotment not covered by NTA

F. At the end of the year, the amount columns for allotment received, NTA received and utilized shall be totaled and ruled.

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Appendix B.2.1 Accounting Forms Manual of Standards for Management of Hospital Finance Service MDS Check Commercial Check ADA Others (Please specify)

B. Accounting Entry: C. Certified: D. A Cash available Subject to Authority to Debit Account (when applicable) Supporting documents complete and amount claimed proper E. Receipt of Payment JEV No. Date Mode of Payment Payee Appendix 32 (GAM) Entity Name Fund Cluster : DISBURSEMENT VOUCHER Date : DV No. : TIN/Employee No.: ORS/BURS No.: Certified: Expenses/Cash Advance necessary, lawful and incurred under my direct supervision. Amount Due Particulars Responsibility Center MFO/PAP Amount Address Head, Accounting Unit/Authorized Representative Account Title UACS Code Debit Approved for Payment Credit Date : Printed Name: Signature Signature Position Check/
ADA No. :

Printed Name, Designation and Signature of Supervisor Agency Head/Authorized Representative Date : Bank Name & Account Number: Printed Name Printed Name Position Official Receipt No. & Date/Other Documents Date Date Signature :

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Appendix B.2.1 Accounting Forms Manual of Standards for Management of Hospital Finance Service Serial Number (one series for each

Year DISBURSEMENT VOUCHER (DV)

INSTRUCTIONS

A. The DV is a form used to pay an obligation to employees/individuals/agencies/creditors for goods purchased or services rendered. It shall be prepared by the Requesting Office/Unit. The Accounting Division/Unit shall stamp on the face of this form the date of receipt from the requesting unit.

B. This form shall be accomplished as follows:

Entity Name – name of the agency/entity
Fund Cluster – the fund cluster name/code in accordance with UACS in which the disbursement should be charged
Date – date of preparation of the DV
DV No. – number assigned to the DV by the Accounting Division/Unit. It shall be numbered as follows:
```
             0000-00-0000 
```
Mode of Payment – put a check "√" mark in the appropriate box of the mode of payment (MDS Check,
Commercial Check, ADA, Others)
Payee – name of the payee/creditor
TIN/Employee No. – Tax Identification Number (TIN) of the claimant/Identification Number assigned by the agency to the officer/employee
ORS/BURS No. – the serial number of the ORS or BURS supporting the DV
Address – address of the claimant
Particulars – brief description of the disbursement
Responsibility Center (Office/Unit/Project and Code) – the office/unit/project and code assigned to the cost center where the disbursement shall be charged
MFO/PAP – MFO or PAP as shown in the GAARD/SARO/GARO
Amount – amount of claim
Certified (Box A) – certification by the responsible officer having direct supervision and knowledge of the facts of the transaction.
Accounting Entry (Box B) – the respective accounting entry for the disbursement
Certified (Box C) – certification by the Head of Accounting Unit or his/her authorized representative on the availability of cash, subject to ADA, on the completeness of the supporting documents and the propriety of the amount claimed. The certifying officer shall affix his/her signature and indicate his/her name and position/designation, and the date of signing on the spaces provided.
Approved for Payment (Box D) – approval by the Head of the Agency or his/her Authorized Representative on the payment covered by the DV. The approving officer shall affix his/her signature and indicate his/her name and position/designation, and the date of signing on the spaces provided.
Receipt of Payment (Box E) – acknowledgment by the claimant or his/her duly authorized representative for the receipt of the check/ADA/cash and the date of receipt. The claimant/payee shall affix his/her signature on the space provided and shall indicate the number and the date of the check, bank name and account number, and OR number and date other relevant documents issued to acknowledge the receipt of payment
JEV No. and Date – number and date of the JEV covering the DV

C. The DVs shall be prepared in four (4) copies to be distributed as follows:

Original – COA, through Accounting Division/Unit together with the supporting documents for submission to the Auditor for post audit Copy 2 – Cash Treasury/Unit Copy 3 – Accounting Division/Unit Copy 4 – Payee

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Appendix B.2.1 Accounting Forms Manual of Standards for Management of Hospital Finance Service Entity Name : Fund Cluster : P TOTAL Prepared by: Certified Correct: Appendix 36 (GAM) Date :

JOURNAL ENTRY VOUCHER JEV No.:________ ACCOUNTING ENTRIES Accounts and Explanation Amount Debit Credit Responsibility Center UACS Object Code

Accounting Personnel

Head, Accounting Division/Unit

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JOURNAL ENTRY VOUCHER (JEV)

INSTRUCTIONS

A. This form shall be used to record all transactions of the NGAs, whether cash receipts, cash disbursements or non-cash transactions. Accounting journal entries shall be reflected therein and it shall serve as the basis for recording in the books of accounts.

B. This form shall be accomplished as follows:

Entity Name – name of the agency/entity
Fund Cluster – the fund cluster name/code in accordance with the UACS
JEV No. –JEV number assigned by the Accounting Division/Unit. The numbering shall be as follows:

00–0000 – 00 – 0000

Date – date of the JEV preparation
Responsibility Center – code assigned to the cost/responsibility center
Accounts and Explanation – account titles and brief explanations of the transactions
UACS Object Code –object code in accordance with the UACS
P – put a check“√” mark to indicate posting to the Special/General Journal
Debit – total amount debited
Credit – total amount credited
Prepared by: – name and signature of the person who prepared the JEV
Certified Correct: – name and signature of the Head of the Accounting Division/Unit certifying to the correctness of the entries in the JEV.

C. It shall be prepared in two (2) copies by the Accounting Division/Unit based on the transaction documents presented and distributed as follows:

Original – submitted to the COA Auditor together with the supporting documents after recording in the journals for post audit Copy 2 – retained by the Accounting Division/Unit for file Fund Cluster Code Year Month Serial Number (one series per year)

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Appendix 38 (GAM)

Employee No.: ____________ TIN: ___________________ No. Fund Cluster: _________________ Deductions INDEX OF PAYMENTS AMOUNT Gross Amount Net Amount Check/LDDAP-ADA Date Date Creditor: _______________________________ Address: ____________________________ Entity Name: ___________________________ Reference/DV/ Payroll No. Particulars

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Appendix B.2.1 Accounting Forms Manual of Standards for Management of Hospital Finance Service

INDEX OF PAYMENTS (IP)

INSTRUCTIONS

A. The IP is used by the Accounting Division/Unit to record/monitor payments made to each creditor/payee. It shall be maintained by fund cluster.

B. This form shall be accomplished as follows:

Entity Name – name of the agency/entity
Fund Cluster – the fund cluster name/code in accordance with the UACS
Creditor/Address/Employee No./TIN – Creditor’s name, address, employee number and/or TIN
Date – date of the source documents such as DVs/Payrolls
Reference/DV/Payroll No. – reference document/serial number of the DV/Payroll
Particulars – details or nature of payments
Check/LDDAP-ADA Date – the date of check/LDDAP-ADA
Check/LDDAP-ADA No. – serial number of the check/LDDAP-ADA to be posted after payment
Gross Amount – total amount payable
Deductions – amount deducted from the gross amount
Net Amount – difference between the gross amount payable and the deductions

C. Transactions shall be posted as they occur.

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Appendix B.2.1 Accounting Forms Manual of Standards for Management of Hospital Finance Service Appendix 44 Serial No.: _________________ Date: _____________________ Responsibility Center Code:

A Certified: Correctness of the Certified: Purpose of travel / above data cash advance duly accomplished

Signature over Printed Name Signature over Printed Name Signature over Printed Name Claimant Immediate Supervisor Head, Accounting Division Unit JEV No.: ___________________ Date: ______________________ Date: _____________________ Date: _____________________ Entity Name : ___________________________________________ Fund Cluster : __________________________________________ PARTICULARS AMOUNT Period Covered ________________ LIQUIDATION REPORT Certified: Supporting documents complete and proper TOTAL AMOUNT SPENT
AMOUNT OF CASH ADVANCE PER DV NO.______DTD. ______ AMOUNT REFUNDED PER OR NO. ________DTD. ___________
AMOUNT TO BE REIMBURSED B C

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LIQUIDATION REPORT (LR)

INSTRUCTIONS

A. The LR shall be used to liquidate cash advances for travel and related expenses by the employees/officers concerned of the agency/entity. It shall be supported by the required supporting documents. This shall be prepared by fund cluster.

B. It shall be accomplished as follows:

Period Covered – the period covered by the report from the date of the grant of cash advance up to the date of liquidation
Entity Name – name of the agency/entity
Fund Cluster – the fund cluster name/code in accordance with the UACS
Serial No./Date – number assigned to the LR by the Accounting Division/Unit and the date of the preparation of the report
Responsibility Center Code – code assigned to each cost/responsibility center
Particulars – brief description of expenses incurred or deviation from original itinerary of travel
Amount – amount of expenses covered by the report
Total amount spent – actual amount spent
Amount of Cash Advance per DV No. – amount of cash advance as indicated in the DV on the grant of cash advance; the DV number and date should be specified
Amount Refunded per OR No.– amount refunded representing excess of the cash advance received over actual expenses incurred; the OR number and date should be specified
Amount to be Reimbursed – amount due to the payee/claimant representing the difference between cash advance received and actual expenses incurred
Box A Certified: Correctness of the above data – name and signature of the employee/officer who was granted the cash advance and the date it was signed.
Box B Certified: Purpose of travel/cash advance duly accomplished– name and signature of immediate supervisor of the official/employee who incurred the expenses and the date it was signed
Box C Certified: Supporting documents complete and proper –name and signature of the Head of the Accounting Division/Unit and the date it was signed; the number of the JEV used as basis in recording the liquidation in the GJ should be indicated

C. The amount spent per LR shall be taken up in the JEV, the refund shall be recorded in the CRJ, and the amount to be reimbursed shall be covered by another DV.

D. It shall be prepared in two copies and shall be distributed as follows:

Original - COA Auditor, through the Accounting Division/Unit, together with the supporting documents Copy 2 - Accounting Division/Unit, to be attached to the JEV Copy 3 - Officer/Employee's File

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Appendix B.2.1 Accounting Forms Manual of Standards for Management of Hospital Finance Service Entity Name : _____________________ Fund Cluster: ____________________ Means of Per Departure Arrival Transportation Diem TOTAL Prepared by : Approved by: Total Amount Transpor- station I certify that : (1) I have reviewed the foregoing
itinerary, (2) the travel is necessary to the service, (3) the period covered is reasonable
and (4) the expenses claimed are proper.

Signature over Printed Name Immediate Supervisor Appendix 45 (GAM) ITINERARY OF TRAVEL Date Places to be visited T I M E No.: _______________ Others (Destination) Agency Head/Authorized Representative Signature over Printed Name

Signature over Printed Name

Name : _________________________________________ Position : _______________________________________ Official Station : ______________________________________________________________________________ Purpose of Travel : __________________________ Date of Travel : _____________________________

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ITINERARY OF TRAVEL
(IoT)

INSTRUCTIONS

A. This form shall be used by the official/employee of the agency/entity making the travel to show the detailed itinerary of travel before and after the travel and shall be attached to all claims for traveling expenses (cash advance for travel and actual expenses). This shall be prepared by fund cluster.

B. It shall be accomplished as follows:

Entity Name– name of the agency/entity
Fund Cluster – the fund cluster name/code in accordance with the UACS
No. – number assigned to the IoT by the Administrative/Travel Unit
Name – name of the official/employee going on travel
Position – position of the official/employee going on travel
Official Station – the official station of the official/employee going on travel
Date of Travel – schedule of travel
Purpose of Travel – purpose of travel based on the approved travel order
Date – schedule of activities to be performed during the travel
Places to be visited – places where the activities are to be performed
Time – time of departure from and arrival to places to be visited
Means of Transportation – means of transportation to be used such as plane, taxi, etc.
Transportation – amount of transportation expenses
Per Diem – amount of allowable traveling expense for subsistence and lodging
Others – amount of other allowable expenses to be incurred/incurred during the travel
Total Amount – total of transportation expense, per diem and other expenses
Total – vertical total of ‘Total Amount’ column

C. The “Prepared by” portion of the IoT shall indicate the printed name of, and be signed by the official/employee going on travel.

D. The IoT shall be certified by the Immediate Supervisor of the official/employee going on travel, as follows:

“I certify that (1) I have reviewed the foregoing itinerary, (2) the travel is necessary to the service, (3) the period covered is reasonable and (4) the expenses claimed are proper.

Signature over Printed Name Immediate Supervisor”

E. The “Approved by” portion of the IoT shall indicate the printed name of, and be signed by the Head of Agency or his/her Authorized Representative.

F. This form shall be prepared in two copies distributed as follows:

Original – COA Auditor, through the Accounting Division/Unit, together with the supporting documents to be attached to the DV for cash advance of estimated traveling expenses or payment of actual traveling expenses Copy 2 – Officer/Employee concerned

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Appendix B.2.1 Accounting Forms Manual of Standards for Management of Hospital Finance Service Appendix 46 (GAM) REIMBURSEMENT EXPENSE RECEIPT

Entity Name: _________________ Fund Cluster : ________________ Date : _______________________ RER No. : ___________________

       RECEIVED from ______________________________________ 
                                  (Name)

_________________________________________________ the amount (Official Designation) of __________________________________________ (P__________) (In Words) (in Figures) in payment for _______________________________________________ (Payments for subsistence, services,

rental or transportation should show inclusive dates,

purpose, distance, inclusive points of travel, etc.) PAYEE Name/Signature __________________________________________ Address ________________________________________________

WITNESS Name/Signature __________________________________________ Address ________________________________________________

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Appendix B.2.1 Accounting Forms Manual of Standards for Management of Hospital Finance Service REIMBURSEMENT EXPENSE RECEIPT (RER)

INSTRUCTIONS

A. The RER is used to support the expenses which cannot be conveniently issued official receipts/invoice. It shall be submitted to the Accounting Division/Unit together with the LR and other supporting documents. It shall be prepared by fund cluster.

B. This form shall be accomplished as follows:

Entity Name – the name of the agency/entity
Date – the date of the receipt
Fund Cluster – the fund cluster name/code based on the UACS in which the disbursement shall be charged
RER No. – the number assigned to the RER
Name – the name of the official/employee who travelled
Official Designation – the official designation or position of the official/employee who travelled
In words – the amount in words of the actual payment made by the official/employee who travelled
In figures – the amount in figures of the actual payment made by the official/employee who travelled
Payments – the payments for subsistence, services, rental or transportation which show inclusive dates, purpose, distance, inclusive points of travel, etc.
Payee – the name, signature and the address of the payee
Witness – the name, signature and the address of the witness to the actual payment made by the official/employee who travelled

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Appendix B.2.1 Accounting Forms Manual of Standards for Management of Hospital Finance Service Appendix 47 (GAM)

CERTIFICATION OF TRAVEL COMPLETED

Entity Name: _______________________ Fund Cluster: __________

Director in-Charge Station

I HEREBY CERTIFY THAT I have completed the travel as authorized in the Travel Order/Itinerary of Travel No. ________ dated ________ under conditions indicated below:

/ x / Strictly in accordance with the approved itinerary.

/ / Cut short as explained below. Excess payment in the amount of P_______ was refunded under O. R. No. ________ dated __________

/ / Extended as explained below, additional itinerary was submitted

/ / Other deviation as explained below.

Explanation or justifications:

Evidence of travel:

Respectfully submitted:

                                                                             _____________________________ 
                                                                            Name of Employee

On evidence and information of which I have the knowledge, the travel was actually undertaken.

Approved:

      Name of Director 






                           Office

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Appendix B.2.1 Accounting Forms Manual of Standards for Management of Hospital Finance Service Date : ________________ I. To be filled out upon request II. To be filled out upon liquidation Requested by: Approved by: Paid by: Cash Received by:

Signature over Printed Name Signature over Printed Name Payee

Signature over Printed Name Petty Cash Custodian

Signature over Printed Name Payee Name of Immediate Supervisor

Signature over Printed Name Petty Cash Custodian

Liquidation Submitted Name of Requestor

Amount Refunded/ (Reimbursed)

Signature over Printed Name Received Refund Reimbursement Paid Appendix 48 (GAM) PETTY CASH VOUCHER Particulars Amount No. : __________________ Responsibility Center Code: Address : ________________________________ Payee/Office : ____________________________ Fund Cluster: _____________________________ Reimbursement Received by: Date: _______________ Date: _______________

Total Amount Paid per Total Amount Granted OR/Invoice No. _______ Entity Name : _____________________________

A C B D

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Appendix B.2.1 Accounting Forms Manual of Standards for Management of Hospital Finance Service

PETTY CASH VOUCHER (PCV)

INSTRUCTIONS

A. The form shall be accomplished as follows:

Entity Name – name of the agency/entity
Fund Cluster – the fund cluster name/code in accordance with the UACS
No. – number assigned to the PCV by the PCFC. It shall be numbered as follows:

0000- 0000-00-0000

Date – date of the preparation of PCV
Payee/Office and Address – name/office/address of payee/employee requesting cash advance charged to the PCF
Responsibility Center Code – the cost/ responsibility center code of the requesting office

I. To be filled out upon request

Particulars – brief description of the nature of disbursement/expense
Amount – amount of petty cash requested
Box A – Requested by – shall be signed by the Requestor
Box A – Approved by - shall be signed by the Immediate Supervisor of the Requestor
Box B - Paid by – shall be signed by the PCFC
Box B - Cash Received by – shall be signed by the recipient of cash

II. To be filled out upon liquidation

Total Amount Granted – the amount of cash received by the claimant
Total Amount Paid Per OR/Invoice No. _______ – the total amount paid as shown in the OR/invoice presented
Amount Refunded/Reimbursed – the difference between the total amount granted less amount spent
Box C – the PCFC shall check the appropriate box for “Received Refund” or “Reimbursement Paid” and affix his/her signature
Box D – the payee shall check the appropriate box for “Liquidation Submitted” and/or “Reimbursement Received by” and affix his/her signature B. Part I shall be filled out upon request of the petty cash advance and Part II shall be filled out upon liquidation.

C. The PCV shall be prepared in two copies distributed as follows:

Original – to be attached to the RPPCV together with the supporting documents
Copy 2
– PCFC file

Serial number (one series for Month Year Petty Cash
Custodian

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Appendix B.2.1 Accounting Forms Manual of Standards for Management of Hospital Finance Service

DATE J E V RADAI No. No. From To UACS Object Code P Amount UACS Object Code P Amount Totals Debit Credit Total Certified Correct: Appendix 52 (GAM) ADVICE TO DEBIT ACCOUNT DISBURSEMENTS JOURNAL
Recapitulation: Month ____________________________________ Entity Name : _________________________________________ Fund Cluster : _________________________________________ Sheet No. : ____________________ LDDAP- ADA No. S UND R Y Name of Disbursing Officer/Cashier C R E D I T D E B I T Chief Accountant/Head of Accounting Division/Unit Amount Account Code P Signature over Printed Name S U N D R Y

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Appendix B.2.1 Accounting Forms Manual of Standards for Management of Hospital Finance Service ADVICE TO DEBIT ACCOUNT DISBURSEMENTS JOURNAL (ADADJ)

INSTRUCTIONS

A. This special journal is used by the Accounting Division/Unit to record the disbursements through LDDAP-ADA made by the Disbursing Officer/Cashier. It shall be maintained by
fund cluster.

B. This journal shall be accomplished as follows:

Month – month covered by the journal 2. Entity Name – name of the agency/entity 3. Fund Cluster – fund cluster name/code to which the disbursement is to be charged 4. Sheet No. – number of sheet of the journal which shall be one series for each year 5. Date – date of the JEV 6. JEV No. – number assigned to the JEV
7. RADAI No. – number indicated in the report 8. LDDAP-ADA No. – number indicated in the LLDAP-ADA which shall be entered in numerical/chronological sequence 9. Name of Disbursing Officer/Cashier – name of the Disbursing Officer/Cashier
10. Credit columns – account code covered by the payment and amount of LDDAP-ADA issued 11. Sundry-UACS Object Code – account code for which no column has been provided 12. Sundry-P (Posting Reference) – place a check mark () to indicate completion of posting in the appropriate GL account 13. Sundry-Amount (Credit) – amount credited to the account 14. Debit columns – account code and amount of expenses paid 15. Sundry-UACS Object Code – account code for which no column has been provided 16. Sundry-P (Posting Reference) – place a check mark () to indicate completion of posting in the appropriate GL account 17. Sundry-Amount (Debit) – amount debited to the account

C. The sundry columns shall be summarized/recapitulated using the format below:

Recapitulation:

Account Code P Amount Debit Credit

Total

E. At the end of the month, it shall be footed, balanced and ruled. The ruling shall be made on the line immediately after the last entry.

F. Posting to the GL shall be made directly from this journal. A check mark immediately underneath the total of the special columns shall be made to indicate completion of posting to the GL.

G. Every sheet shall be certified by the Chief Accountant/Head of Accounting Division/Unit as follows:

                                      “CERTIFIED CORRECT:

(Signature over the Printed Name)

Designation”

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Appendix B.2.1 Accounting Forms Manual of Standards for Management of Hospital Finance Service

Entity Name: ______________________________ Fund Cluster: ______________________________ UACS Object Code : ______________ less than 91-365 Over Over Over 3 years 90 days days 1 year 2 years and onwards 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. Certified Correct : Appendix 54 (GAM) SCHEDULE OF ACCOUNTS PAYABLE Current Past Due Amount Due As at __________________ Amount Balance Name of Creditor
(in alphabetical order) No. Remarks Chief Accountant/Head of Accounting Division/Unit

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Appendix B.2.1 Accounting Forms Manual of Standards for Management of Hospital Finance Service

SCHEDULE OF ACCOUNTS PAYABLE (SAP)

INSTRUCTIONS

A. This form shall be used by the Accounting Division/Unit in the preparation of the list of accounts payable. It shall be prepared by fund cluster.

B. This form shall be accomplished as follows:

As at – the reporting period in which the accounts are outstanding
Entity Name – the name of the agency/entity
Fund Cluster – the fund cluster name/code in accordance with the UACS
UACS Object Code – the object code in accordance with the UACS
Name of Creditor – the names of the creditors in each account in alphabetical order
Amount Balance – the outstanding balance in each account
Amount Due Columns – the amount of the debt is divided by the period in which it will become due and demandable. The range of the period is as follows:  Current

Less than 90 days
91-365 days
 Past Due
Over 1 year
Over 2 years
Over 3 years and onwards

Remarks –comments on the status or condition of the accounts payable or of the debt/obligation.

C. The Chief Accountant or Head of Accounting Division/Unit shall affix his/her signature to certify that data reported are duly correct.

D. At the end of each reporting period, the schedule shall be footed and appropriate disclosures shall be made in the Notes to the Financial Statements.

E. The SAP shall be prepared in two (2) copies to be distributed as follows:

Original – COA Auditor, for post audit Copy 2 – Accounting Division/Unit

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Appendix B.2.1 Accounting Forms Manual of Standards for Management of Hospital Finance Service less than 91-365 Over Over Over 3 years 90 days days 1 year 2 years and onwards 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. Certified Correct : SCHEDULE OF ACCOUNTS RECEIVABLE As at ___________________ Amount Due Current Past Due No. Name of Debtor (in alphabetical order) Amount Balance Remarks Chief Accountant/Head of Accounting Division/Unit UACS Object Code : ______________ Entity Name: ______________________________ Fund Cluster: _____________________________ Appendix 55 (GAM)

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Appendix B.2.1 Accounting Forms Manual of Standards for Management of Hospital Finance Service

SCHEDULE OF ACCOUNTS RECEIVABLE
(SAR)

INSTRUCTIONS

A. This form shall be used by the Accounting Division/Unit in the preparation of the list of accounts receivable. It shall be prepared by fund cluster.

B. This form shall be accomplished as follows:

As at – the reporting period in which the accounts are outstanding
Entity Name – the name of the agency/entity
Fund Cluster – the fund cluster name/code in accordance with the UACS
UACS Object Code – the object code in accordance with the UACS
Name of Debtor – the names of the debtors in each account in alphabetical order
Amount Balance – the outstanding balance in each account
Amount Due Columns – the amount of the debt is divided by the period in which it will become due and demandable. The range of the period is as follows:  Current

Less than 90 days

91-365 days
 Past Due

Over 1 year

Over 2 years

Over 3 years and onwards

Remarks – comments on the status or condition of the accounts receivable or of the debt/obligation.

C. The Chief Accountant or Head of Accounting Division/Unit shall affix his/her signature to certify that data reported are duly correct.

D. At the end of each reporting period, the schedule shall be footed and appropriate disclosures shall be made in the Notes to the Financial Statements.

E. The SAR shall be prepared in two (2) copies to be distributed as follows:

Original – COA Auditor, for post audit Copy 2 – Accounting Division/Unit

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Appendix B.2.2 Budget Forms Manual of Standards for Management of Hospital Finance Service

STANDARD FORMS USED IN FINANCE SERVICE

B.2.2: FORMS USED IN BUDGET DEPARTMENT

Registry of Appropriations and Allotments (RAPAL)
Registry of Allotments, Obligations and Disbursements (RAOD)
Registry of Budget, Utilization and Disbursements (RBUD)
Obligation Request and Status (ORS)
Budget Utilization Request and Status (BURS)
Quarterly Physical Report of Operation (QPRO)
Statement of Appropriations, Allotments, Obligations, Disbursements and Balances (SAAODB) – FAR No. 1
Summary of Appropriations, Allotments, Obligations, Disbursements and Balances by Object of Expenditures (SAAODBOE) – FAR No. 1-A
List of Allotments and Sub-Allotments (LASA) – FAR No. 1-B
Statement of Approved Budget, Utilizations, Disbursements and Balances (SABUDB) – FAR No. 2
Summary of Approved Budget, Utilizations, Disbursements and Balances by Object of Expenditures (SABUDBOE) – FAR No. 2-A
Aging of Unpaid Obligations (ADDO) – FAR No. 3

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Appendix B.2.2 Budget Forms Manual of Standards for Management of Hospital Finance Service

Entity Name : ___________________________________ Fund Cluster : __________________________________ Personnel Services Maintenance and Other Operating Expenses Financial Expenses Capital Outlays Personnel Services Maintenance and Other Operating Expenses Financial Expenses Capital Outlays Personnel Services Maintenance and Other Operating Expenses Financial Expenses Capital Outlays (1) (2) (3) (4) (1)+(2)+(3)+(4)= (5) (6) (7) (8) (9) (6)+(7)+(8)+(9) =(10) (11) (12) (13) (14) (11)+(12)+(13)+ (14)=(15) Page 1 of 2 GAA/SA/ GARO/ SARO No. Adjustment/s on Appropriations Total Adjustment/s on Appropriations Adjusted Appropriations Appropriations Total Appropriations For the year ____________________ REGISTRY OF APPROPRIATIONS AND ALLOTMENTS Appendix 8 (GAM) Date Sheet No. : ________________________ Total Adjusted Appropriations Reference MFO/PAP Date

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Appendix B.2.2 Budget Forms Manual of Standards for Management of Hospital Finance Service

Personnel Services Maintenance and Other Operating Expenses Financial Expenses Capital Outlays Personnel Services Maintenance and Other Operating Expenses Financial Expenses Capital Outlays Personnel Services Maintenance and Other Operating Expenses Financial Expenses Capital Outlays Personnel Services Maintenance and Other Operating Expenses Financial Expenses Capital Outlays (16) (17) (18) (19) (16)+(17)+(18)+ (19)=(20) (21) (22) (23) (24) (21)+(22)+(23) +(24)=(25) (26) (27) (28) (29) (26)+(27)+(28) +(29)=(30) (31) (32) (33) (34) (31)+(32)+(33) +(34)= (35) Date Reference MFO/PAP Page 2 of 2 Appendix 8 (GAM) Unreleased Appropriations GAA/SA/ GARO/ SARO No. Adjustment/s on Allotments Total Adjustment/s on Allotments For the year ___________________ REGISTRY OF APPROPRIATIONS AND ALLOTMENTS Sheet No. : ___________________________ Entity Name : _____________________________ Fund Cluster : ____________________________ Total Allotments Date Total Unreleased Appropriations Allotments
Adjusted Allotments Total Adjusted Allotments

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Appendix B.2.2 Budget Forms Manual of Standards for Management of Hospital Finance Service

REGISTRY OF APPROPRIATIONS AND ALLOTMENTS (RAPAL)

INSTRUCTIONS

A. This form shall be accomplished as follows:

Entity Name – name of the agency/entity
Fund – name of the fund/code in accordance with the UACS:

01 Regular Agency Fund 02 Foreign Assisted Projects Fund 03 Special Account - Locally Funded 04 Special Account - Foreign Assisted / Grant

Sheet No. – sheet number which shall be one series per year
Date – date of recording
Reference - Date – the date/year of the appropriations law/other authority and the allotment release documents such as: GAA, Supplemental Appropriation (SA), SARO and GARO, etc.
Reference - GAA/GARO/SARO No. – the serial number of the GAA for comprehensive release, SARO and GARO
MFO/PAP – code for MFO and PAP of the entity per GAA/SARO/ GARO
Appropriations - PS, MOOE, FE and CO – amounts of approved appropriation for each allotment class
Total Appropriations – the sum of the appropriation columns for PS, MOOE, FE and CO
Adjustment/s on Appropriations – amount of the adjustment on the appropriation like realignment, transfers (to and from), withdrawals, and other adjustments based on SARO, and other authorities.
Total Adjustment/s on Appropriations – the sum of the Adjustment/s on Appropriations columns
Adjusted Appropriations – amount of appropriation by allotment class after taking effect the adjustments
Total Adjusted Appropriations – the sum of the Adjusted Appropriation columns
Allotments - PS, MOOE, FE and CO – amount of allotment released per GAA/SARO/GARO for each allotment class (PS, MOOE, FE and CO)
Total Allotments – the sum of the allotment columns
Adjustment/s on Allotments – amount of adjustments on allotments based on SARO, and other authorities.
Total Adjustment/s on Allotments – the sum of the Adjustment/s on Allotments columns
Adjusted Allotments – amount of allotment after taking effect the adjustment
Total Adjusted Allotments – the sum of the Adjusted Allotment columns
Unreleased Appropriations – running balance of appropriations or the unalloted appropriation balance (Adjusted Appropriation Less Adjusted Allotment)
Total Unreleased Appropriations – the sum of the Unreleased Appropriations columns

B. This Registry shall be maintained by fund by the Budget Unit of each government entity to ensure that allotment releases are within the authorized appropriation. Separate registry shall be maintained for prior year’s appropriations.

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Appendix B.2.2 Budget Forms Manual of Standards for Management of Hospital Finance Service

PERSONNEL SERVICES/MO/CO REGISTRY OF ALLOTMENTS, OBLIGATIONS AND DISBURSEMENTS For the year ______________ Unpaid Obligations Not Yet Due and Demandable Due and Demandable Appendix 9 (GAM) Reference MFO/PAP : ___________________________ Sheet No. : _____________________ Fund Cluster : __________________________________ UACS Object Code/
Expenditures Serial Number Date Legal Basis : ___________________________________ Entity Name: ___________________________________ Obligations Unobligated Allotments Disbursements Date Allotments

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Appendix B.2.2 Budget Forms Manual of Standards for Management of Hospital Finance Service

REGISTRY OF ALLOTMENTS, OBLIGATIONS AND DISBURSEMENTS (RAOD)

INSTRUCTIONS

A. This form shall be accomplished as follows:

Allotment Class – indicate the allotment class (e.g. PS, MOOE, FE and CO)
Entity Name – name of the entity
MFO/PAP – the code for MFO or PAP as shown in the GAA/SARO/GARO
Fund – name of the fund/code based on the Unified Accounts Code Structure:

01 Regular Agency Fund 02 Foreign Assisted Projects Fund 03 Special Account - Locally Funded 04 Special Account - Foreign Assisted / Grant

Sheet No. – sheet number which shall be one series per year
Date – the date of recording
Reference Date – the date of the reference document
Reference Serial Number – the number of the GAA/GARO/SARO/ORS/Reports of Checks Issued (RCI)/Report of Advice to Debit Account Issued (RADAI)/ Tax Remittance Advice (TRA)/JEV/ Notice of Obligation Request and Status Adjustment (NORSA) with the original ORS number adjusted
UACS Object Code/Expenditures – the expenditure code based on the UACS
Allotments – amount of allotment received based on the General Appropriations Act (GAA)/General Allotment Release Order (GARO)/Special Allotment Release Order (SARO)/Tax Remittance Advice (TRA), etc. including adjustments on allotments based on SARO, and other obligational authorities
Obligations – amount of obligation incurred based on the approved Obligation Request and Status (ORS) and adjustments based on Notice of Obligation Request and Status Adjustment (NORSA) supported by pertinent documents
Unobligated Allotments – balance of available allotment that can still be obligated (Allotments less Obligations)
Payables – amount of obligations with delivered goods and services based on Journal Entry Vouchers
Disbursements – actual amounts paid based on RCI/RADAI/TRA/JEV including adjustments thereto supporting by pertinent documents
Unpaid Obligations – Due and Demandable - balance of obligation with delivered goods and services but not yet to be paid (Payable less Disbursement)
Unpaid Obligations - Not Yet Due and Demandable – the amount of obligations without delivered goods and services (Obligations less Payable)

B. This Registry shall be maintained by the Budget Unit of each entity.

C. The RAOD shall be maintained by fund, by Major Final Output (MFO) or Program/Activity/Project (PAP), and by allotment class.

D. Separate Registry shall be maintained for Overdraft/Obligations Incurred in Excess of Allotment and for prior year’s continuing appropriations (unreleased and unobligated allotments).

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Appendix B.2.2 Budget Forms Manual of Standards for Management of Hospital Finance Service

Entity Name : ________________________________ Fund Cluster : _______________________________ Legal Basis: ________________________________ Date Serial Number Due and Demandable Not Yet Due and Demandable MFO/PAP : _______________________ Sheet No. : _______________________ Appendix 10 (GAM) PERSONNEL SERVICES/MOOE/FE/CO REGISTRY OF BUDGET, UTILIZATION AND DISBURSEMENTS For the year ___________________ Unpaid Utilization Date Disbursements Reference UACS Object Code/
Expenditures Budgeted Amount Utilization Unutilized Budgeted Amount

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Appendix B.2.2 Budget Forms Manual of Standards for Management of Hospital Finance Service

REGISTRY OF BUDGET, UTILIZATION AND DISBURSEMENTS PERSONNEL SERVICES/MOOE/FE/CO (RBUDPS/MOOE/FE/CO)

INSTRUCTIONS

A. This registry shall be maintained by the Budget Division/Unit of each entity by fund cluster, by MFO or PAP for Personnel Services.

B. This form shall be accomplished as follows:

For the year – the year covered by the registry 2. Entity Name – name of the agency/entity 3. Fund Cluster – fund cluster name/code in accordance with the UACS:

03 Special Account-Locally Funded/Domestic Grants Fund 05 Internally Generated Funds (Off-Budgetary Funds – Retained Income Funds) 06 Business Related Funds 07 Trust Receipts/Inter-Agency Transferred Funds

Legal Basis – the Republic Act/Administrative Order/Executive Order/Authority from oversight body
MFO/PAP – the MFO/PAP as shown in the Special Budget
Sheet No. – sheet number which shall be one series per year
Date – the date of recording/posting
Reference Date – the date of the reference documents
Reference Serial No. – the serial number of the BURS/RCI/RADAI/RTRAI/ NBURSA/JEV
UACS Object Code/Expenditures – the object code based on the UACS
Budgeted Amount – the amount of approved budget and any supplemental/ additional budget as of a given date
Utilization – the amount of utilized budget/commitment made based on the approved BURS supported by pertinent documents
Unutilized Budgeted Amount – the amount of budget still available for utilization (Budgeted Amount less Utilization)
Payable – the amount of budget utilization for services rendered based on JEV
Disbursement – the actual amount paid based on the RCI and JEV
Unpaid Utilization-Due and Demandable – balance of budget utilization for services rendered yet to be paid (Payable less Disbursement)
Unpaid Utilization-Not Yet Due and Demandable – the amount of budget utilization without services rendered (Utilizations less Payable)

C. Separate registry shall be maintained for overdraft/utilizations incurred in excess of budgeted amount.

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Certified: Allotment available and obligated for the purpose/adjustment necessary as supporting documents valid, proper and legal indicated above Signature : ______________________________ Printed Name:______________________________ Position : ______________________________ Date :____________________________ C. Not Yet Due Due and Demandable (a) (c) (a-b) (b-c) Appendix 11 (GAM) Total B. (b) Date Particulars ORS/JEV/Check/
ADA/TRA No. Obligation Payable Reference Amount

Head, Requesting Office/Authorized Representative Balance Payment necessary, lawful and under my direct supervision;and Certified: Head, Budget Division/Unit/Authorized Representative STATUS OF OBLIGATION A. Charges to appropriation/alloment are Position : ____________________________________ Date : Fund Cluster : ___________________ Particulars MFO/PAP UACS Object Code Amount Payee Office Address Serial No. : _____________________

Printed Name: ____________________________________ Responsibility Center OBLIGATION REQUEST AND STATUS Signature : ___________________________________ Date : _________________________ Entity Name

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OBLIGATION REQUEST AND STATUS (ORS)

INSTRUCTIONS

A. The form shall be accomplished as follows:

Serial No. – Number assigned to the ORS by the

Budget Section/Unit, as follows:

            00–000000–0000–00–00000 
                        
                                    Serial number (one series for

each year) Month Year UACS Funding Source
Code Allotment Class
1 – Personnel Services

    2 – Maintenance & Other

Operating Expenses 3 – Financial Expenses

4 - Direct Costs
(manufacturing and
trading)

5 – Non-cash expense

6 - Capital Outlays 2. Date – Date of receipt 3. Fund – name of the fund/code in which the obligation is to be charged

NOTE: Items 1-3 shall be accomplished by the Budget Unit upon receipt of contracts, purchase orders, claim vouchers and other supporting documents 4. Entity Name – name of the agency/entity 5. Payee – Name of payee or creditor 6. Office/Address – Name of the office/address of payee/creditor 7. Responsibility Center – Code of the cost center where expenses shall be charged 8. Particulars – Brief description of the obligation requested code for 9. MFO/PAP – Major Final Output or Program/ Activity/Project as shown in the GAA/SARO/GARO 10. UACS Object Code – the appropriate account code based on the UACS in which the object of obligation shall be charged 11. Amount – Amount of obligation

NOTE: Items 4 to 11 shall be accomplished by the Head of Requesting Office/Authorized Representative upon submission of claim based on the Budget/Allotment Allocation of the Office received from the Budget Unit.

B. The three sections of the ORS shall be accomplished as follows:

Box A – Certification by the Head of Requesting Office/Authorized Representative that charges to the responsibility center are proper, necessary, and under his direct supervision.

Box B – Certification by the Head of Budget Unit/Authorized Representative that allotment is available for obligation based on the Registries of Allotments, Obligations and Disbursements (RAODs) maintained.

Box C – Status of Obligation. It shall serve as the subsidiary ledger for obligations to be maintained by the Budget Unit.

Obligations shall be posted in the Obligation Column based on ORS issued. A Notice of Obligation Request and Status Adjustment (NORSA) shall be issued to the Budget Unit by the Accounting Unit for any correction made in the ORS, as the basis of the Budget Unit in effecting adjustment in the RAOD. Services rendered/goods delivered per Inspection and Acceptance Report (IAR) shall be posted in the Payable Column based on Journal Entry Voucher (JEV) drawn. Amount of expenses paid shall be posted in the Payment Column based on JEV drawn. Thus, Balance of obligation shall be generated in the last columns, whether Not Yet Due (Obligation less Payable) or Due and Demandable (Payable less Payment).

After every transaction, pencil footing shall be made to determine available balance. At the end of the month, each column shall be footed to arrive at the balances. When the obligation is fully liquidated, any excess obligation shall be adjusted/or negated in the Section C of the ORS.

C. ORS which have been fully liquidated or with zero balances shall be filed separately from those with balances.

D. This form shall be prepared in three (3) copies to be distributed as follows:

        Original                    – Budget Unit (as SL) 
        Duplicate Copy         – to be attached to the DV 
        Triplicate Copy         – Accounting Unit

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BUDGET UTILIZATION REQUEST AND STATUS
(BURS)

INSTRUCTIONS A. The form shall be accomplished as follows:

Serial No. – Number assigned to the BURS by

the Budget Section/Unit, as follows:

            00–000000–0000–00–00000 
                        
                                    Serial number (one series

for each year) Month Year UACS Funding Source
Code Allotment Class
1 – Personnel Services

    2 – Maintenance & Other

Operating Expenses 3 – Financial Expenses

4 - Direct Costs
(manufacturing and
trading)

5 – Non-cash expense

6 - Capital Outlays

```
Date – Date of receipt 
```
Fund – the fund code based on UACS in which the budget utilization is to be charged

NOTE: Items 1-3 shall be accomplished by the Budget Unit upon receipt of contracts, purchase orders, claim vouchers and other supporting documents 4. Entity Name – name of the agency/entity 5. Payee – Name of payee or creditor 6. Office/Address – Name of the office/address of payee/creditor 7. Responsibility Center – Code of the cost center where expenses shall be charged 8. Particulars – Brief description of the obligation requested code for 9. MFO/PAP – Major Final Output or Program/ Activity/Project as shown in the Approved Budget 10. UACS Object Code/Expenditures – the appropriate account code according to the UACS 11. Amount – Amount of obligation

NOTE: Items 4 to 11 shall be accomplished by the Head of Requesting Office/Authorized Representative upon submission of claim based on the Approved Budget received from the Budget Unit.

B. The three sections of the BURS shall be accomplished as follows:

Box A – Certification by the Head of Requesting Office/Authorized Representative that charges to the responsibility center are proper, necessary, and under his direct supervision.

Box B – Certification by the Head of Budget Unit/Authorized Representative that budget is available for utilization.

Box C – Status of Utilization. It shall serve as the subsidiary ledger for budget utilizations to be maintained by the Budget Unit.

Budget utilizations shall be posted in the Utilization Column based on BURS issued. A NBURSA shall be issued to the Budget Unit by the Accounting Unit for any correction made in the BURS, as the basis of the Budget Unit in effecting adjustment in the RBUD. Services rendered/goods delivered per Inspection and Acceptance Report (IAR) shall be posted in the Payable Column based on JEV drawn. Amount of expenses paid shall be posted in the Payment Column based on JEV drawn. Thus, balance of Utilization shall be generated in the last columns, whether Not Yet Due (Utilization less Payable) or Due and Demandable (Payable less Payment).

After every transaction, pencil footing shall be made to determine available balance. At the end of the month, each column shall be footed to arrive at the balances. When the utilization is fully disbursed, any excess certification/ utilization shall be adjusted/negated in the Section C of the BURS.

C. BURS which have been fully liquidated or with zero balances shall be filed separately from those with balances.

D. New BURS shall be prepared/ issued for additional obligation.

E. This form shall be prepared in three (3) copies to be distributed as follows:

       Original             – Budget Unit (as SL) 
       Duplicate Copy – to be attached to the DV 
       Triplicate Copy – Accounting Unit

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Appendix B.2.2 Budget Forms Manual of Standards for Management of Hospital Finance Service QUARTERLY PHYSICAL REPORT OF OPERATION (QPRO) BAR No. 1

INSTRUCTIONS

A. The QPRO shall reflect the agency's/OU's actual physical accomplishments as of a given quarter, in terms of the performance measures indicated in its Physical Plan (BED No. 2). This report shall be prepared capturing all fund sources. This shall be submitted to DBM and COA not later than the 30th day following the end of the quarter.

B. Column 1 - This shall reflect the Program and the corresponding Outcome and Output Indicators.

This shall also reflect the corresponding Program Outcome and Outcome Indicators for Automatic Appropriations (i.e., Special Account in the General Fund) if applicable.

C. Column 2 – Adopt the UACS Object Code per COA-DBM-DOF Joint Circular Nos. 2013- 1 dated 6 August 2013 and 2017-1 dated August 11, 2017

D. Columns 3 to 7 – These shall reflect the annual physical targets with quarterly breakdown consistent with BED No. 2 (Physical Plan).

E. Column 8 to 12 – These shall reflect the quarterly physical accomplishments and the cumulative accomplishment as of a given quarter.

F. Column 13 – Shall reflect the total variance between the agencies actual accomplishment versus physical targets as of the quarter covered by the report.

G. Column 14 – Shall indicate the reasons/justifications for variances as of the quarter covered by the report.

NOTE: Off-Budget indicators should be limited to the Indicators identified in the Performance Informed Budget (PIB).

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STATEMENT OF APPROPRIATIONS, ALLOTMENTS, OBLIGATIONS, DISBURSEMENTS AND BALANCES
(SAAODB) FAR No. 1

INSTRUCTIONS A. The Statement of Appropriations, Allotments, Obligations, Disbursements and Balances (SAAODB) shall be:

prepared by all national government agencies (NGAs) Central Offices (COs)/Regional Offices (ROs)/Operating Units (OUs) and government-owned or –controlled corporations (GOCCs) maintaining Special Account in the General Fund in reporting the appropriations, the allotments received, the obligations, the disbursements made and balances for the reporting period.
For highly decentralized departments (such as DepEd, DPWH, DENR, etc.) their lowest OUs (e.g., schools/districts/provincial offices) shall submit a copy of their reports to the next higher level units (e.g., Division Offices (DOs), ROs) for consolidation. For DepEd, the consolidated report of DOs shall be submitted to their respective ROs. Subsequently, the Agency/Entity ROs shall prepare a consolidated report (ROs and OUs under its coverage) and submit the same to their CO and to the Commission on Audit (COA)-Government Accountancy Sector (GAS) including copies of the submitted SAAODB of the lowest OU. In turn, the Agency/Entity CO shall prepare an overall consolidated report (CO, ROs, all OUs) for submission to the COA-GAS. The Agency/Entity CO shall disclose the OUs/ROs which are not included in the consolidated report, in case not all OUs/ROs submitted their reports for consolidation. All COs/ROs/OUs shall provide a copy of their report to their respective Audit Team Leader. 2. presented by Fund Cluster. It shall be prepared by agencies/entities maintaining books of accounts for Fund Cluster Codes 01-Regular Agency Fund, 02-Foreign Assisted Projects Fund, 03-Special Account-Locally Funded/Domestic Grants Fund, and 04-Special Account-Foreign Assisted/Foreign Grants Fund.

likewise presented by Organizational Outcome (OO), by Cost Structure/Program, Activity, Project Code, by Allotment Class and by Major Programs/Projects

certified correct by the Budget Officer (data on appropriations, allotments, obligations and obligations-Not Yet Due and Demandable) and Chief Accountant (data on disbursements and obligations-Due and Demandable). This shall be approved by Agency/Entity Head or Authorized Representative as recommended by the Director of Financial Management Service (FMS) or Equivalent.

submitted to the Department of Budget and Management (DBM) and COA-GAS. In submitting their reports to DBM, agencies and OUs under the coverage of DBM Central Office shall submit their signed Unified Reporting System (URS)-generated reports directly to the Budget and Management Bureau (BMB) concerned. In the case however of DepEd, DOH, DPWH, TESDA, SUCs and CHED, their ROs and lowest OUs shall submit their signed URS-generated reports directly to the DBM RO concerned. The CO of these departments/agencies/entities shall also submit a signed URS-generated consolidated report to the DBM-BMB concerned.

due for submission to COA and DBM within 30 days after the end of the quarter.

B. Column 1 - Particulars shall indicate the sources of funds, OOs, Cost Structure/Program, Activity, Project, Major Programs/Projects, Expense Class, consistent with the UACS. Summary "By Object Code" shall be reflected under FAR No. 1-A.

C. Column 2 - Adopt the UACS Code per COA-DBM-DOF Joint Circular (JC) No. 2013-1 dated 6 August 2013, JC No. 2014-1 dated 7 November 2014, and JC No. 1 dated 11 August 2017.

D. Columns 3 to 5 shall reflect the available appropriations from all sources, as recorded in the Registry of Appropriations and Allotments (RAPAL):

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Column 3

authorized agency/entity appropriations. Column 4
allotment releases from Special Purpose Funds, grants/donations on top of the expenditure program, and transfers to/from other department/agency/entity resulting in increase/reduction of appropriations. This shall include modifications from one P/A/P, allotment class, or OU to another.
Column 5
adjusted appropriations.

E. Columns 6 to 10 shall reflect the available allotments identified by source, as recorded in the RAPAL and Registry of Allotments, Obligations and Disbursements (RAODs): Column 6 - allotments received for the period.

Column 7

adjustments of allotments through withdrawals of previously released allotments and modifications/augmentations within the regular agency budget. Column 8
allotments transferred to bureaus/ROs/OUs. This should correspond to the data reflected under FAR No. 1-B, Item A, columns 11 to 15. Column 9
additional allotments received from COs/ROs/OUs. This should correspond to the data reflected under FAR No. 1-B, Item B, columns 6 to 10. Column 10 - adjusted allotments (total of columns 6, 7, 8 and 9).

F. Columns 11 to 15 shall reflect the actual obligations incurred, broken down by quarter, as recorded in the RAODs:

Columns 11 to 14

total obligations for the quarter ending March, June, September and December.
Column 15
total of columns 11, 12, 13 and 14.

G. Columns 16 to 20 shall reflect the actual disbursements pertaining to obligations in columns 11-15, broken down by quarter:

Columns 16 to 19

total disbursements for the quarters ending March, June, September and December, including non-cash disbursements effected through Tax Remittance Advice (TRA), Non-Cash Availment Authority (NCAA), and other disbursements effected through deductions from claims (e.g., salary deduction, deduction from payments to contractors/suppliers, etc.) of any amount due the Government such as overpayment of personnel benefits or expenses, restitution for loss of government property, liquidated damages and similar claims.

Column 20

total of columns 16, 17, 18 and 19.

H. Columns 21 to 24 shall reflect the balances of appropriations, allotments and unpaid obligations at the end of the reporting period:

Column 21

balance of appropriations not released for the period. Column 22
balance of allotments not obligated for the period. Column 23 to 24
balance of unpaid obligations for the period equivalent to the difference between columns 15 and 20, broken down into: Due and Demandable Obligations and Not Yet Due and Demandable Obligations.

I. The SAAOBD shall be prepared for the Current Year Appropriations, Supplemental Appropriations and for the Continuing Appropriations, Allotted and Unallotted Continuing.

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SUMMARY OF APPROPRIATIONS, ALLOTMENTS, OBLIGATIONS, DISBURSEMENTS AND BALANCES BY OBJECT OF EXPENDITURES (SAAODBOE) FAR No, 1-A

INSTRUCTIONS A. The Summary of Appropriations, Allotments, Obligations, Disbursements and Balances by Object of Expenditures (SAAODBOE) shall be: 1. prepared by all national government agencies (NGAs) Central Offices (COs)/Regional Offices (ROs)/Operating Units (OUs) and government-owned or -controlled corporations (GOCCs) maintaining Special Account in the General Fund in reporting the appropriations, the allotments received, the obligations, the disbursements made and balances by object of expenditures for the reporting period. For highly decentralized departments (such as DepEd, DPWH, DENR, etc.) their lowest OUs (e.g., schools/districts/provincial offices) shall submit a copy of their reports to the next higher level units (e.g., Division Offices (DOs), ROs) for consolidation. For DepEd, the consolidated report of DOs shall be submitted to their respective ROs. Subsequently, the Agency/Entity ROs shall prepare a consolidated report (ROs and OUs under its coverage) and submit the same to their CO and to the Commission on Audit (COA)-Government Accountancy Sector (GAS) including copies of the submitted SAAODBOE of the lowest operating unit. In turn, the Agency/Entity CO shall prepare an overall consolidated report (CO, ROs, all OUs) for submission to the COA-GAS. The Agency/Entity CO shall disclose the OUs/ROs which are not included in the consolidated report, in case not all OUs/ROs submitted their reports for consolidation.
All COs/ROs/OUs shall provide a copy of their report to their respective Audit Team Leader.

presented by Fund Cluster. It shall be prepared by agencies/entities maintaining books of accounts for Fund Cluster Codes 01-Regular Agency Fund, 02-Foreign Assisted Projects Fund, 03-Special Account-Locally Funded/Domestic Grants Fund, and 04-Special Account-Foreign Assisted/Foreign Grants Fund. 3. certified correct by the Budget Officer (data on appropriations, allotments, obligations and obligations-Not Yet Due and Demandable) and Chief Accountant (data on disbursements and obligations-Due and Demandable). This shall be approved by Agency/Entity Head or Authorized Representative as recommended by the Director of Financial Management Service (FMS) or Equivalent.
4. submitted to the Department of Budget and Management (DBM) and COA-GAS. In submitting their reports to DBM, agencies and OUs under the coverage of DBM Central Office shall submit their signed Unified Reporting System (URS)-generated reports directly to the Budget and Management Bureau (BMB) concerned. In the case however of DepEd, DOH, DPWH, TESDA, SUCs and CHED, their ROs and lowest OUs shall submit their signed URS-generated reports directly to the DBM RO concerned. The CO of these departments/agencies/entities shall also submit a signed URS- generated consolidated report to the DBM concerned. 5. due for submission to COA and DBM within 30 days after the end of the quarter. B. Column 1 - Particulars shall indicate the sources of funds, the Expense Class, and the Object of Expenditures consistent with the UACS.

C. Column 2 - Adopt the UACS Code per COA-DBM-DOF Joint Circular (JC) No. 2013-1 dated 6 August 2013, JC No. 2014-1 dated 7 November 2014, and JC No. 1 dated 11 August 2017.

D. Columns 3 to 5 shall reflect the available appropriations from all sources, as recorded in the Registry on Appropriations and Allotments (RAPAL):

Column 3

authorized agency/entity appropriations. Column 4
adjustments representing appropriations corresponding to allotment releases from Special Purpose Funds and transfers to/from other department/agency/entity resulting in increase/reduction of appropriations. This shall include modifications from one P/A/P, allotment class, or OU to another.
Column 5
adjusted appropriations.

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E. Columns 6 to 10 shall reflect the available allotments identified by source, as recorded in the RAPAL and Registry of Allotments, Obligations and Disbursements(RAODs):

Column 6

allotments received for the period. Column 7
adjustments of allotments through withdrawals of previously released allotments and modifications/augmentations within the regular agency budget. Column 8
allotments transferred to bureaus/ROs/OUs. This should correspond to the data reflected under FAR No. 1-B, Item A, columns 11 to 15.
Column 9
additional allotments received from CO/ROs/OUs. This should correspond to the data reflected under FAR No. 1-B, Item B, columns 6 to 10. Column 10
adjusted allotments (total of columns 6, 7, 8 and 9).

F. Columns 11 to 15 shall reflect the actual obligations incurred, broken down by quarter, as recorded in the RAODs:
Columns 11 to 14 - total obligations for the quarter ending March, June, September and December.
Column 15

sum of columns 11, 12, 13 and 14

G. Columns 16 to 20 shall reflect the actual disbursements pertaining to obligations in columns 11-15, broken down by quarter:

Columns 16 to 19

total disbursements for the quarters ending March, June, September and December, including non-cash disbursements effected through Tax Remittance Advice (TRA), Non-Cash Availment Authority (NCAA), and other disbursements effected through deductions from claims (e.g. salary deduction, deduction from payments to contractors/suppliers, etc.) of any amount due the Government such as overpayment of personnel benefits or expenses, restitution for loss of government property, liquidated damages and similar claims.
Column 20
sum of columns 16, 17, 18 and 19

H. Columns 21 to 24 shall reflect the balances of appropriations, allotments and unpaid obligations at the end of the reporting period:

Column 21

balance of appropriations not released for the period. Column 22
balance of allotments not obligated for the period. Column 23 to 24
balance of unpaid obligations for the period equivalent to the difference between columns 15 and 20, broken down into: Due and Demandable Obligations and Not Yet Due and Demandable Obligations.

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Appendix B.2.2 Budget Forms Manual of Standards for Management of Hospital Finance Service LIST OF ALLOTMENTS AND SUB-ALLOTMENTS (LASA) FAR No. 1-B

INSTRUCTIONS

A. The List of Allotments and Sub-Allotments (LASA) shall be prepared to support the quarterly SAAODB per FAR No. 1. This form shall be submitted to COA and DBM within 30 days after the end of the quarter.

B. Columns 1 to 20 shall reflect the following information:

Column 1 – sequential numbering to determine how many obligational authorities were received/issued. Columns 2 and 3 – Assigned reference numbers of allotments/Sub-allotments numbers and the date of issuance. Columns 4 and 5 – the source of the allotments/ sub-allotments for Agency Specific Budget, Special Purpose Funds, Automatic Appropriations (i.e., RLIP, SAGF, etc.) and the corresponding Funding Source Code. Columns 6 to 9 – the amount of Allotments and Sub-Allotments transferred from Central Office (CO)/Regional Offices (ROs) under each allotment class should tally with the amount reflected in Column 9 of FAR Nos. 1 and 1-A. Column 10 – sum of columns 6, 7, 8 and 9. Columns 11 to 14 – the amount of Sub-Allotments transferred ROs / Operating Units (OUs).
Column 15 – sum of columns 11, 12, 14, 14. Total transfers to other OUs under each allotment class should tally with the amount reflected in column 8 of FAR Nos. 1 and 1-A Column 16 – sum of columns 6 and 11 Column 17 – sum of columns 7 and 12 Column 18 – sum of columns 8 and 13 Column 19 – sum of columns 9 and 14 Column 20 – sum of columns 16, 17, 18 and 19

C. The column for the Financial Expenses (Columns 8, 13 and 18) shall only be accomplished by the Bureau of the Treasury (BTr)

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Appendix B.2.2 Budget Forms Manual of Standards for Management of Hospital Finance Service STATEMENT OF APPROVED BUDGET, UTILIZATIONS, DISBURSEMENTS AND BALANCES (SABUDB) FAR No. 2

INSTRUCTIONS

A. The agency SABUDB for Off-Budgetary Funds shall be:

Prepared by all national government agencies' Central Offices/ROs/OUs with authority to use their revenue in reporting the budgeted income received, the utilizations made, disbursements and balances for the reporting period.

For highly decentralized departments (such as DepEd, DPWH, DENR, etc.) their lowest operating units (schools/districts/provincial offices) shall submit a copy of their reports to the next higher level units (e.g., Division/ROs) for consolidation. For DepEd, the consolidated report of Division Offices (DOs) shall be submitted to their respective ROs. Subsequently the Agency ROs shall prepare a consolidated report (RO and OUs under its coverage) and submit the same to their Central Office and to the Commission on Audit (COA)-Government Accountancy Sector (GAS) including copies of the submitted SABUDB of the lowest operating unit. In turn, the ACO shall prepare an overall consolidated report (CO, RO, all OUs) for submission to the COA - GAS. The Agency CO shall disclose the OUs/ROs which are not included in the consolidated report, in case not all OUs/ROs submitted their reports for consolidation.

All operating units shall provide a copy of their report to their respective Audit Team Leader.

presented by Fund Cluster. It shall be prepared by agencies maintaining books of accounts
for Fund Cluster Codes 05-Internally Generated Funds and 06-Business Related Funds.
likewise presented by Organizational Outcome (OO), by Cost Structure/Program, Activity, Project Code, by Expense Class and by Major Programs/Projects
Certified correct by the Budget Officer (data on approved budget, budget utilizations and unpaid utilizations - Not Yet Due and Demandable) and Chief Accountant (data on disbursements & unpaid utilizations - Due and Demandable). This shall be approved by Head of the Department/Agency/Authorized Representative as recommended by the Director of FMS or equivalent
Submitted to the DBM and COA - GAS. In submitting their reports to DBM, agencies and OUs under the coverage of DBM Central Office shall submit their signed Unified Reporting System (URS)-generated reports directly to the BMB concerned. In the case however of DepEd, DOH, DPWH, TESDA, SUCs and CHED, their ROs and lowest OUs shall submit their signed URS-generated reports directly to the DBM RO concerned. The CO of these departments/agencies shall also submit a signed URS-generated consolidated department/agency report to the DBM-BMB concerned.
Due for submission to COA and DBM within 30 days after the end of the quarter.

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Appendix B.2.2 Budget Forms Manual of Standards for Management of Hospital Finance Service B. Column 1 – Particulars shall indicate the OO, by Cost Structure/Program, Activity, Project Code, by Expense Class and by Major Programs/Projects, consistent with the UACS.
Summary "By Object Code" shall be reflected under FAR No. 2-A. C. Column 2 – Adopt the UACS Code per COA-DBM-DOF Joint Circular No. 2013-1 dated 6 August 2013, JC No. 2014-1 dated 7 November 2014, and JC No. 1 dated 11 August 2017. D. Columns 3 to 5 shall reflect the approved budgeted revenue of the agency: Column 3 – Approved budgeted revenue for the period Column 4 – Adjustments representing reductions modifications or augmentation within the agency approved budgeted revenue Column 5 – Adjusted budgeted revenue E. Columns 6 to 10 shall reflect the utilization, broken down by quarter, as recorded in the Registry of Budget, Utilization and Disbursements (RBUDs)
Columns 6 to 9 – total budget utilized for the quarter ending March, June, September and December. Column 10 – sum of columns 6, 7, 8 and 9 F. Columns 11 to 15 shall reflect the actual disbursements made pertaining to the utilizations in Columns 6-10, broken down by quarter, as recorded in the RBUDs Columns 11 to 14 – total disbursements for the quarters ending March, June, September and December including non-cash disbursements effected through deductions from claims (e.g., salary deduction, deduction from payments to contractors/suppliers, etc.) of any amount due the Government such as overpayment of personnel benefits or expenses, restitution for loss of government property, liquidated damages and similar claims. Column 15 – sum of columns 11, 12, 13, and 14 G. Columns 16 to 18 shall reflect the balances of the approved budgeted revenue at the end of the reporting period: Column 16 – balance of approved budgeted revenue unutilized for the period Column 17 to 18 – balance of unpaid utilizations for the period equivalent to the difference between columns 10 and 15 broken down into: Due and Demandable and Not Yet Due and Demandable.

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SUMMARY OF APPROVED BUDGET, UTILIZATIONS, DISBURSEMENTS AND BALANCES BY OBJECT OF EXPENDITURES (SABUDBOE) FAR No. 2-A

INSTRUCTIONS

A. The agency SABUDBOE for Off-Budget Funds shall be:

Prepared by all national government agencies' Central Offices/ROs/OUs with authority to use their revenue in reporting budgeted income received, the utilizations made, disbursements and balances for the reporting period.

For highly decentralized departments (such as DepEd, DPWH, DENR, etc.) their lowest OUs (schools/districts/provincial offices) shall submit a copy of their reports to the next higher level units (e.g., Division/ROs) for consolidation. For DepEd, the consolidated report of Division Offices (DOs) shall be submitted to their respective ROs. Subsequently the Agency ROs shall prepare a consolidated report (RO and OUs under its coverage) and submit the same to their Central Office and to the Commission on Audit (COA)- Government Accountancy Sector (GAS) including copies of the submitted SABUDBOE of the lowest OUs. In turn, the ACO shall prepare an overall consolidated report (CO, RO, all OUs) for submission to the COA - GAS. The Agency CO shall disclose the OUs/ROs which are not included in the consolidated report, in case not all OUs/ROs submitted their reports for consolidation.

All operating units shall provide a copy of their report to their respective Audit Team Leader.

presented Fund Cluster. It shall be prepared by agencies maintaining books of accounts for Fund Cluster Codes 05-Internally Generated Funds and 06-Business Related Funds.
Certified correct by the Budget Officer (data on approved budget, utilizations and unpaid utilizations - Not Yet Due and Demandable) and Chief Accountant (data on disbursements & unpaid utilizations - Due and Demandable). This shall be approved by Head of the Department/Agency/Authorized Representative as recommended by the Director of Financial Management Service (FMS) or equivalent
Submitted to the DBM and COA - GAS. In submitting their reports to DBM, agencies and OUs under the coverage of DBM Central Office shall submit their signed Unified Reporting System (URS)-generated reports directly to the Budget and Management Bureau (BMB) concerned. In the case however of DepEd, DOH, DPWH, TESDA, SUCs and CHED, their ROs and lowest OUs shall submit their signed Unified Reporting System (URS)-generated reports directly to the DBM RO concerned. The Central Office of these departments/agencies shall also submit a signed URS-generated consolidated report to the DBM-BMB concerned.
Due for submission to COA and DBM within 30 days after the end of the quarter.

318

Appendix B.2.2 Budget Forms Manual of Standards for Management of Hospital Finance Service B. Column 1 – Particulars shall indicate the source of Funds, Expense Class and Object of Expenditures consistent with the UACS.

C. Column 2 – Adopt the UACS Code per COA-DBM-DOF Joint Circular No. 2013-1 dated 6 August 2013, JC No. 2014-1 dated 7 November 2014, and JC No. 1 dated 11 August 2017.
D. Columns 3 to 5 shall reflect the approved budgeted revenue of the agency:
Column 3

Approved budgeted revenue for the period.
Column 4

Adjustments representing reductions or modifications/augmentations within the agency approved budgeted revenue. Column 5

Adjusted budgeted revenue. E. Columns 6 to 10 shall reflect the utilizations, broken down by quarter, as recorded in the Registry of Budget Utilization and Disbursements (RBUDs):
Columns 6 to 9

total budget utilized for the quarter ending March, June, September and December. Column 10

sum of columns 6, 7, 8, and 9

F. Columns 11 to 15 shall reflect the actual disbursements made pertaining to utilizations in Columns 6-10, broken down by quarter, as recorded in the RBUDs: Columns 11 to 14

total disbursements for the quarters ending March, June, September and December including non-cash disbursements effected through deductions from claims (e.g., salary deduction, deduction from payments to contractors/suppliers, etc.) of any amount due the Government such as overpayment of personnel benefits or expenses, restitution for loss of government property, liquidated damages and similar claims. Column 15

sum of columns 11, 12, 13, and 14 G. Columns 16 to 18 shall reflect the balances of the approved budgeted revenue at the end of the reporting period: Column 16 - balance of approved budgeted revenue unutilized for the period. Columns 16

balance of approved budgeted revenue unutilized for the period. Columns 17-18

balance of unpaid utilizations for the period equivalent to the difference between columns 10 and 15 broken down into: Due and Demandable/Accounts/Payable and Not Yet Due and Demandable.

319

Appendix B.2.2 Budget Forms Manual of Standards for Management of Hospital Finance Service

320

Appendix B.2.2 Budget Forms Manual of Standards for Management of Hospital Finance Service

AGING OF UNPAID OBLIGATIONS (ADDO) FAR No. 3

INSTRUCTIONS

A. The ADDO shall be:

Prepared by national government agencies (NGAs) central offices/regional offices/operating units and GOCCs maintaining Special Account in the General Fund. Adopt the UACS Code per COA-DBM- DOF Joint Circular No. 2013-1 dated 6 August 2013, JC No. 2014-1 dated 7 November 2014, and JC No. 1 dated 11 August 2017. 2. Certified correct by the Budget Officer (data on Obligation Request and Status number and amount and data on aging of Not Yet Due and Demandable Obligations) and Chief Accountant (data on the aging of Due and Demandable Obligations) and approved by the Head of Department/Agency/Authorized Representative as recommended by the Director of FMS or Equivalent

Due for submission to COA, DBM and BTr within 30 days after the end of the year.

B. Columns 1 to 12 shall reflect the following information: Column 1 – Particulars indicating source of funds and the names of creditors broken down into Due and Demandable Obligations and Not Yet Due and Demandable Obligations, Current Year's Appropriations and Prior Years' Appropriations Due and Demandable Obligations (Accounts Payable) - Obligations of NGAs' CO/ROs/OUs and GOCCs maintaining SAGF for which goods, services, and projects have been delivered, rendered, completed and/or accepted regardless of the year when these obligations were incurred (i.e., current year or previous years). Not Yet Due and Demandable Obligations - Obligations, of NGA COs/ROs/OUs and GOCCs maintaining SAGF, charged against current year and prior years' budget for which goods, services and projects are not yet delivered, rendered. completed and/or accepted year. Columns 2 to 4 – Obligation Request and Status Number, Date and Total Amount of unpaid obligations Column 5 – Amount of Due and Demandable Obligations or not Yet Due and Demandable Columns 6 to 11 – Aging of Unpaid Due and Demandable Obligations (Accounts Payable) and Not Yet Due and Demandable Obligations. Column 12 – Reasons for having Due and Demandable Obligations (Accounts Payable) outstanding above 90 days.

Manual of Standards for Management of Hospital Finance Service 321 Appendix B.2.3 Cash Operations Forms

STANDARD FORMS IN FINANCE SERVICE

B.2.3:   FORMS USED IN CASH OPERATIONS DEPARTMENT

Report of Advice to Debit Account Issued (RADAI)
Report of Collections and Deposits (RCD)
Cash Receipts Register (CRReg)
Cash Receipts Record (CRRec)
Notice of Dishonored Checks (NDC)
Checks and Advices to Debit Account Disbursements Record (CkADADRec)
Report of Checks Issued (RCI)
Advice of Checks Issued and Cancelled (ACIC)
Cash Disbursements Record (CDRec)
Report of Cash Disbursements (RCDisb)
List of Due and Demandable Accounts Payable – Advice to Debit Account (LDDAP-ADA)
Report on Paid Petty Cash Voucher (RPPCV)
Petty Cash Fund Record (PCFR)
Petty Cash Fund Register (PCFReg)
Summary of LDDAP-ADAs Issued and Invalidated ADA Entries (SLIIAE)

Manual of Standards for Management of Hospital Finance Service 322 Appendix B.2.3 Cash Operations Forms

Date Serial No.

Date Amount Payee Nature of Payment Name and Signature of Disbursing Officer/Cashier I hereby certify on my official oath that the above is a true statement of all ADAs issued by me during

Official Designation Entity Name : ____________________________________________ Fund Cluster : ___________________________________________ Bank Name/Account No. : __________________________________ Report No.: ____________________________ Sheet No.: ____________________________ CERTIFICATION the period stated above for which ADA Nos. ____________ to ___________ inclusive, were actually issued by me in the amounts shown thereon. Period Covered: UACS Object Code

REPORT OF ADVICE TO DEBIT ACCOUNT ISSUED ADA Appendix 13 (GAM) DV/Payroll No. ORS/BURS No. Responsibility Center Code

Manual of Standards for Management of Hospital Finance Service 323 Appendix B.2.3 Cash Operations Forms REPORT OF ADVICE TO DEBIT ACCOUNT ISSUED
(RADAI)

INSTRUCTIONS

A. This report shall be used by the Disbursing Officer to report daily or as often as necessary his/her disbursements made through ADA. It shall include cancelled ADA and be maintained by fund cluster. One (1) report shall be prepared for each bank account which shall be the basis for the preparation of JEV.

B. The report shall be accomplished as follows:

Period Covered – period covered by the report
Entity Name – name of the agency/entity
Report No. – number assigned by the Cash/Treasury Unit on the report. It shall be numbered as follows: 0000-00-0000
Fund Cluster – the fund cluster name/code in accordance with the UACS in which issuance of ADAs is charged
Sheet No. – sheet number of the report
Bank Name/Account No. – name of the bank and the account number where the ADA is drawn
ADA Date – date of the ADA issued
ADA Serial No. – serial number of the ADA issued whether released or unreleased including the cancelled ones
DV/Payroll No. – number of the reference DV/Payroll
ORS/BURS No. – Obligation Request Status/Budget Utilization Request Status Number
Responsibility Center Code – code assigned to each cost/responsibility center
Payee – name of the payee/claimant
UACS Object Code – the object code based on the UACS
Nature of Payment – brief description of the disbursement
Amount – amount of the ADA issued whether released or unreleased

C. The RADAI shall be certified by the Disbursing Officer/Cashier on the last sheet of the report after the totals as follows: “CERTIFICATION

            I hereby certify on my official oath that the above is a true statement of all

ADAs issued by me during the period stated above for which ADA Nos. ____________ to ___________ inclusive, were actually issued by me in the amounts shown thereon.

Name and Signature of Disbursing Officer/Cashier

Official Designation

Date”

D. The report shall be prepared in four (4) copies daily or as often as necessary to be distributed as follows:

Original – COA Auditor, through the Accounting Division/Unit, together with the original copy of the paid DVs/payroll, copy of the ADA and supporting documents
Copy 2 – Accounting Division/Unit Copy 3 – Budget Division/Unit Copy 4 – Cash/Treasury Unit

Year Serial Number (one series per year) Month

Manual of Standards for Management of Hospital Finance Service 324 Appendix B.2.3 Cash Operations Forms

Report No. : ______________________ Entity Name : _________________________________ Sheet No. : _______________________ Fund Cluster : ________________________________ Date : ___________________________ Taxes Fees Date Number 40101010 40201010 Total Summary: Undeposited Collections per last Report Deposits

 Date: ________________                                   P  xxx.xx
 Date: ________________                                       xxx.xx

Undeposited Collections, this Report

Official Designation Date Appendix 26 (GAM) MFO/PAP CERTIFICATION Collections per OR Nos. to__
REPORT OF COLLECTIONS AND DEPOSITS Amount Total per OR Breakdown of Collections Responsibility Center Code I hereby certify on my official oath that the above is a true statement of all collections and deposits had by me during the period stated above for which Official Receipt Nos. ____________ to ___________ inclusive, were actually issued by me in the amounts shown thereon. I also certify that I have not received money from whatever source without having issued the necessary Official Receipt in acknowledgement thereof. Collections received by sub-collectors are recorded above in lump-sum opposite their respective collection report numbers. I certify further that the balance shown above agrees with the balance appearing in my Cash Receipts Record. Payor Particulars Official Receipt/ Report of Collections by Sub- Collector Name and Signature of the Collecting Officer P xxx.xx xxx.xx xxx.xx P xxx.xx

Manual of Standards for Management of Hospital Finance Service 325 Appendix B.2.3 Cash Operations Forms

REPORT OF COLLECTIONS AND DEPOSITS (RCD)

INSTRUCTIONS

A. The Collecting Officer/Cashier shall prepare this report to record his/her collections and deposits to an AGDB as of specific date and shall be maintained by fund cluster.

B. It shall be accomplished as follows:

Entity Name – name of the agency/entity
Fund Cluster – fund cluster name/code in accordance with the UACS in which the collections and deposits are attributable to.
Report No. – shall be numbered one series for each year as follows:

00-00-000

Sheet No. – page number of the report which shall be series for each month
Date – date covered by the report
Official Receipt Date – date of the OR or Report of Collections by Sub-Collector
Official Receipt Number – serial numbers of the ORs issued by the Cashier or Sub-Collector including the cancelled ones listed in numerical sequence
Responsibility Center Code – code assigned to each cost/responsibility center
Payor – name of the person/agency/entity/sub-collector from whom the amount was received
Particulars – details or nature of the collection
MFO/PAP – the code for the major final output or program/activity/project as shown in GAA/SARO/GARO
Amount-Total Collections – the total amount of collections per OR or per Report of Collections of the Sub-Collector.
Amount-Breakdown of Collections – amount per nature of collections. The Cash/Treasury Unit or Collecting Officer may insert additional columns for each nature of collections.

C. A summary shall be prepared below the last entry in the report as follows: Summary:

Undeposited Collections per last Report

P xxx.xx
Collections per OR Nos. ______ to _______

  xxx.xx 
 Deposits:

Pxxx.xx

      Date:   ______________

xxx.xx xxx.xx Date: ______________ xxx.xx

Undeposited Collections, this Report

P xxx.xx

D. Collections should be deposited intact daily. The balance of collections not deposited during the day due to cut-off should be deposited on the first banking hour of the next working day.

E. The RCD shall be certified by the Collecting Officer on the last sheet of the report after the totals as follows:

Serial number (one series per year) Month Year

Manual of Standards for Management of Hospital Finance Service 326 Appendix B.2.3 Cash Operations Forms

“CERTIFICATION

            I hereby certify on my official oath that the above is a true statement of all collections

and deposits had by me during the period stated above for which Official Receipt Nos. ____________ to ___________ inclusive, were actually issued by me in the amounts shown thereon. I also certify that I have not received money from whatever source without having issued the necessary Official Receipt in acknowledgement thereof. Collections received by sub-collectors are recorded above in lump-sum opposite their respective collection report numbers. I certify
further that the balance shown above agrees with the balance appearing in my Cash Receipts Record.

Name and Signature of the Collecting Officer

Official Designation

Date”

F. This report shall be prepared in four (4) copies daily to be distributed as follows:

Original
– Cash Treasury/Unit/Collecting Officer's File, together with the triplicate copy of the ORs and validated DSs Copy 2
– COA Auditor thru the Accounting Division/Unit of Central/Regional/ Division Office concerned, together with the duplicate copy of the ORs and validated DSs Copy 3
– Accounting Division/Unit of Central/Regional/Division Office concerned to be attached to the copy of the JEV Copy 4 – Budget Division/Unit of Central/Regional/Division Office concerned

Manual of Standards for Management of Hospital Finance Service 327 Appendix B.2.3 Cash Operations Forms

Entity Name : ___________________________________________ Sub-Office/District/Division : ______________________________ Municipality/City/Province : ______________________________ National Treasury AGDB (+) (-) (-) (=) (40201010) (40201020) (40201040) (40201140) TOTALS 0 0 0 0 0 0 0 0 CERTIFIED CORRECT: Appendix 27 (GAM) Registration Fess Clearance and Certification Fees
Fines and Penalties - Service Income OTHERS Fund Cluster : _____________________________________ Sheet No. : _______________________________________ Date : ____________________________________________ Name of Collecting Officer/Cashier : ____________________ Number Amount
Permit Fees Payor UACS Object Code Account Description Official Receipt/ Deposit Slip Date CASH RECEIPTS REGISTER Cash - Collecting Officer (10101010) BREAKDOWN OF RECEIPTS Deposits
Receipts
Balance
Signature over Printed Name of Collecting Officer/Cashier Date

Manual of Standards for Management of Hospital Finance Service 328 Appendix B.2.3 Cash Operations Forms

CASH RECEIPTS REGISTER (CRReg)

INSTRUCTIONS

A. The CRReg shall be used by field offices without complete set of books to record the cash collections and deposits in the books of their mother unit (central/regional/division office).

B. The Collecting Officer/Cashier shall maintain this Register to monitor the cash collections and deposits and to summarize the breakdown of receipts/income received as of specific date.

C. This shall be accomplished as follows:

Entity Name – name of the agency/entity
Sub-Office/District/Division – name of the FO/OU which maybe a sub-office, district, etc.
Municipality/City/Province – Municipality/City/Province where the FO/OU is located
Name of Collecting Officer/Cashier – duly designated Collecting Officer/Cashier
Fund Cluster – the fund cluster name/code in accordance with UACS
Sheet No. – sheet/page number of the register
Date – date covered by the register
OR/DS-Date – date of the ORs and Deposit Slips (DSs).
OR/DS-No. –serial number of the ORs and DSs issued including the cancelled ones listed in correct numerical sequence
Payor – name of the person/agency/entity from whom the amount was received.
Cash Collecting Officers (10101010):  Receipts – amount received/collected based on the ORs  Deposits-National Treasury or AGDB – amount deposited/remitted based on the DS  Balance – the difference between the receipts and deposits  Breakdown of Receipts such as:

Permit Fees – amount received for the issuance of permit
Registration Fees – amount received for registration of assets, individuals and associations.
Clearance and Certification Fees – amount received for the issuance of clearances or certifications
Fines and Penalties-Service Income – amount received for the processing of documents for fines and penalties charged to service income.
Blank Columns – for other types of receipts not indicated in the other columns  Others – shall be accomplished as follows:
Account Description – account title used in accordance with the UACS
UACS Object Code – object code used in accordance with the UACS
Amount – amount of other receipts

D. The total of the “Receipts” columns must always equal to the sum of all the totals of the “Breakdown of Receipts” columns. The “Others” columns shall be used for refunds of overpayment of expenses and other collections which cannot be conveniently classified under the previously enumerated columns

E. A new sheet shall be used at the beginning of each month. Each sheet shall be totaled and the totals carried forward to the next sheet. The succeeding sheet shall start with the totals brought forward.

F. At the end of the month, this Register shall be totaled, balanced and ruled on the line immediately after the last entry.

G. In case there are dishonored checks, the Cash/Treasury Unit or Collecting Officer shall retrieves RCD/CRRec on file and records the dishonored checks with the notation:

“To take up Bank’s Debit Memo No. ___ dated ____ covering Check No. ___ for P ____________ acknowledged under OR No. _____ dated _______.”

Manual of Standards for Management of Hospital Finance Service 329 Appendix B.2.3 Cash Operations Forms

H. Certification:

 Every sheet, except the last sheet, of the Register shall be certified by the Collecting Officer/Cashier as follows:

 The last sheet of the Register shall be certified by the Collecting Officer after the totals as follows:

“CERTIFICATION

            I hereby certify on my official oath that the above is a true statement of all collections

received by me during the period stated above for which Official Receipt Nos. ____________ to ___________ inclusive, were actually issued by me in the amounts shown thereon. I also certify that I have not received money from whatever source without having issued the necessary Official Receipt in acknowledgement thereof. Collections received by sub-collectors are recorded above in lump-sum opposite their respective collection report numbers.

Name and Signature of the Collecting Officer

Official Designation

Date”

I. This Register shall be prepared in four (4) copies to be distributed as follows:

Original – Cash Unit/Collecting Officer's File, together with the triplicate copy of the ORs and validated DSs Copy 2
– COA Auditor thru the Accounting Division/Unit of Central/Regional/Division Office concerned, together with the duplicate copy of the ORs and validated DSs Copy 3 – Accounting Division/Unit of Central/Regional/Division Office concerned to be attached to the copy of the JEV Copy 4 – Budget Division/Unit of Central/Regional/Division Office concerned

“CERTIFIED CORRECT:

(Signature over Printed Name) Collecting Officer/Cashier”

Date”

Manual of Standards for Management of Hospital Finance Service 330 Appendix B.2.3 Cash Operations Forms

MFO/PAP Object Code ______, inclusives, as indicated in the corresponding columns. Undeposited Collection Date Reference No./OR No./DS Name and Signature I hereby certify on my official oath that the foregoing is a correct and complete record
of all collections and deposits had by me in my capacity as (Designation) of (Name of Agency) during the period from _________________ to Deposit CASH RECEIPTS RECORD Sheet No. : _________________ Year : _____________________ Entity Name : _______________________________ Fund Cluster : ______________________________

Accountable Officer C E R T I F I C A T I O N Date Payor UACS Code Nature of Collection Collection Station

Appendix 29 (GAM) Official Designation

Manual of Standards for Management of Hospital Finance Service 331 Appendix B.2.3 Cash Operations Forms

CASH RECEIPTS RECORD (CRRec)

INSTRUCTIONS

A. Each Collecting Officer/Accountable Officer shall maintain this record to monitor his/her accountability. All transactions for the day shall be recorded immediately and a balance (Undeposited Collection) shall be extracted.

B. This record shall be accomplished as follows:

Entity Name – name of the agency/entity
Fund Cluster – the fund cluster name/code in accordance with UACS to which the receipt is to be recorded
Sheet No. – sheet/page number of the record
Year – year covered by the record
Accountable Officer/Official Designation/Station – name of the Collecting Officer, his/her respective designation and station
Date – date of the source documents (reference/OR/DS)
Reference No./OR No./DS – reference document used as the basis in the recording of collections (ORs) and deposits (DSs)
Payor – the name of the payor
UACS Code - MFO/PAP – the code for MFO/PAP as provided in the UACS
UACS Code - Object Code – the code for each object as provided in the RCA prescribed by the COA
Nature of Collections – brief description of the nature of collections
Collection – the amount collected based on ORs
Deposit – the amount of collections deposited with the AGDB based on validated DS
Undeposited Collections – the difference between the Collection and Deposit columns which shall be equal to the amount of cash/checks in the hands of the Collecting Officer

C. The record shall be certified correct by the Collecting Officer at the end of each month or when required to do so by proper competent authority as follows:

“C E R T I F I C A T I O N

          I hereby certify on my official oath that the foregoing is a correct and complete record

of all collections and deposits had by me in my capacity as (Designation)
of (Name of Agency) during the period from _________________ to________, inclusives, as indicated in the corresponding columns.

Name and Signature

Date”

Manual of Standards for Management of Hospital Finance Service 332 Appendix B.2.3 Cash Operations Forms

Appendix 25 (GAM)

NOTICE OF DISHONORED CHECKS

Sir/Madam:

      You are hereby notified that your (name of bank) Check No. _________ dated

, 20, in the amount of P__ paid to us and acknowledged by our Official Receipt No. __________ dated _________, 20 has been deposited but was dishonored and returned to us due to __________________________.

      In view thereof, we have, today, reversed the payment recorded and reinstated your

liability in the same manner as if you had never tendered any payment.

      Please settle your account in cash or by certified check to the undersigned within

five days from receipt of this notice. Otherwise, we will be constrained to institute criminal action against you as may be warranted under Article 315 of the Revised Penal Code and Batas Pambansa Blg. 22.

                                                                                       Very truly yours,

   (Head of Agency) 

                                                                                       By:

   (Collecting Officer)

Note: The last paragraph applies only to cases where the cause of the dishonor of the check is lack or insufficiency of funds. Where the check is dishonored by reason of defect in form, such as incomplete signature or the like, the following paragraph should be used in lieu of the aforementioned last paragraph.

Please settle your account in cash or by certified check to the undersigned within three days from receipt of this notice. Otherwise, we will be constrained to initiate appropriate action to enforce our claim.

Manual of Standards for Management of Hospital Finance Service 333 Appendix B.2.3 Cash Operations Forms

Entity Name : _________________________________________ Bank Name/Bank Account Number : _____________________ Check ADA NCA Received/ Deposit Made Serial No. Date Name and Signature Official Designation Station Fund Cluster :______________ Sheet No. : _________________ C E R T I F I C A T I O N

Payee I hereby certify on my official oath that the foregoing is a correct and complete record of all checks/ADAs issued by me in my capacity as _________________________ of _____________________________________ (Designation) (Name of Agency) during the period from _______________ to _______________, inclusive, as indicated in the corresponding columns. ADA Issued NCA/Bank Balance

Appendix 34 (GAM) Check Issued Date CHECKS AND ADVICES TO DEBIT ACCOUNT DISBURSEMENTS RECORD Accountable Officer UACS Object Code Date Released NCA/DS/DV/Payroll No. Date Amount

Nature of Payment Check/ADA

Manual of Standards for Management of Hospital Finance Service 334 Appendix B.2.3 Cash Operations Forms

CHECKS AND ADVICES TO DEBIT ACCOUNT DISBURSEMENTS RECORD
(CkADADRec)

INSTRUCTIONS

A. The CkADADRec shall be maintained by each Disbursing/Accountable Officer, by fund cluster, to record/monitor all checks drawn (MDS or Commercial) and ADAs issued by him/her during the day. Whether released or unreleased, checks/ADAs shall be recorded immediately and the NCA/Bank balance shall be extracted.

B. This record shall be accomplished as follows:

Entity Name – name of the agency/entity
Fund Cluster – the fund cluster name/code in accordance with UACS in which the disbursements should be charged
Bank Name/Bank Account Number – name of the bank where the account is maintained and the account number
Sheet No. – the sheet number which shall be one series per year
Accountable Officer/Official Designation/Station – name, designation and station of the Accountable Officer
NCA/DS/DV/Payroll No. – number of the NCA, number of the validated DS if applicable, or number assigned to the DV/Payroll by the Accounting Division/Unit
NCA/DS/DV/Payroll Date – date of the NCA, date of validated DS, or the date of DV/Payroll preparation.
Check/ADA-Serial No. – serial number of the MDS check/ADA drawn shall be entered in numerical sequence, including cancelled ones
Check/ADA-Date – date of the check/ADA
Check/ADA-Date Released – date when the check/ADA is released to the payee
Payee – name of the payee/claimant
UACS Object Code – the object code in accordance with the UACS
Nature of Payment – brief description of the disbursement
Amount-NCA Received/Deposit Made – amount of NCA received or collection deposited
Amount-Check Issued – amount of check issued by the Accountable Officer
Amount-ADA Issued – amount of ADA issued by the Accountable Officer
Amount-NCA/Bank Balance – difference between the ‘NCA Received/Deposit Made’ column, and ‘Check Issued’ and ‘ADA Issued’ columns which shall be equal to the NCA/Bank checking account balance

C. The record shall be certified by the Disbursing/Accountable Officer at the end of each month or when required to do so by proper competent authority, as follows:

“C E R T I F I C A T I O N

I hereby certify on my official oath that the foregoing is a correct and complete record of all checks/ADAs issued by me in my capacity as _________________________ of _____________________________________
(Designation)

           (Name of Agency)

during the period from _______________ to _______________, inclusive, as indicated in the corresponding columns.

Name and Signature

Date”

Manual of Standards for Management of Hospital Finance Service 335 Appendix B.2.3 Cash Operations Forms

Appendix 35 (GAM) Entity Name : ____________________________________________ Fund Cluster : ___________________________________________ Report No.: __________ Bank Name/Account No. : __________________________________ Sheet No.: ___________ Date Serial No.

Official Designation Date

Name and Signature of Disbursing Officer/Cashier ORS/BURS No. Responsibility Center Code Period Covered: ________________ Amount UACS Object Code I hereby certify on my official oath that this Report of Checks Issued in _________ sheet(s) is a full, true and correct statement of all checks issued by me during the period stated above for which Check Nos. ___________ to _____________ inclusive, were actually issued by me in payment for obligations shown in the attached disbursement vouchers/payroll. C E R T I F I C A T I O N REPORT OF CHECKS ISSUED Check Payee Nature of Payment DV/Payroll No.

Manual of Standards for Management of Hospital Finance Service 336 Appendix B.2.3 Cash Operations Forms

REPORT OF CHECKS ISSUED
(RCI)

INSTRUCTIONS

A. This report shall be used by the Disbursing Officer to report daily or as often as necessary his/her disbursements made through checks. It shall include cancelled checks and be maintained by fund cluster. One (1) report shall be prepared for each bank account which shall be the basis for the preparation of JEV.

B. The report shall be accomplished as follows:

Period Covered – period covered by the report
Entity Name – name of the agency/entity
Report No. – number assigned by the Cash/Treasury Unit on the report. It shall be numbered as follows: 0000-00-0000
Fund Cluster – the fund cluster name/code in accordance with the UACS in which issuance of checks is charged
Sheet No. – sheet number of the report
Bank Name/Account No. – name of the bank and the account number where the check is drawn
Check Date – date of the check issued
Check Serial No. – serial number of the check issued whether released or unreleased including the cancelled ones
DV/Payroll No. – number of the reference DV/Payroll
ORS/BURS No. – Obligation Request Status/Budget Utilization Request Status Number
Responsibility Center Code – code assigned to each cost/responsibility center
Payee – name of the payee/claimant
UACS Object Code – the object code in accordance the UACS
Nature of Payment – brief description of the disbursement
Amount – amount of the check issued whether released or unreleased

C. The RCI shall be certified by the Disbursing Officer/Cashier on the last sheet of the report after the totals as follows: “CERTIFICATION

        I hereby certify on my official oath that this Report of Checks Issued in _________ sheet(s) is

a full, true and correct statement of all checks issued by me during the period stated above for which Check Nos. ___________ to _____________ inclusive, were actually issued by me in payment for obligations shown in the attached disbursement vouchers/payroll.

Name and Signature of Disbursing Officer/Cashier

Official Designation

Date”

D. The report shall be prepared in four (4) copies daily or as often as necessary to be distributed as follows:

Original – COA Auditor, through the Accounting Division/Unit, together with the original copy of the paid DVs/payroll, copy of the check and supporting documents
Copy 2 – Accounting Division/Unit Copy 3 – Budget Division/Unit Copy 4
– Cash/Treasury Unit

Year Serial Number (one series per year) Month

Manual of Standards for Management of Hospital Finance Service 337 Appendix B.2.3 Cash Operations Forms

To: The Bank Manager ACIC No. : ___________________ Bank Account No. ______________ Organization Code : ___________________
Fund Cluster : Date _________________________ Area Code : NCA No. : DATE OF ISSUE DATE NEGT'D. REMARKS Total ACIC Amount Total number of checks: __________Amount in words __________________________________________________ Page 1 of 2 Entity Name UACS OBJECT CODE ADVICE OF CHECKS ISSUED AND CANCELLED CHECK NO. PAYEE AMOUNT FOR GSB USE ONLY

Appendix 39 (GAM)

Manual of Standards for Management of Hospital Finance Service 338 Appendix B.2.3 Cash Operations Forms

Certified Correct By: Received by: Check No. Date Issued R e m a r k s Approved by: Delivered by: Number of ACIC(s) : __________________________________ Grand Total : _________________________________________ Amount in Words : _________________________________________________________________________________ Certified Correct by : Received by: Approved by: Delivered by: Page 2 of 2 CANCELLED CHECK Signature over Printed Name of Disbursing Officer/Cashier/Head of Cash/Treasury Unit Signature over Printed Name of GSB personnel who received the ACIC Signature over Printed Name of Head of
Office/Unit or his/her authorized representative Signature over Printed Name of Agency personnel who delivered the ACIC to the GSB R E P O R T S U M M A R Y Signature over Printed Name of Disbursing Officer/Cashier/Head of Cash/Treasury Unit Signature over Printed Name of GSB personnel who received the ACIC Signature over Printed Name of Head of Office/Unit or his/her authorized representative Signature over Printed Name of Agency personnel who delivered the ACIC to the GSB Appendix 39 (GAM)

Manual of Standards for Management of Hospital Finance Service 339 Appendix B.2.3 Cash Operations Forms ADVICE OF CHECKS ISSUED AND CANCELLED (ACIC)

INSTRUCTIONS

A. The ACIC is a report prepared and submitted at least daily by an agency/entity to the GSB to enable the payees to encash/negotiate the issued checks. The advice shall be promptly submitted to the GSB.

B. This form shall be accomplished as follows: 1. Entity Name – name of the agency/entity 2. The Bank Manager – include the name of Bank and its Address 3. Bank Account No. – Bank Account Number maintained by the agency 4. Date – the date of preparation of the form 5. ACIC No. – the ACIC number assigned by the Cash/Treasury Unit which shall be as follows:
0000 - 00 - 0000

Serial Number (One Series per fund for each year) Month Year

Organization Code – organization code assigned to the agency/entity based on the UACS 7. Fund Cluster – fund cluster name/code based in the UACS where the check should be charged 8. Area Code – four-digit code that pinpoints the region and province/city where the Deputized Disbursing Officer (DDO) is stationed 9. NCA No. – number of the NCA where the check was charged 10. Check No. – number of the Check 11. Date of Issue – date when the check was issued/drawn 12. Payee – name of the payee/claimant 13. Amount – amount indicated in the check 14. UACS Object Code – particular object/allotment class in accordance with the UACS 15. For GSB use only 16. Cancelled Check – the check number, date the check was issued/drawn and the reason why the check was cancelled 17. Certified Correct by – printed name and signature of Disbursing Officer (DO)/Cashier/Head of Cash/Treasury Unit 18. Approved by – printed name and signature of the Head of Office/Unit or his/her authorized representative 19. Received by – printed name and signature of the GSB personnel who received the ACIC 20. Delivered by – printed name and signature of the agency personnel who delivered the ACIC to the GSB

C. The “Report of Summary” portion shall be accomplished as follows:

Number of ACIC(s) – the number of report(s) submitted 2. Grand Total - the total amount in figures of the ACIC(s) submitted 3. Amount in words – the amount in words of the ACIC(s) submitted 4. Certified Correct by – printed name and signature of the Disbursing Officer (DO)/Cashier/Head of the Cash/Treasury Unit 5. Approved by – printed name and signature of the Head of the Office/Unit or his/her authorized representative 6. Received by – printed name and signature of the GSB personnel who received the ACIC 7. Delivered by – printed name and signature of the agency personnel who delivered the ACIC to the GSB

D. It shall be prepared in five (5) copies and distributed as follows:

Original – BTr, through GSB Copy 2 – Cash/Treasury Unit of the Agency Copy 3-5 – GSB

Manual of Standards for Management of Hospital Finance Service 340 Appendix B.2.3 Cash Operations Forms

Entity Name : __________________________ Fund Cluster : __________________________ Appendix 40 (GAM) Sheet No. : _________________

C E R T I F I C A T I O N

Name and Signature of Disbursing Officer

        I hereby certify on my official oath that the foregoing is a correct and complete record of all cash

disbursements had by me in my capacity as __(Designation) of (Name of Agency)
during the period from _______________ to _______________,inclusive, as indicated in the corresponding columns.
Date CASH DISBURSEMENTS RECORD Date Payee Nature of Payment Cash Advance Received/ (Refunded) Disbursements UACS Object Code ADA/Check/ DV/Payroll/ Reference No. Accountable Officer Official Designation

Station

Cash Advance Balance

Manual of Standards for Management of Hospital Finance Service 341 Appendix B.2.3 Cash Operations Forms CASH DISBURSEMENTS RECORD
(CDRec)

INSTRUCTIONS

A. This record shall be maintained by each Disbursing/Accountable Officer to monitor the cash advance balance. All transactions for the day shall be recorded immediately. It shall be maintained by fund cluster.

B. This form shall be accomplished as follows:

Entity Name – name of the agency/entity
Fund Cluster – the fund cluster name/code in accordance with the UACS
Sheet No. – the sheet number which shall be one series per year
Accountable Officer/Official Designation/Station – name, designation and station of the Accountable Officer/Disbursing Officer
Date – date of the source document
ADA/Check/DV/Payroll/Reference No. – serial number of the ADA/Check/DV/Payroll or other reference document
Payee – name of the payee/claimant
UACS Object Code – object code in accordance with the UACS
Nature of Payment – brief description of the payment
Cash Advance Received/(Refunded) – amount of cash advance received, or refunded in negative amount
Disbursements – amount disbursed out of the cash advance received
Cash Advance Balance – cash advance received less disbursements

C. The record shall be certified by the Disbursing Officer at the end of each month, or when required to do so by proper competent authority, as follows:

“C E R T I F I C A T I O N

I hereby certify on my official oath that the foregoing is a correct and complete record of all cash disbursements had by me in my capacity as _________________________of _______________________________ during the (Designation)

           (Name of Agency)

period from _______________ to _______________,inclusive, as indicated in the corresponding columns.

Name and Signature of Disbursing Officer

Date”

Manual of Standards for Management of Hospital Finance Service 342 Appendix B.2.3 Cash Operations Forms

Appendix 41 (GAM) Entity Name : __________________________ Report No. : _________________ Fund Cluster : _________________________ Sheet No. : __________________

Official Designation Date Date Payee Amount CERTIFICATION UACS Object Code DV/Payroll No. ORS/BURS No. Responsibility Center Code Nature of Payment I hereby certify on my official oath that this Report of Cash Disbursements in _________ sheet(s) is a full, true and correct statement of all cash disbursements during the period stated above actually made by me in payment for obligations shown in pertinent disbursement vouchers/payroll. Period Covered _____________________ Name and Signature of Disbursing Officer/Cashier REPORT OF CASH DISBURSEMENTS

Manual of Standards for Management of Hospital Finance Service 343 Appendix B.2.3 Cash Operations Forms

REPORT OF CASH DISBURSEMENTS
(RCDisb)

INSTRUCTIONS

A. This report shall be prepared by the Disbursing Officer to liquidate his/her cash advances for payment of salaries, wages, honoraria, allowances, and other personnel benefits, current operating expenses, and special purpose/time-bound undertakings. It shall be maintained by fund cluster.

B. This report shall be accomplished as follows:

Period Covered – period covered by the report
Entity Name – name of the agency/entity
Fund Cluster – the fund cluster name/code in accordance with the UACS
Report No. – number assigned to the RCDisb which shall be as follows:

0000-00-0000

                                     Serial number (one series per year)

5.
Sheet No. – sheet number of the report which shall be one series for each month 6. Date – date of the DV/Payroll 7. DV/Payroll No. – assigned DV/Payroll number attached to RCDisb 8. ORS/BURS No. – number assigned to Obligation Request Status or Budget Utilization Request Status 9. Responsibility Center Code – code assigned to each cost/responsibility center 10. Payee – name of the payee/claimant 11. UACS Object Code – object code based on UACS 12. Nature of Payment-nature of claims paid 13. Amount – amount of disbursement paid per DV/Payroll

C. The RCDisb shall be certified by the Disbursing Officer/Cashier on the last sheet of the report after the totals or when required to do so by proper competent authority, as follows:

“CERTIFICATION

I hereby certify on my official oath that this Report of Cash Disbursements in _________ sheet(s) is a full, true and correct statement of all cash disbursements during the period stated above actually made by me in payment for obligations shown in pertinent disbursement vouchers/payroll.

D. This report shall be prepared in three (3) copies and to be distributed as follows:

Original – COA Auditor, through Accounting Division/Unit together with the original of the paid DVs/payroll and supporting documents Copy 2 – Accounting Division/Unit Copy 3 – Disbursing Officer’s file

Name and Signature of the Disbursing Officer/Cashier

Official Designation

Date” Year Month

Manual of Standards for Management of Hospital Finance Service 344 Appendix B.2.3 Cash Operations Forms

NAME GROSS AMOUNT WITHHOLDING TAX NET AMOUNT FOR MDS- GSB USE ONLY P____ P _ P ____

Certified Correct: Approved: To: MDS-GSB of the Agency Please debit MDS Sub-Account Number : ________________________________ Please credit the accounts of the above listed creditors to cover payment of accounts payable TOTAL AMOUNT : P 1. 2. I hereby assume full responsibility for the veracity and accuracy of the listed claims, and the authencity of the supporting documents as submitted by the claimants. MDS-GSB BRANCH/MDS SUB ACCOUNT NO.: _____________________________ (Erasures shall invalidate this document) Agency Authorized Signatories II. ADVICE TO DEBIT ACCOUNT (ADA) In Pesos REMARKS Sub-total II. Prior Year's A/Ps Sub-total TOTAL I hereby warrant that the above List of Due and Demandable A/Ps was prepared in accordance with existing budgeting, accounting and auditing rules and regulations. (In Words) I. LIST OF DUE AND DEMANDABLE ACCOUNTS PAYABLE (LDDAP) CREDITOR PREFERRED SERVICING BANKS/SAVINGS/CURRENT ACCOUNT NO. Obligation Request and Status No. ALLOTMENT CLASS per (UACS) (Signature over Printed Name) Head of Accounting Division/Unit (Signature over Printed Name) Head of Agency or Authorized Official Department : ___________________________ I. Current Year A/Ps LDDAP-ADA No. ______________ Date : ________________________ Fund Cluster : _________________ Appendix 42 (GAM) LIST OF DUE AND DEMANDABLE ACCOUNTS PAYABLE - ADVICE TO DEBIT ACCOUNTS (LDDAP-ADA) Entity Name : ___________________________ Operating Unit : _________________________

Manual of Standards for Management of Hospital Finance Service 345 Appendix B.2.3 Cash Operations Forms

LIST OF DUE AND DEMANDABLE ACCOUNTS PAYABLE –
ADVICE TO DEBIT ACCOUNT (LDDAP-ADA)

INSTRUCTIONS

A. The LDDAP-ADA is an accountable form used as an authorization issued by the NGA/OU to the MDS-GSB instructing the bank to debit a specified amount from its available NCA to pay the creditors/payees listed in the upper portion of the LDDAP-ADA.

B. This accountable form shall be accomplished as follows:

Department/Entity Name/Operating Unit – name of the department/agency/OU
LDDAP-ADA No. – the number of the LDDAP-ADA form which shall be assigned by the Accounting Division/Unit, as follows:

01101101-06- 001- 2015 Year

                                                       Serial Number (One Series per fund for each year) 
                                                       Month           
                                                       Funding Source Code

3. Fund Cluster – the fund cluster name/code in accordance with the UACS 4. Date – date the form was accomplished 5. MDS-GSB Branch/MDS Sub-Account No. – the MDS-GSB branch sub account no. 6. Creditor Name – name of the creditor 7. Creditor Preferred Servicing Banks/Savings/Current Account No. – savings/current account number and the preferred servicing bank of the creditor 8. Obligation Request and Status No. – number assigned to the ORS by the Budget Section/Unit 9. Allotment Class – PS, MOOE, FE and CO
10. Gross Amount – gross amount of payable 11. Withholding Tax – amount of withholding tax to be deducted 12. Net Amount – gross amount less withholding tax 13. Remarks – MDS-GSB branch concerned shall indicate under ‘Remarks’ column, non- payments made to creditors concerned due to inconsistency.

C. Agency shall arrange the LDDAP-ADA on a “first-in, first-out” basis according to the date of receipt by the NGA/OU of the supplier’s/creditor’s billings with complete supporting documents.

Manual of Standards for Management of Hospital Finance Service 346 Appendix B.2.3 Cash Operations Forms

D. The “LDDAP” portion shall be certified correct by the Head of Accounting Division/Unit that the list was prepared in accordance with existing budgeting, accounting and auditing rules and regulations.

E. The “LDDAP” portion shall be approved by the Head of Agency or his/her Authorized Representative as to the veracity and accuracy of the listed claims, and the authenticity of the supporting documents submitted by the claimants.

F. The “ADA” portion shall be signed by the Cashier/Authorized Official and countersigned by the Head of Agency/Authorized Representative/Official.

G. The LDDAP-ADA shall be prepared in five copies to be distributed as follows:

Original – MDS-GSB Copy 2 – BTr, through MDS-GSB, must be originally signed by the Authorized Signatories Copy 3 – COA Auditor, through the Accounting Division/Unit, must be originally signed by the Authorized Signatories; to be submitted first to the MDS-GSB along with the Original and Copy 2 for bank validation

Note: The validated Copy 3 of the LDDAP-ADA shall be returned by the MDS- GSB to the agency to be attached by the Accounting Division/Unit to the original DV and SDs. Copy 4 – Cash/Treasury Unit, to be stamped “Received” by the MDS-GSB upon receipt of Copies 1-3 of the LDDAP-ADA
Copy 5 – Cash/Treasury Unit, to be attached to the RADAI

H. The agency shall reproduce copies of the validated Copy 3 of LDDAP-ADA to be attached to the Copies 2-4 of the DV.

Manual of Standards for Management of Hospital Finance Service 347 Appendix B.2.3 Cash Operations Forms

Appendix 49 (GAM) REPORT ON PAID PETTY CASH VOUCHERS Period Covered ______________________ Entity Name: _______________ Report No:__________________ Fund Cluster: ______________ Sheet No.:___________________ Date Petty Cash Particulars Amount Voucher No.

C E R T I F I C A T I O N

 I hereby certify to the correctness of the above information.

Petty Cash Custodian Date

Manual of Standards for Management of Hospital Finance Service 348 Appendix B.2.3 Cash Operations Forms

REPORT ON PAID PETTY CASH VOUCHER (RPPCV)

INSTRUCTIONS

A. The RPPCV shall be prepared by the PCFC to replenish his/her PCF. All liquidated PCVs shall be attached together with all the supporting documents.

B. This report shall be accomplished as follows:

Period Covered – period covered by the report 2. Entity Name – name of the agency/entity 3. Fund Cluster – the fund cluster name/code in accordance with the UACS 4. Report No. – report number assigned which shall be as follows:

000-0000-00-000

                                      Serial number (one series for each year) 
                                      Month 
                                      Year 
                                       Petty Cash Custodian Code

5. Sheet No. – the sheet number which shall be one series per year 6. Date – date of the PCV 7. Petty Cash Voucher No. – the serial number of the PCV to be presented in numerical order
8. Particulars – nature of disbursements/expenses as shown in the PCV 9. Amount – amount paid covered by the PCV 10. Certification – name and signature of the designated PCFC and date of signing

C. At the end of the year, the PCFC shall prepare RPPCV covering all paid PCVs for replenishment and submit the same to the Accounting Division/Unit for the recording of expenses incurred.

D. The PCFC shall prepare this report in two copies distributed as follows:

Original – COA Auditor, through the Accounting Division/Unit, as attachment to the DV together with the original PCVs and supporting documents Copy 2 – PCFC file copy

Manual of Standards for Management of Hospital Finance Service 349 Appendix B.2.3 Cash Operations Forms Fund Cluster: _________________________ Date Reference/ Check/ PCV No. Cash Advance/ Replenishments Received Disbursements Cash Advance Balance Date PETTY CASH FUND RECORD Entity Name : _________________________ Appendix 50 (GAM)

Petty Cash Fund Custodian Official Designation

Station

C E R T I F I C A T I O N

Payee Nature of Payment I hereby certify that the foregoing is a correct and complete record of all cash advances received and disbursements made by me in my capacity as Petty Cash Fund Custodian of________________________ during the period from _________________ to _______________, inclusive, as indicated in the corresponding columns. Name and Signature of Petty Cash Fund

Manual of Standards for Management of Hospital Finance Service 350 Appendix B.2.3 Cash Operations Forms

PETTY CASH FUND RECORD
(PCFR)

INSTRUCTIONS

A. Each PCFC shall maintain this PCFR to record his/her cash advance, utilization and replenishment made and to monitor the PCF balance. All transactions for the day shall be recorded immediately.

B. This form shall be accomplished as follows:

Entity Name – name of the agency/entity
Fund Cluster – the fund cluster name/code in accordance with the UACS
Petty Cash Fund Custodian/Official Designation/Station – name of the Petty Cash Fund Custodian, his/her designation and station
Date – date of the source document
Reference/Check/PCV No. – reference document used as the basis in recording the granting/replenishment and utilization of PCF
Payee – name of the payee
Nature of Payment – brief description of the nature of payment
Cash Advance/Replenishments Received – amount of cash advance/replenishments received by the PCFC
Disbursements – amount of expenses paid by the PCFC
Cash Advance Balance – the difference between the Debit and Credit columns which shall be equal to the amount of cash in the hands of the PCFC.

C. The record shall be certified by the PCFC at the end of each month or when required to do so by proper competent authority, as follows:

“CERTIFICATION

I hereby certify that the foregoing is a correct and complete record of all cash advances received and disbursements made by me in my capacity as Petty Cash Fund Custodian of
(Name of Agency) during the period from _______________ to _______________, inclusive, as indicated in the corresponding columns.

Name and Signature of Petty Cash Fund Custodian

Date”

Manual of Standards for Management of Hospital Finance Service 351 Appendix B.2.3 Cash Operations Forms

Department/Agency : ____________________________ Petty Cash Fund Custodian : _ Sub-Office/District/Division: ________ Fund Cluster : _ Municipality/City/Province:_ Sheet No. : ________________ PERSONNEL SERVICES (+) (-) (50101020) (50201010) (50203010) (50204010) (50204020) (5020502002) TOTALS

(Signature over Printed) Name Petty Cash Fund Custodian PETTY CASH FUND REGISTER BREAKDOWN OF PAYMENTS Appendix 51 (GAM) PETTY CASH FUND '(10101020) Office Supplies Expenses
Water Expenses Electricity Expenses

Payments Balance Salaries and Wages- Casual/ Contractual Telephone Expenses - Landline Date PCV/ Check No. Particulars MAINTENANCE AND OTHER OPERATING EXPENSES Traveling Expenses- Local Receipts

Manual of Standards for Management of Hospital Finance Service 352 Appendix B.2.3 Cash Operations Forms

PETTY CASH FUND REGISTER
(PCFReg)

INSTRUCTIONS

A. The PCFReg shall be maintained by the Petty Cash Fund Custodian (PCFC) of Government Units without complete set of books of accounts to monitor/summarize the Petty Cash Fund (PCF) established/replenished and the disbursements charged thereto. It shall be accomplished as follows:

Department/Agency – Department/Office/Bureau
Sub-Office/District/Division – name of operating unit
Municipality/City/Province – municipality/city/ province where the operating unit is located.
Petty Cash Fund Custodian – name of the PCFC
Fund Cluster – fund cluster name/code in accordance with UACS
Sheet No. – sheet/page number
Date –date of the Petty Cash Voucher (PCV)
PCV/Check No. – assigned PCV number/ serial number of the replenishment checks received
Particulars – name of payee and/or details or nature of payments
Petty Cash Fund (10101020):  Receipts – amount of PCF established/ replenished  Payments – amount disbursed out of the PCF covered by PCV  Balance – the difference between the receipts and payments
Breakdown of Payments:  Personnel Services (PS):

Salaries and Wages - Casual/ Contractual (50101020) – amount paid for salaries/wages of casual employees  Maintenance and Other Operating Expenses (MOOE):
Traveling Expenses-Local (50201010) – amount paid for local travel
Office Supplies (50203010) – amount paid for office supplies purchased
Water Expenses (50204010) – amount paid for water consumption
Electricity Expenses (50204020) – amount paid for electric bills
Telephone Expenses-Landline (5020502002) – amount paid for landline telephone bills

Note: Insert additional columns for other PS and MOOE expenses where no columns were provided.

B. The total of the ‘Payments’ column must always equal to the sum of the totals of the ‘Breakdown of Payments’ columns for PS and MOOE.

C. A new sheet shall be started at the beginning of each month. Each sheet shall be totaled and the totals carried forward to the next sheet. The succeeding sheet shall start with the totals brought forward.

D. At the end of the month, this register shall be totaled, balanced and ruled. The ruling shall be made on the line immediately after the last entry.

E. A photocopy of this Register together with original PCV and its supporting documents shall be submitted to the Accounting Division/Unit of their respective Central/Regional/Division Office to serve as basis in the preparation of the DV to replenish the payments made or the JEV, at year-end, if no replenishment is made.

F. Every sheet shall be certified by the PCFC as follows:

                                 “CERTIFIED CORRECT: 


    (Signature over Printed Name) 

      Petty Cash Fund Custodian”

Manual of Standards for Management of Hospital Finance Service 353 Appendix B.2.3 Cash Operations Forms

To: The Bank Manager (Bank Branch) (Address) PS MOOE CO FE No. of pcs of LDDAP-ADA ____________ PS MOOE CO FE TOTAL Certified Correct by: Approved by: TRANSMITTAL INFORMATION Delivered by: Received by: (Signature) (Signature) (Name in Print) (Name in Print) Appendix 53 (GAM) Designation Designation Head of Cash/Treasury Unit/Authorized Official Head of Agency/Authorized Official SLIIAE No.: ________________________ Date : _____________________________ (Name in Print) (Signature) (Signature) (Name in Print) For GSB Use Only Remarks LDDAP-ADA No. SUMMARY OF LDDAP-ADAs ISSUED AND INVALIDATED ADA ENTRIES Department: ______________________________ Entity Name: ______________________________ Operating Unit: ____________________________ Fund Cluster: _______________________ Allotment/Object Class Total Amount Amount in Words Remarks Date Issued OF WHICH INVALIDATED ENTRIES OF PREVIOUSLY ISSUED LDDAP-ADAs LDDAP-ADA No. Date of Issue Allotment/Object Class Total Amount Amount

Manual of Standards for Management of Hospital Finance Service 354 Appendix B.2.4 Billing, Claims and Other Forms

STANDARD FORMS USED IN FINANCE SERVICE

B.2.4: FORMS USED IN BILLING AND CLAIMS DEPARTMENT

Billing Charge Slip 2. Charge Form (all wards) 3. Pay Patient-Statement of Professional Fees 4. Statement of Account 5. Billing Notice 6. Discharge Clearance 7. Summary of Bills Rendered Form

Manual of Standards for Management of Hospital Finance Service 355 Appendix B.2.4 Billing, Claims and Other Forms

FS FORM No. 1

Manual of Standards for Management of Hospital Finance Service 356 Appendix B.2.4 Billing, Claims and Other Forms

FS Form No. 2

Manual of Standards for Management of Hospital Finance Service 357 Appendix B.2.4 Billing, Claims and Other Forms

Manual of Standards for Management of Hospital Finance Service 358 Appendix B.2.4 Billing, Claims and Other Forms

FS Form No. 3

Manual of Standards for Management of Hospital Finance Service 359 Appendix B.2.4 Billing, Claims and Other Forms

FS Form No. 4

Manual of Standards for Management of Hospital Finance Service 360 Appendix B.2.4 Billing, Claims and Other Forms

FS Form No. 5

Manual of Standards for Management of Hospital Finance Service 361 Appendix B.2.4 Billing, Claims and Other Forms

FS Form No. 6

Manual of Standards for Management of Hospital Finance Service 362 Appendix B.2.4 Billing, Claims and Other Forms

FS Form No. 7

Manual of Standards for Management of Hospital Finance Service 363 Appendix B.2.4 Billing, Claims and Other Forms

*cont. FS Form No. 7

*Note: This is the continuation of the Summary of Bills Rendered Form. You may download the template at https://bit.ly/SummaryofBillsRenderedForm

364 Manual of Standards and Procedures for Hospital Finance Service B.3 Finance Service Self-Assessment Tool

SELF-ASSESSMENT TOOL FINANCE SERVICE Name of Hospital :
SCORE

Data Collected

Yes / No Yes / No Yes / No Yes / No Yes / No Yes / No Yes / No

Evidence

Displayed (1pt) Presence (1pt) Presence (1pt) Presence (1pt) Presence (1pt) Presence (1pt) Presence (1pt)

Validation

Ocular Validation Document Review Document Review Document Review Document Review Document Review Document Review

Indicators

Presence of updated Vision, Mission, Goal (consistent with the hospital's VMG) Has an approved Strategic Plan Has an approved Work and Financial Plan Has an approved OPCR / DPCR Has an approved Hospital Scorecard Has an approved PPMP, APP Budget and Financial Accountability Reports (BFARs)

Standards Input

Finance Service Planning, Execution and Monitoring System

365 Manual of Standards and Procedures for Hospital Finance Service B.3 Finance Service Self-Assessment Tool SELF-ASSESSMENT TOOL FINANCE SERVICE

Rate: Rate: Rate: Yes / No Yes / No Yes / No

Exact Measurem ent Exact Measurem ent

90% (1 pt) Less than 90% (0) 100% (1 pt) Less than 100% (0) 90% (1 pt) Less than 90% (0) Presence (1pt) Presence (1pt) Presence (1pt)

100% compliant
(1pt) Less than 100% (0) 100% compliant
(1pt) Less than 100% (0)

Comparison of staffing with standards Comparison of QS with standards Document Review Document Review Approved Training Report Approved Training Report

Ocular Visit Ocular Visit

90% of plantilla position of the standard staffing are filled up % compliance to the Qualification standards 90% Finance Staff received LDI (# of LDI attended over # of Staff) Approved TNAs Approved Individual Development Plan Approved Training Report

of personnel in the office x 5.02

s.q.m

of personnel in the office x 5.02

s.q.m

Staff adequate and appropriate
All staff received LDI intervention 3.1 Training Needs Analysis (TNAs) 3.2 Annual Training Plan 3.3 Training Report
Provided with office space compliant to standards 4.1 FMO 4.2 Accounting

366 B.3 Finance Service Self-Assessment Tool Manual of Standards and Procedures for Hospital Finance Service

SELF-ASSESSMENT TOOL FINANCE SERVICE

Exact measurement Exact measurement Exact measurement

Rate Rate Rate

100% compliant (1pt) / Less than 100% (0) 100% compliant (1pt) / Less than 100% (0) 100% compliant (1pt) / Less than 100% (0) 100% compliant (1pt) / Less than 100% (0) 100% compliant (1pt) / Less than 100% (0) 100% compliant (1pt) / Less than 100% (0)

Ocular visit Ocular visit Ocular visit

of personnel in the office x 5.02 sqm.

% of personnel provided with adequate office equipment % of personnel provided with adequate office equipment % of personnel provided with adequate office equipment

Input 4.3 Budget 4.4 Billing and Claims 4.5 Cash operations 5. Provided with office equipment: Adequate number of tables and chairs, All staff have computers, adequate filing area 5.1 FMO 5.2 Accounting 5.3 Budget

367 Manual of Standards and Procedures for Hospital Finance Service B.3 Finance Service Self-Assessment Tool SELF-ASSESSMENT TOOL FINANCE SERVICE SCORE

Data Collected

Rate: Rate:

Yes / No

of

meetings with minutes

of

meetings with minutes Evidence

100% compliant
(1pt) Less than 100% (0) 100% compliant
(1pt) Less than 100% (0)

Presence (1pt) Presence (1pt) Presence (1pt) Validation

Ocular visit Ocular visit

Document Review Document Review Document Review Indicators

% of personnel provided with adequate office equipment % of personnel provided with adequate office equipment

Minutes of meetings Once in a month with Minutes of Meetings Once in a month with Minutes of Meetings Standards Input 5.4 Billing and claims 5.5 Cash operations 6 Administration and Supervision
6.1 FMO attends the ManCom Meetings 6.2 FS has a regular Management Meeting 6.3 Each department has a regular staff meeting

368 B.3 Finance Service Self-Assessment Tool Manual of Standards and Procedures for Hospital Finance Service

SELF-ASSESSMENT TOOL FINANCE SERVICE

Rate Yes / No Rate Rate Rate Rate Rate

100% (1pt) Less than 100% (0) Updated (1pt) 100% (1pt) Less than 100% (0) 100% (1pt) Less than 100% (0) 100% (1pt) Less than 100% (0) 100% (1pt) Less than 100% (0) 100% (1pt) Less than 100% (0)

Document Review (Sampling) Document Review Document Review (Sampling) Document Review Document Review Document review of all Subsidiary ledgers and General ledgers Document Review (Sampling)

100% of contracts and purchase requests were certified Updated registries (NCA) 100% of Financial Transactions with Journal Entry Vouchers 100% of Books of Account updated 100% Financial Reports submitted within the prescribed timeline 100% of the Subsidiary Ledgers were reconciled with the General Ledger 100% of the Disbursement Vouchers has certification of availability of cash, reviewed as to propriety and completeness

Process
A. Accounting Department

Certifies the availability of funds of contracts and purchase orders
Monitors and controls allotment and disbursement utilization
Implements and monitors the systematic recording of financial transactions
Maintains/updates the Books of Accounts per fund cluster
Prepares and submits Financial Reports
Maintains/reconciles General Ledger Accounts with Subsidiary Ledgers
Certifies the availability of cash, propriety and completeness of supporting documents for disbursements

369 Manual of Standards and Procedures for Hospital Finance Service B.3 Finance Service Self-Assessment Tool SELF-ASSESSMENT TOOL FINANCE SERVICE

Rate: Rate: Rate: Yes / No

100% (1 pt) Less than 100% (0) 100% (1 pt) Less than 100% (0) 80 % of officers given demand letters is (1 pt) less is 0 Updated (1 pt) Not updated (0)

Document review of all funds for financial assistance Document Review Document Review Document Review

100% of the Liquidation Reports submitted 100% of cash advances liquidated % of officers with unliquidated cash advances given Demand Letter/s Updated institutional procedure manual Process Accounting Department 8. Prepares and submits liquidation reports for other funding sources received 9. Monitors status of liquidation of cash advances granted to officers and employees

10 Established procedures on: a. Processing of Purchase Order (PO) b. Processing of Disbursement Voucher for Payment Processing of Financial Report

370 B.3 Finance Service Self-Assessment Tool Manual of Standards and Procedures for Hospital Finance Service

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Rate Yes / No Yes / No Yes / No Rate Yes / No Yes / No

100% (1pt) Less than 100% (0) Timely (1pt) 100% of the process were followed (1 pt) Less than 100% (0) Updated (1 pt) Not updated (0) 100% (1pt) Less than 100% (0) Presence (1) Presence (1)

Document Review (Sampling) Document Review (Check if transmittal date is within given deadline) Process of preparation of budget proposal was followed Document Review Document Review Document review Document review 100% of Approved Budget Utilization Request (BUR)/Obligation Request (ObR)are in accordance with PPAPS in WFP and APP Timely submission of approved Budget Proposal Process of preparation of budget proposal was followed Updated registries % of funds allocated to priority programs Presence of policy Endorsement letter to program managers 100% of Approved Budget Utilization Request (BUR)/Obligation Request (ObR)are in accordance with PPAPS in WFP and APP Budget Department

Ensures that utilization of funds is in accordance with Projects, Activities/ Projects (P/A/Ps) in the WFP and APP
Prepares and Submits Budget Proposal
Monitors and controls allotment and fund utilization
Allocates available funds to hospital priority programs, activities and projects based on approved guidelines, policies and priorities 4.1 Has established criteria for allocation 4.2 Informs program managers of their approved budget

371 Manual of Standards and Procedures for Hospital Finance Service B.3 Finance Service Self-Assessment Tool SELF-ASSESSMENT TOOL FINANCE SERVICE

Rate: Rate: Rate: Rate: Rate:
Yes / No

100% (1 pt) Less than 100% (0) 100% (1 pt) Less than 100% (0) 100% (1 pt) Less than 100% (0) 10% (1 pt) More than 10% (0) 100% (1 pt) Less than 100% (0) Timely Submission of report as seen in transmittal (1 pt)

Document review Document review Document review Document Review Document Review Document Review

100 % of the obligation / utilization were certified 100% of the registries are updated 100% of the Obligation Requests / Budget Utilization Requests were reviewed for accuracy and correctness % of Obligation Requests / Budget utilization Requests were returned % of Funds requested for realignment were approved 100% of Technical Assistance provided Budget Department 5. Certifies Availability of Allotment/Budget and the purpose of obligation/utilization 6. Maintains and updates the registries of appropriations, allotments, obligations, and disbursements 7. Reviews accuracy and correctness of Obligation Requests / Budget Utilization Requests

Plans, directs and prepares request for realignment/reprogramming of funds
Provides technical assistance to and coordinates with all units regarding budget related matters

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Yes / No Number of communications Yes / No

Timely Submission of report as seen in transmittal (1 pt) Presence (1 pt) Presence (1 pt)

Document Review Document review Document Review

Quarterly estimate of income collection and utilization approved by ManCom and submitted to DBM No. of requests submitted to DOH, DBM and other funding agencies Updated Procedure Manual Budget Department 10. Forecasts future hospital operating income for planning and for decision making 11. Prepares various communications/requests relating to the release of additional/supplemental allotment and other matters relating to the budget of the hospital 12. Established procedures on: a. Preparation of Budget Proposal
b. Processing of Obligation Request & Status (ORS)and Budget Utilization Request & Status (BURS) c. Preparation and Submission of Statement of Appropriations, Allotments, Obligations, Balances and Disbursements (SAAOBD)

373 Manual of Standards and Procedures for Hospital Finance Service B.3 Finance Service Self-Assessment Tool SELF-ASSESSMENT TOOL FINANCE SERVICE

Rate: Rate: Rate: Rate: Yes / No Yes / No

100% (1 pt) Less than 100% (0) 100% (1 pt) Less than 100% (0) 100% (1 pt) Less than 100% (0) 100% (1 pt) Less than 100% (0) Presence (1 pt) Presence (1 pt)

Document review Document review Sample 10 patients randomly Document review Determine online submission Document Review

% of accurate Statement of Accounts issued in a timely manner % of the claims were transmitted within the prescribed timeline. Progress Bill can be issued upon demand % of complete PhilHealth Claims Phil Health Claims submitted online Report of RTH and Denied claims with analysis Billing and Claims Department

Prepares accurate and timely Statement of Account of patients after verifying all hospital charges reflected on the patient account
Processes accurate and timely transmittal of PHIC and other claims
Prepares progress billing and informs patients/relatives accordingly
Processes and reviews PhilHealth claims prior to e-claims transmittal
Submitted Philhealth claims electronically
Monitors Philhealth claims filed and analyze causes of RTH and denied claims for appropriate action

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Yes / No Yes / No Yes / No Yes / No Yes / No

Presence (1 pt) Presence (1 pt) Presence (1 pt) Presence (1 pt) Presence (1 pt)

Document Review Determine system and check 3 demand letters Document Review Document Review Document Review

Corrective Measures or action plan Presence of monitoring system and Demand Letters issued Policy on enforcing collection of receivables Summary of Bills Rendered submitted within the required timeline PHIC reconciliation modules and subsidiary Ledgers maintained by both accounting and billing department

Billing and Claims Department 7. Institutes measures to address or rectify RTH and denied claims 8. Monitors outstanding & overdue accounts, and in so doing, makes the necessary follow up and sends at least three demand letters for overdue accounts 9. Establishes other measures to enforce collection of receivables 10. Prepares and submits Summary of Bills Rendered to Accounting Department within the required timeline 11. Conducts periodic reconciliation of accounts receivable with Accounting Department/Section and vice versa. 12. Maintains and updates procedures on:

375 Manual of Standards and Procedures for Hospital Finance Service B.3 Finance Service Self-Assessment Tool SELF-ASSESSMENT TOOL FINANCE SERVICE

Rate:

Yes / No Yes / No

100% (1 pt) Less than 100% (0)

Presence (1 pt) Presence (1 pt)

Document review

Document review Documentation Review (RCD and Deposit Slip)

% of accurate Statement of Accounts issued in a timely manner

RCD/RCI/RADAI submitted within the prescribed timeline Record of cash collections, deposits and disbursements All collections must be deposited intact within the prescribed timeline Billing and Claims Department 12.1 Processing and Issuance of Statement of Accounts

12.2 Processing and Issuance of Discharge Clearance

12.3 Processing and transmittal of Philhealth Claims

12.4 Preparation of Summary of Bills Rendered

Cash Operations Department

Manages all collections, deposits and disbursements
Verifies/Certifies the accuracy of the cash collections/remittances report and regular reports of accountabilities

376 B.3 Finance Service Self-Assessment Tool Manual of Standards and Procedures for Hospital Finance Service SELF-ASSESSMENT TOOL FINANCE SERVICE

Yes / No Yes / No Number Yes / No Yes / No Yes / No Yes / No

Daily submission documented (1 pt) 100% compliance (1 pt) Less than is (0) No cancelled checks (1 pt) With cancelled checks (0) Presence (1 pt) Presence (1 pt) Provided at the given time (1 pt) Submitted within required time (1 pt)

Document Review Process review Document Review (Report of checks issued and cancelled) Document Review Document Review Document Review Document Review

Daily reports are submitted % of compliance to standard procedure No. of Checks issued but cancelled Monthly Reports of Accountability for Accountable Forms (MRAAF) prepared Updated Reports of unreleased checks Timely payment of compensation and other monetary benefits Timely submission of report Billing and Claims Department 3. Maintains records of cash collections, deposits, disbursements and other related transactions 4. Implements the prescribed disbursement systems and procedures based on existing accounting and auditing standards
5. Ensures accuracy and timely preparation of checks/LDDAP- ADA 6. Manages the safekeeping and monitoring of accountable forms 7. Monitors unclaimed checks 8. Pays compensation and other monetary benefits of hospital officials and employees 9. Ensures the submissions of required reports within the required timeline

377 Manual of Standards and Procedures for Hospital Finance Service B.3 Finance Service Self-Assessment Tool SELF-ASSESSMENT TOOL FINANCE SERVICE

Yes / No Yes / No

Submitted within required time Presence (1 pt)

Presence (1 pt) Presence (1 pt)

Document review Document review

Document review Documentation Review (RCD and Deposit Slip)

Daily Report submitted Updated policy

RCD/RCI/RADAI submitted within the prescribed timeline Record of cash collections, deposits and disbursements All collections must be deposited intact within the prescribed timeline Billing and Claims Department 10. Monitors cash balance regularly in coordination with the Accounting Department 11. Maintains and updates procedures on:

a. Processing of Collections and Deposits

b. Processing of Disbursements

Cash Operations Department

Manages all collections, deposits and disbursements
Verifies/Certifies the accuracy of the cash collections/remittances report and regular reports of accountabilities

378 B.3 Finance Service Self-Assessment Tool Manual of Standards and Procedures for Hospital Finance Service

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Yes / No Yes / No Number Yes / No Yes / No Yes / No Yes / No

Document Review Process review Document Review (Report of checks issued and cancelled) Document Review Document Review Document Review Document Review

Daily reports are submitted % of compliance to standard procedure No. of Checks issued but cancelled Monthly Reports of Accountability for Accountable Forms (MRAAF) prepared Updated Reports of unreleased checks Timely payment of compensation and other monetary benefits Timely submission of report Cash Operations Department 3. Maintains records of cash collections, deposits, disbursements and other related transactions 4. Implements the prescribed disbursement systems and procedures based on existing accounting and auditing standards
5. Ensures accuracy and timely preparation of checks/LDDAP- ADA 6. Manages the safekeeping and monitoring of accountable forms 7. Monitors unclaimed checks 8. Pays compensation and other monetary benefits of hospital officials and employees 9. Ensures the submissions of required reports within the required timeline

379 Manual of Standards and Procedures for Hospital Finance Service B.3 Finance Service Self-Assessment Tool SELF-ASSESSMENT TOOL FINANCE SERVICE

Yes / No Yes / No

Yes / No

Submitted within required time Presence (1 pt)

100% (1 pt) Less than 100% (0) Presence (2 pts)

Document review Document review

Document review (Annual Report) Document review

Daily Report submitted Updated policy

% of staff undergone LDI on CQI Documented improvement of process Cash Operations Department 10. Monitors cash balance regularly in coordination with the Accounting Department 11. Maintains and updates procedures on:

a. Processing of Collections and Deposits

b. Processing of Disbursements Continuous Quality improvement (CQI)

Trains staff in the development and implementation of CQI
Implemented CQI for HFS

380 B.3 Finance Service Self-Assessment Tool Manual of Standards and Procedures for Hospital Finance Service

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Yes / No

Yes / No Yes / No Yes / No Rate Rate Rate Rate

Presence (2 pts) 100% (1 pt) Less than 100% (0)

Presence (2 pts) Presence (1 pt) Presence (2 pts) Presence (1 pt) Presence (1 pt) Presence (1 pt) Presence (1 pt)

Document Review Document review

Document Review Document Review Document Review Document Review Document Review Document Review Document Review

Updated Risk Assessment and Plan % of staff trained on Risk Management

Copy of 2 years Audited Financial Statement and analysis Auditors' Report and action taken for any recommendation Cost per patient per day % of Total Treatment cost covered by All available funds in the Malasakit Center % of Total Treatment cost covered by Philhealth % of Total Treatment cost charged to QFS Overhead ratio: Mgmt & General+Funding Expenses over Total Expenses Risk Management

Implements Risk Assessment and Management for all Finance Service Departments
Trains staff on the development and implementation of Risk Management Output
Available Audited Financial Statement
Financial Ratios

381 Manual of Standards and Procedures for Hospital Finance Service B.3 Finance Service Self-Assessment Tool SELF-ASSESSMENT TOOL FINANCE SERVICE

Data on utilization rate Rate:

Number Rate:

80 to 90% utilization by end of the year (2 pts) less than 80% (0) 0-9% (2 pts) More than 9 (0)

3 months and above (2 pts) Less than 3 months (0) Liabilities is less than fifty percent; for baseline

% of Utilization Document review

Document Review Document Review

Budget Utilization rate (Obligation and Disbursement) % of RTH claims No of months of expenses that can be covered with available cash or without new revenue % of liabilities: Total Liabilities over total assets Debt agreement terms Output

Can maintain appropriate liquidity: organizations financial ability to withstand risks and respond to new opportunities.
Ability to manage debt: Debt is a critical financial tool that can help organizations manage the ebbs and flows of cash for operations, facility purchases and upgrades, and more. (For GOCC)

382 B.3 Finance Service Self-Assessment Tool Manual of Standards and Procedures for Hospital Finance Service

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Total Score: __________

Other Findings:

Name and Position of Assessor:

State amount Rate:

Presence (2 pts) 80% and above (1 pt)

Document Review Process review

Amount of allocation for facility Improvements and replacement. Amount of depreciation of fixed assets Rate of Customer Satisfaction

Output 5. Ability to steward facilities: If owning property and equipment is necessary for an organization’s mission delivery, it has a responsibility to maintain and replace these assets over time. 6. Customer Satisfaction

383 Manual of Standards and Procedures for Hospital Finance Service B.3 Finance Service Self-Assessment Tool

SELF-ASSESSMENT TOOL FINANCE SERVICE Interpretation of Scores: Excellence - Congratulations! You are a technical expert that can provide technical assistance to other hospitals. Quality - Congratulations for achieving quality service! Continue improving yourself. Safety - Good effort! But we know that you can do better. Start planning your quality improvement. Probationary- What can we do to help you? Please contact HFDU or HFDB. 90 - 100%
80 - 89% 60 – 79% Below 60 %

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411 APPENDIX C.4 Manual of Standards for Management of Hospital Finance Service

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413 APPENDIX C.5 Manual of Standards for Management of Hospital Finance Service

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Manual of Standards for Management of Hospital Finance Service, 1st Edition

Document Info

Less than 90 days

91-365 days
 Past Due

Over 1 year

Over 2 years

C. Column 2 – Adopt the UACS Code per COA-DBM-DOF Joint Circular No. 2013-1 dated 6 August 2013, JC No. 2014-1 dated 7 November 2014, and JC No. 1 dated 11 August 2017.
D. Columns 3 to 5 shall reflect the approved budgeted revenue of the agency:
Column 3

Approved budgeted revenue for the period.
Column 4

Adjustments representing reductions or modifications/augmentations within the agency approved budgeted revenue. Column 5

Adjusted budgeted revenue. E. Columns 6 to 10 shall reflect the utilizations, broken down by quarter, as recorded in the Registry of Budget Utilization and Disbursements (RBUDs):
Columns 6 to 9

total budget utilized for the quarter ending March, June, September and December. Column 10

F. Columns 11 to 15 shall reflect the actual disbursements made pertaining to utilizations in Columns 6-10, broken down by quarter, as recorded in the RBUDs: Columns 11 to 14

sum of columns 11, 12, 13, and 14 G. Columns 16 to 18 shall reflect the balances of the approved budgeted revenue at the end of the reporting period: Column 16 - balance of approved budgeted revenue unutilized for the period. Columns 16

balance of approved budgeted revenue unutilized for the period. Columns 17-18

NAME GROSS AMOUNT WITHHOLDING TAX NET AMOUNT FOR MDS- GSB USE ONLY P____ P _ P ____

Department/Agency : ____________________________ Petty Cash Fund Custodian : _ Sub-Office/District/Division: ________ Fund Cluster : _ Municipality/City/Province:_ Sheet No. : ________________ PERSONNEL SERVICES (+) (-) (50101020) (50201010) (50203010) (50204010) (50204020) (5020502002) TOTALS

of personnel in the office x 5.02

of personnel in the office x 5.02

of personnel in the office x 5.02 sqm.

of personnel in the office x 5.02 sqm.

of personnel in the office x 5.02 sqm.

of

of

Related Documents

Manual of Standards for Management of Hospital Finance Service, 1st Edition

Document Info

Less than 90 days

91-365 days  Past Due

Over 1 year

Over 2 years

C. Column 2 – Adopt the UACS Code per COA-DBM-DOF Joint Circular No. 2013-1 dated 6 August 2013, JC No. 2014-1 dated 7 November 2014, and JC No. 1 dated 11 August 2017. D. Columns 3 to 5 shall reflect the approved budgeted revenue of the agency: Column 3

Approved budgeted revenue for the period. Column 4

Adjustments representing reductions or modifications/augmentations within the agency approved budgeted revenue. Column 5

Adjusted budgeted revenue. E. Columns 6 to 10 shall reflect the utilizations, broken down by quarter, as recorded in the Registry of Budget Utilization and Disbursements (RBUDs): Columns 6 to 9

total budget utilized for the quarter ending March, June, September and December. Column 10

F. Columns 11 to 15 shall reflect the actual disbursements made pertaining to utilizations in Columns 6-10, broken down by quarter, as recorded in the RBUDs: Columns 11 to 14

sum of columns 11, 12, 13, and 14 G. Columns 16 to 18 shall reflect the balances of the approved budgeted revenue at the end of the reporting period: Column 16 - balance of approved budgeted revenue unutilized for the period. Columns 16

balance of approved budgeted revenue unutilized for the period. Columns 17-18

NAME GROSS AMOUNT WITHHOLDING TAX NET AMOUNT FOR MDS- GSB USE ONLY P______ P _____ P ______

of personnel in the office x 5.02

of personnel in the office x 5.02

of personnel in the office x 5.02 sqm.

of personnel in the office x 5.02 sqm.

of personnel in the office x 5.02 sqm.

of

of

Related Documents

91-365 days
 Past Due

C. Column 2 – Adopt the UACS Code per COA-DBM-DOF Joint Circular No. 2013-1 dated 6 August 2013, JC No. 2014-1 dated 7 November 2014, and JC No. 1 dated 11 August 2017.
D. Columns 3 to 5 shall reflect the approved budgeted revenue of the agency:
Column 3

Approved budgeted revenue for the period.
Column 4

Adjusted budgeted revenue. E. Columns 6 to 10 shall reflect the utilizations, broken down by quarter, as recorded in the Registry of Budget Utilization and Disbursements (RBUDs):
Columns 6 to 9

NAME GROSS AMOUNT WITHHOLDING TAX NET AMOUNT FOR MDS- GSB USE ONLY P____ P _ P ____