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Chapter 8
Collecting Fees
179
Medical
Post-Graduate
02/27/2012
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Term
Another word for Complicated
 Definition
Complexity
Term
Another word for
 Definition
Indigent
Term
Another word for
 Definition
Nominal
Term
Another word for
 Definition
Subsequent
Term
Another word for
 Definition
Verify
Term
What are the factors to consider in determining fees for patient care?
 Definition
Physicians must consider the amount of time spent with patients, the complexity of the diagnosis and treatment, and the cost of maintaining the office and staff.
Term
When insurance companies and government agencies establish a fee profile for physicians, how does it affect payment for patients?
 Definition
When this type of profile is established, it represents the highest payment the insurance company or government will make for services listed.
Term
Explain what you should do if an indigent patient wants an appointment in your facility and your physician cannot accept another indigent patient at this time.
 Definition
explain to the patient that the doctor cannot take any more patients at this time and that you will be glad to refer him/her to another facility. You should give the names addresses, phone numbers, and eligibility requirements of local clinics for medical services to the patient.
Term
List the information that should be obtained on the personal data sheet of ea. patient
 Definition
Patient's full name, DOB, SSN, Marital status, Current address, Phone #s,Name and relationship of person legally responsible for payment, Patient's occupation, name of referring the patient, health insurance info, and driver's license copy
Term
Explain when you should discuss payment planning and health insurance coverage with patients and give examples.
 Definition
The medical assistant should review the patient's health insurance coverage and payment planning treatment, anesthesia, consultants, hospital charges, etc...
Term
What is specified in the Truth in Lending Act
 Definition
this act specifies that when there is an agreement between physician and patient to accept more than four installments, the physician is required to provide disclosure of finance charges.
Term
How are physicians required under the AMA Code of Ethics to allow patients to use credit cards for services?
 Definition
Physicians may not increase their charges for services to patients who wish to use credit cards; they may not encourage patients to use credit cards or use debit cards to solicit patients; credit cards may be used to pay for services, but physicians may not advertise this fact.
Term
Why are credit card payments advantageous if there is a 1 percent to 3 percent assessment charged to the physician?
 Definition
Many physicians feel that this fee is to their advantage because there is little office time used and not delinquent accounts to process
Term
What is the purpose of the Bureau of Medical Economics?
 Definition
To provide credit information and to perform collection services
Term
If a request is received from a credit bureau regarding a patient, what information are you to disclose in your answer?
 Definition
You may say when a patient's account was opened, the current balance, and the largest amount due at any time
Term
Physicians discuss fees with patients
 Definition
F
A designated employee discusses fees with patients
Term
Insurance companies and government agencies establish a fee profile for physicians based on charges averaged over a period of time
 Definition
T
Term
Physicians should never be told when a patient is unhappy with the cost of treatment
 Definition
F
The physician should be informed if a patient complaints about the cost of their treatment
Term
Indigent patients should receive the same care as paying patients
 Definition
T
Term
Two copies of the reduced-fee agreement, with the words "without prejudice" stated, should be witnessed as they are signed for those with limited income
 Definition
T
Term
Each time a patient arrives for an appointment, you should verify his/her personal data sheet information
 Definition
T
Term
The personal data sheet should ask for additional insurance coverage
 Definition
T
Term
It is not necessary for the records release form to have a witness sign it
 Definition
F
The records release form must include a witness's signature
Term
On the third-party liability statement, the name of the patient and the name of the responsible party are always one and the same person
 Definition
F
Third-party liability means that someone other than the patient is responsible for payment
Term
A cost estimate sheet for surgery should include cost of the surgery and the approximate cost of the anesthesia, consultants, and hospital costs
 Definition
T
Term
The truth in Lending Act is enforced by the International Trade Commission
 Definition
F
The Truth in Lending Act is enforced by the Federal Trade Commission
Term
Physicians may increase charges for services to patients who wish to use credit cards for medical services
 Definition
F
Physicians may not increase charges for services to patients who wish to use credit cards for medical expenses
Term
It is not only lawful but good practice to disclose information to referring offices regarding paying habits of patients
 Definition
F
It is a violation of the law to disclose information to referring offices regarding paying habits of patients
Term
The Truth in Lending form must be signed by the patient in your presence
 Definition
T
Term
Who should handle a situation about explaining to a patient that there are charges even for a consultation
 Definition
the billing and collections person
Term
What must a physician do if agree to accept payments in more than 4 installments
 Definition
he must provide disclosure of finance charges
Term
Assisting patients with a plan for payment of costly medical expenses is the responsibility of the

physician
interpreter
ma
pa
 Definition
medical assistant
Term
how long must be (signed) Truth in Lending form be kept on file?

two yrs
six yrs
ten yrs
indefinitely
 Definition
two yrs
Term
Patients should be reminded to check with their __________ for the amount that they are responsible for (co-pay) if their insurance does not pay the total cost
 Definition
insurance company
Term
In large cities it is wise to check ______ before extending credit for a large medical expense
 Definition
medical history
Term
It is a violation of the law if you disclose _________ in requests from creditors regarding patients
 Definition
character of patient
Term
completed annually, this form provides a "signature on file" for your records
 Definition
personal/patient data sheet
Term
fees should be discussed with patients
 Definition
in a private area
Term
at ea. office visit you should ask patients for their insurance card so that you can
 Definition
copy it
Term
if a third-party is responsible for a patient's charges, that person should sign a (n)
 Definition
liability statement
Term
you should obtain a release of info form
 Definition
at the first visit
Term
journalizing
 Definition
entries in the daily log which should be kept in chronological order
Term
trial balance
 Definition
bookkeeping strategy to confirm accuracy in debits and credits ledger
Term
daily log/ journal/ or day sheet
 Definition
sheet containing all patient charges and receipts for ea. day
Term
ledgers
 Definition
the principal account book containing the credits and debits. It includes charges or services rendered, payments, and adjustments
Term
bookkeeper
 Definition
one who records the accounts and transactions of a business
Term
posted
 Definition
info has been transferred from one record to another
Term
assets
 Definition
anything owned that has exchange value
Term
bankrupt
 Definition
legally declared unable to pay debts
Term
petition
 Definition
a written plea in which specific court action is sought
Term
debit
 Definition
a charged added to the existing balance
Term
credit
 Definition
a payment subtracted from the existing balance
Term
accounts receivable (A/R)
 Definition
all of the outstanding accounts
(amount owed)
Term
posting
 Definition
transferring of info from one record to another
Term
adjustment
 Definition
professional courtesy discounts
Term
balance
 Definition
difference between debit and credit
Term
cash payment
 Definition
must be given a receipt
Term
petition
 Definition
formal written application seeking specific judicial action
Term
proprietorship
 Definition
owner-manager of a business
Term
bankruptcy
 Definition
legal petition to the courts if one is unable to pay creditors
Term
bookkeeper
 Definition
one who records transactions/accounts of a business
Term
journalizing
 Definition
to record bookkepping trasactions in a journal
Term
Describe the exceptions to the usual billing procedures.
 Definition
statements may be sent to employer for company physicals; statements may be sent to insurance company for insurance physicals; schools or professional sports teams may pay for athletes' exams; no statements are sent to a patient who has filed for bankruptcy; the estate is billed for a diseased patient; statements for consultations are usually sent to the person or agency requesting consultation.
Term
describe the advantages of a write-it-once bookkeeping system
 Definition
after you set up the board for the day, you have the daily log, charge slip and receipt, and appointment all on one form. When you write on the charge receipt slip, the info is being simultaneously written on the daily log sheet. When you record the services fro the charge slip, it is also written on the ledger card and daily log. The patient is given a statement and receipt for payment along with an appointment if one is needed.
Term
adjustments are ______________ discounts, ___________, or amounts not paid by ______________
 Definition
professional courtesy, write-offs, and insurance
Term
the ma will record the charges for ea. patient on the ____________
 Definition
daily log sheet.
Term
patients are more likely to pay if statements are received on a (n) _____ basis
 Definition
regular
Term
many offices choose to print and process statements through a(n) ________
 Definition
billing service
Term
entries on a daily log are referred to as _____________
 Definition
journalizing
Term
the peg board system is referred to as the _____ system
 Definition
write-it-once
Term
a(n) _____ balance reflects that the amount paid is less than the total due
 Definition
debit
Term
a(n) _____ balance is written in red ink, circled, or noted in parenthesis
 Definition
credit
Term
a patient account shows the

balance due
charges
payments
 Definition
all of these
Term
besides the app schedule, the ______ will reflect the names of all patients seen each day
 Definition
daily log sheet
Term
patients should be ______ from sending cash payments through the mail
 Definition
discouraged
Term
dividing account cards into groups to correspond to the number of times billing is done is called
 Definition
cycle billing
Term
patients who have filed bankruptcy may continue to see the physician, but must pay with
 Definition
cash
Term
in which of the following bookkeeping systems are all necessary forms generated with one posting?
 Definition
peg board
Term
which type of billing system can generate reports that can be used to make the practice more efficient?
 Definition
computerized
Term
which of the following methods of bookkeeping records all increases and decreases in the assets of a practice?
 Definition
single entry
Term
who receives the bill for an insurance physical?
 Definition
the insurance company
Term
which of the following cases should result in no further statements being sent to the patient?
 Definition
bankruptcy
Term
describe the advantages of comnputerized belling
 Definition
the computer will tell the amount due after diagnosis code numbers are fed into it. The printout will give the patient a receipt and a copy of the charges for insurance purposes. you can get a printout summary of accounts receivable, or a breakdown of patients for ea. physician in a group practice, or the amount earned on an individual procedure. It can aid in discovering which accounts are past due
Term
describe different ways to locate an account in a computer system
 Definition
patient account numbers, alpha search (type in first few letters of name and receive an on-screen listing of patient names starting with those letters)
Term
list reasons why billing statements would/should be withheld.
 Definition
accounts for which you do not need or wish to send statements (for example, Welfare patients and Workers' Compensation); families of patients who have recently died
Term
define alpha search
 Definition
the alpha search system involves typing in the first few letters of the name and then finding the name in the listing of patient's names starting with those letters
Term
list the necessary guidelines for placing collection calls
 Definition
obtain permission to do so from your office/business manager or physician

check the laws in your state for appropriate calling hrs

calls should be made from an area of the office where there is no chance to be overhead
Term
prior to making the collection call, you should review what info
 Definition
account to verify if any payments have posted since the collection report

Review any notes on the account

verify that insurance has been billed

decide what you are going to say to the patient before placing the call

attempt to reach the patient at his/her home number first
Term
explain why computerized billing claims can make a practice more efficient
 Definition
the computer can speed up the billing process and filing of insurance claim forms and can also generate needed reports on accounts. It can also generate a daily journal, a monthly summary of charges, payments, and accounts receivable along with many other docs and reports
Term
explain the difference b/t a collection sticker and a collection letter
 Definition
a collection sticker is placed directly on the patient billing statement and a collection letter is a separate doc sent to the patient
Term
define aging of accounts
 Definition
a means of dividing accounts into categories according to the amount of time since the first billing date
Term
how long are accounts ordinarily carried before being referred to a collection agency?
 Definition
ninety days is the usual limit
Term
should accounts automatically be referred to collection after the prescribed period of time? why or why not?
 Definition
no, because the physician must approve first
Term
list the advantages of the use of telephone calls for account collection
 Definition
personal contact may result in more prompt payment

may establish a date when payment will be made
Term
define statute of limitations
 Definition
laws that establish the number of yrs during legal collection procedures may be filed against a patient. The last date of debit or credit on an account is the starting date of the debt. In written contracts the statute starts from the due date
Term
to avoid having to ask patients to sign insurance forms each time they are seen, you can initially have them sign a form and keep it as a "signature on file"
 Definition
t
Term
when the computer system accepts only a number, you must maintain a cross-reference file of an alphabetical listing of patients along with their account numbers.
 Definition
t
Term
for an alpha search, the acc. number is entered in the computer to find the patient's ledger card.
 Definition
F
For an alpha search, the patient's name is entered into the computer
Term
making idle threats can encourage patients to pay their bills
 Definition
f
you must carry through with any statements made in an attempt to collect payments
Term
the process of computer analysis of accounts receivable is known as aging of accounts
 Definition
t
Term
if you make collection calls early in the morning or late at night, you can be held liable for harassment
 Definition
T
Term
you should have a reminder file to help you follow up on promises to pay
 Definition
T
Term
before sending a claim to a third-party, you must have permission from the _______ to do so
 Definition
patient
Term
a(n) ________ should be obtained ea. yr from a patient in order to file claims for them
 Definition
signature-on-file
Term
accounts that are within 30 days of the billing date are considered to be
 Definition
current
Term
never choose words that could______ the patient when composing a collection letter
 Definition
antagonize
Term
collections are best made at the ______ of ______
 Definition
time
service
Term
the challenge with ____ collections is getting the patient to the phone
 Definition
telephone
Term
placing collection calls at the wrong time can result in charges of ________
 Definition
harassment
Term
the practice should make every effort to collect its accounts without resorting to a(n) ____________
 Definition
collection agency
Term
a patient's account history is also referred to as a ______
 Definition
patient ledger
Term
backing up a file disk of all transactions _________ is necessary to keep billing records secure
 Definition
daily
Term
in computer terminology, a record of the info obtained for a patient ledger for every patient is a (n)
 Definition
account history
Term
_____ should be programmed into the computer along with their descriptions and the fees to be charged for each.
 Definition
CPT codes
Term
a computer statement should show the portion of the amount due that is current and

over 30 days
over 60 days
over 90 days
 Definition
all of these
Term
in some intances, you will find that insurance companies and government agencies establish a fee profile for the physician based on __________.

And when such profile is established, it represents the highest payment the ins. company or gov't agency will make for services listed in the profile.
 Definition
charges averaged over a period of time

T
Term
When should a patient complete a personal data sheet?
 Definition
the initial office visit. And verify/update info at each following office visit
Term
The MA can assist patients who are going to have a baby, elective surgery, or extensive therapy by helping them develop a
 Definition
payment plan
Term
an estimate sheet should include
 Definition
anesthetic, consultants, and hospital charges
Term
if the patient does not have the current resources to pay the full amount in one payment, then the MA should
 Definition
offer the option of a fixed amount on specified dates.
Term
The Truth in Lending Act is enforced by
 Definition
Federal Trade Commission
Term
What specifies the following

when there is an agreement between the physician and the patient to accept payments in more than 4 installments, the physician
 Definition
is required to provide disclosure of finance charges. which must be signed in your presence and kept in file for 2 yrs
Term
many physicians feel that the 1% - 3% fee from payment with credit cards are to their advantage. why?
 Definition
because office time is not used for collection of any delinquent accounts
Term
account
 Definition
a record for ea. patient, which will show charges, payments, and balance due
Term
debit balance
 Definition
reflects the amount paid is less than the total due
Term
credit balance
 Definition
reflects the amount paid is greater than was due or the account is being paid in advance of service provided. A credit balance is written is red ink, circled, or noted in parenthesis
Term
adjustment
 Definition
professional courtesy discount, write-offs, or amounts not paid by insurance. If no adjustment column is included, discounts are listed in red in the debit column
Term
if your office uses monthly billing
 Definition
send out bills on the last day of the month
Term
PMS
 Definition
Practive Management System
Term
bookkeeper
 Definition
one who records information
Term
CFO
 Definition
Chief Financial Officer
Term
there is no almost right in bookkeeping
 Definition
T

the work is wither 100% correct, or it is incorrect and must be corrected
Term
the bookkeeper who can independently compute numbers quickly and accurately is considered an
 Definition
asset to any office
Term
billing is the most common use for a computer in the medical office
 Definition
t
Term
CPT
 Definition
Current Procedural Terminology
Term
ICD
 Definition
International Classification of Diseases
Term
making a backup file disk of all transactions daily is
 Definition
necessary to keep billing records secure
Term
YTD
 Definition
Year-to-date
Term
DOS
 Definition
Date(s) of service(s)
Term
antagonizing words
 Definition
neglected, ignored, failure

Better words are: missed, overlooked, and forgotten
Term
skip
 Definition
someone that has moved to avoid payment of medical bills.
Term
statute of limitations
 Definition
establish the number of yrs during which legal collection procedures may be filed against a patient
Term
which one item is notpart of an office visit data sheet update?
 Definition
SSN
Term
an acc. receivable record should be kept weekly
 Definition
F
Term
you can tell a patient you are sending their bill to collections, hoping they will pay their bill but not really send them to collections
 Definition
f
Term
how long must disclosure statements be kept
 Definition
2 yrs
Term
when composing collection letters, what words should be avoided?
 Definition
neglected, ignored, failure
Term
the pegboard system is referred to as the "write it once system
 Definition
t
Term
if a patient conveys dissatisfaction with the result of medical care, be sure to note it in their chart
 Definition
f
Term
acc. are considered current if paid within 60 days of a billing date
 Definition
f
Term
you should only use a new log sheet when the page is completely full
 Definition
f
Term
you office should display payment methods acceptable to your practice
 Definition
t
Term
all charges encountered by a patient are ultimately their responsibility
 Definition
t
Term
a medical office should make sure a patient understands that the anticipated charges on an estimate form is just that, an estimate
 Definition
t
Term
a bookkeeper will always use blue ink pen when doing the acc books
 Definition
f
black ink pen
Term
what is the average minimum monthly payment accepted by a med. practice when a patient is making monthly payments
 Definition
10%
Term
an asset is anything that has value that is owned by the business
 Definition
t
Term
to keep billing records secure, it is necessary to make a back up file disk daily
 Definition
t
Term
a debit is a payment substracted from an existing balance
 Definition
f
Term
All outside vendors should sign a Business Associates Agreement so they understand the office expectations to privacy
 Definition
t
Term
after face to face contact, what is the next best opportunity to collecting fees
 Definition
telephone
Term
the easiest and fastes method of looking for a particular patient on the computer is called an alpha search
 Definition
t
Term
when using monthly billing, send bills out on the last day of the month
 Definition
t
Term
credit card monies are generally available to the physician within 48 hrs of deposing
 Definition
f
Term
the best collection opportunity is when the patient is in the office
 Definition
t
Term
the entries on the daily log should be kept in what kind of order
 Definition
chronological
Term
to collect a bill of a deceased patient, the statement should be addressed and sent to the next of kin
 Definition
f,
Term
when attempting to reach a patient who owes the office money, what phone number would you try first
 Definition
Home
Term
it is illegal to ask a patient for their driver's license number
 Definition
f
Term
what is the most common use for a computer in the medical office
 Definition
billing
Term
many insurance policies require _______ before certain procedures or before a visit can be made to a specialist or even a physical therapiest
 Definition
preauthorization
Term
Medicare part B covers inpatient hospital expenses, home health care, and hospice care
 Definition
f
Term
______ is medical insurance for dependents of active duty military personnel, retires military personnel, dependents or retired military personnel, and dependents of personnel who died while on active duty
 Definition
TRICARE
Term
which is considered features of a traditional ins. plan
 Definition
covers illness or injury only
Term
nonverbal communication is often referred as
 Definition
body language
Term
which is considered an appropriate distance for personal space in the US
 Definition
1 1/2 - 4 ft
Term
a third party is one that is not invoved in the patient-provider relatioonship but rather with _____ procedures
 Definition
Reimbursement
Term
an authorization exception is allowed by the federal government when the patient is being admitted to a hospital
 Definition
t
Term
the abbreviation SOF is often seen on the CMS-1500 and stands for Symptoms on File
 Definition
f. Sig. on file
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