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PT Bill/collections

Chapter 20 Medical Assisting

Payment Arrangements Third party payers, Balance billing, Payment Plans, Outstanding balances.
What to manage in the office Accounts payable vs. accounts receivable. Billing and collections are vital tasks, Copays are due immediately.
Commonly accepted forms of payment Cash, check, credit cards, Insurance.
Cash Acceptance Count money carefully, record payment, give pt a receipt for payment.
Check Acceptance Check ID, Check date and amount, Endorse it immediately.
Debit card Acceptance Immediate transfer of funds, processed like a credit transaction.
Credit Card Acceptance Check expiration date, Keep a signed receipt and give pt a copy, check for transaction fee, online payment friendly.
Guarantor Person paying for the bill. Examples include: Parent of a minor child (custodial parent), emancipated minors, self.
elderly Concerns consent in writing such as a living will or poa. Also request proof of guardianship.
Professional Courtesy Waived charges or accept amount that the insurance pays. Must collect co-pays. Usually for other medical professionals and their family members.
What is the difference between accounts payable and accounts receivable? Accounts payable is money that the practice owes for bills. Accounts receivable is money that is owed to the practice for copays and insurance payments.
Preparing Statements Practice contact information, patient name and address, Guarantor's name, balance, itemized list of services and charges, payments received, total balance due.
Standard Billing procedures manual statements, ledger cards, computer generated statements, independent billing services, superbill
Cycle Billing Bills each patient monthly, Staggers billing workload, more even cash flow.
What is cycle billing? Cycle billing is a system in which each patient is billed only once a month but groups of patients are billed every few days. It spreads the work of billing over the month.
Collection of payment is guided by? Laws, Professional standards, and guidelines.
Statue of limitations State time limit that is allowable for collection of payment from a patient or insurance company
Open-book accounting statue of limitations Last payment date or charge for each illness
Written-contract account Payment agreement stipulated and regulated by truth in lending ACT
Single entry account Shorter statue of limitations
Initial telephone calls or letters for collection Friendly and sympathetic, call the patient at home, assume the patient forgot, ask for the full amount (acceptable amount, expected payments dates)
Follow up statements and collection letters 60 days past due- friendly but firm 90 days past due- Stronger wording 120 days past due- Final letter, verify cutoff date on ledger card, send certified letter/return receipt
Preparing an age analysis The process of classifying and reviewing past-due accounts by age from the first date of billing. Use the pt ledger cards and color coded tags to indicate the number of days past due. List all pts' account balances and when the charges originated.
Fair debt collection practices act of 1977 Governs collection of unpaid debts. Guidelines: Do not call before 8 AM or after 9 PM, do not make threats or use profane language, do not discuss pt's debt with anyone else, do not use any form of deception or violence to collect a debt.
Telephone Consumer Protection Act Protects against telemarketing, Prohibits: automated calls to certain numbers, prerecorded calls to homes, unsolicited advertising via fax. Most provisions do not apply to medical practices.
Professional Guidelines AMA Appropriate to assess finance charges or late charges on past-due accounts if the patient is notified in advance. The physician must adhere to federal and state guidelines.
Using outside collection agencies Avoid those that use harsh language or harassing collection practices.
Once the collection agency has the account: No further contact with the patient, Maintain list of files sent for collection, practice decides how to best deal with the account.
Insuring Accounts receivable Protects the practice from lost income (nonpayment, destruction of a/r records) Protects cash flow and ensures that the practice will have funds to cover expected expenses.
What law governs the methods that can be used to collect unpaid debts? The fair debt collection practices act of 1977
Credit Extended by the physician.
Equal Credit Opportunity Act Reasons for not denying credit, must tell patient why credit was denied, preform a credit check.
Credit Checks and creditworthiness Preforming a credit check: verify employment and credit bureau report. (credit worthiness of person seeking credit, payment history) Fair credit reporting act.
Unilateral agreement Physician agrees to patient offer. Not subject to truth in lending act.
Mutual Agreement B/T patient and physician, subject to truth in lending act. (finance charges and more than four payments)
Truth in lending act Consumer Protection act. Credit arrangements of more than four payments. The practice must discuss agreement with patient and sign and retain a disclosure statement.
Disclosure statement Truth in lending statement. Agreement on payment terms: Total amount of debt, down payment and payment amount, final due date, and interest rate and total finance charges.
Hardship cases ECOA- all patients in the same circumstances must be afforded the same consideration. May refer to clinics that provide free or reduced fee services.
Patient relocation and address changes Skips. Telephone or email, ask post office for forwarding address, keep all returned statements and envelopes as proof of reasonable attempts to collect.
What is a "skip"? A patient who moves without leaving a forwarding address to which the office can send a statement of unpaid charges.