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CRCS Chapter 5
AAHAM CRCS CERTIFICATION Chapter 5
| Question | Answer |
|---|---|
| What is Charity Care? | Serice provided that is never expected to result in cash flow. |
| What is Indigent? | An individual who has no means of paying for medical services or treatments and is not eligible for benefits under Medicaid or any other public assistance program. |
| What is Bad Debt? | An uncollectible account resulting form the extension of credit. |
| Define Statute of limitations | the amount of time in which a claim must be collected before it is deemed paid or satisfied. |
| Can legal proceedings be initiated after the statute of limitations is expire? | No |
| Do statute of limitations vary from state to state? | Yes |
| What are the usual periods for statues of limitations? | Less for open-end accounts or oral agreements, greater for notes or written agreements, greatest for judgments |
| When can a statue of limitation be extended? | Obtaining a written promise to pay, obtaining a partial payment on the principal account, reducing the account to judgment immediately, executing a new contract. |
| What should a written effective collection policy include? | Admission policy, minimum acceptable payments, follow-up policy, public relations policy, charity care protocols, discount policy, practice of charging interest, contract amount implications, age when they count is considered for bad debt, determination/verification of responsible party, process for handling errors and complaints |
| What are some common self-pay options? | Cash your check, credit cards, health savings accounts, Credit Union funds, cash from sales of assets, loan programs, money transfers, money orders. |
| What are some advantages of accepting credit card payments? | Immediate payment, payments met sooner, method to accept payments over the phone, ability to get prior authorization to charge a balance after insurance payment |
| What are some disadvantages of credit card payments? | Additional costs due to discount rate or credit card processing fees, potentially more paperwork, potential public relation problem, additional work to follow payment card industry regulations. |
| Why would a provider offer extended payment plans? | In order to boost cash flow and reduce bad debt |
| What are some options for extended payment plans? | 3 months, same as cash, periodic payments without finance charges, periodic payments with finance charges, lower payments now with higher payments or Bloom payment later. |
| What is personal bankruptcy? | A legal proceeding taken when the debts of an individual or company far exceeds the assets, and there is presumptionally no reasonable hope of repayment. |
| Who handles bankruptcies? | The u.s.courtsystem within the state of residence. |
| What are the five types of bankruptcies? | Chapter 7, chapter 11, involuntary bankruptcy, chapter 12, chapter 13 |
| What is chapter 7 bankruptcy? | Applies to individuals and businesses that cannot pay their debts based on their income. Except for exempt property. The debtor's assets are auctioned to satisfy creditors claims. About 70% of all bankruptcies are filed under chapter 7 |
| What is chapter 11 bankruptcy? | Gives a distressed business, a reprieve from credit or claims while continues to functions and work out a repayment plan; a bankruptcy judge oversees all important decisions. |
| What are chapter 11 bankruptcies frequently referred to? | Reorganization bankruptcy |
| How many months does A business under chapter 11 have to work out A reorganization plan? | 3 months |
| How do most chapter 11 cases end up? | Chapter 7 liquidation cases |
| What is involuntary bankruptcy? | A debtor can be placed in involuntary bankruptcy under chapter 7 or 11 if the debtor has 12 or more creditors, three of which have claims over $5,000 each and are willing to force the issue. If fewer than 12 creditors, only one creditor needs to have at least $10,775 |
| What is chapter 12 bankruptcy? | This type is for Farmers only and provides that only family farmer with regular annual income May file a petition for relief. |
| What is a chapter 13 bankruptcy? | This is for individuals with regular income who desire to pay their debts but currently aren't able to do so. It enables financially distressed individuals under Court supervision and protection to propose and carry out a repayment plan under which creditors are paid over an extended period of time. |
| How long does a debtor have to pay a chapter 13 bankruptcy? | 3 years however maybe extended to 5 years if approved by the court. |
| What are the potential outcomes of bankruptcy? | Discharge of debtor or dismissal? |
| What is discharge of debtor? | It releases the guarantor/patient from financial responsibility of any and all account balances listed on the bankruptcy petition. |
| What is dismissal of bankruptcy? | Is a court order whereby the bankruptcy is rejected by the courts. This means that the creditors May pursue the debt. |
| What must a creditor do upon notification of a chapter 7 bankruptcy? | Flag the patient account, suspend all collection activity, cease contact with the patient demanding payment, notify any third-party collection agencies, forward a copy to any collection agencies, notify all parties if a payment is received on the account. |
| What are some basic principles to determine the responsible party? | The responsible party is the adult patient themselves, some states spouses are responsible for each other's debts incurred during marriage, even if the marriage ends or the spouse dies, if a patient is minor, both parents are responsible. |
| Does lack of authorization in a life-threatening emergency relieve a responsible party of financial obligation for services rendered? | No |
| Are children and relatives legally responsible for the debts of a deceased person? | No |
| Who is responsible for a deceased person 's debts? | The deceased person's estate |
| What are the steps to take when notified that a patient is deceased? | Check if they an estate exist and file paperwork, check the registry of wills for an estate, change the mailing address to quotes the estate of _______", if no estate and no party assumes financial responsibility right off any self-paid balance remaining after insurance paid. |
| What is a courtesy discharge? | When the patient is allowed to leave the hospital without going through the usual discharge formalities. The patient is billed at a later date. |
| What are some advantages of courtesy discharge? | Improves patient hospital relations, improves traffic flow, reduces need for additional staff at peak. Discharge times, allows for greater accuracy in billing. |
| What are some common stall tactics and delays by third party payers? | Bill never received, cob or MSP problems, medical records needed, incorrect information provided by insured, authorization. Not complete or on file, referral form not available or on file, timely filing issues, unprocessable claims, Pre-Existing conditions, preserk needs, coding issues, stop loss issues, invalid WC information. |
| What are two debt collection methods? | In-House collection and Collection Agencies |
| What is a key, vital element in the best practices for in-house collecions? | document, document, document. |
| What are some ways to work accounts with internal resources? | Higher balance first, by payer, aging, denial reason, use work lists, call, be aggressive and determined, have all info handy when calling, involve the pt, involve the state ins commissioner, appeal, bill electronically, use denial tracking tools. |
| What is the primary objective of making collection calls? | To receive payment in full for outstanding account balances. |
| What steps to consider when making collection call? | Review account first for pmts, adj, etc, determine previous work done, rev pmt history, know who to speak to, determine min pmt, prepare all ?'s, prepare opening statement, remain in control of the call. |
| What is the success of a collection call measured by? | By the outcome/agreement for payment in full |
| What is the "Mini Miranda" | A statement that the collectors say when contacting a debtor. "This is an attempt to collect a debt and any information obtained will be used for that purpose." |
| If a third-party debt collector does not provide the debtor with the mini Miranda disclosure, what is it a violation of? | the Fair Debt Collection Practices Act |
| When can an account be sent to a third party collection agency? | Any time there is a valid and documented service. |
| Does a statement need to be sent to the debtor notifying the patient/guarantor of the intent to forward the account to a collection agency? | No |
| What are three types of collection lawsuits? | Judgement, Lien, Tort Liability |
| What is a Judgement? | A legally verified claim against a debtor validated by the court; a legal right to collect a debt that can be used to obtain a lien. |
| What is a Lien? | A recorded claim against real or personal property, generally arising out of a debt; if the property is sold by the debtor, the creditor (the provider) must be paid out of the proceeds of that sale. |
| What is Tort Liability? | a liability for an injury or wrongdoing by one person to another resulting from a breach of legal duty. |
| What is a "skip"? | A debtor who cannot be located by a creditor. |
| What are the three types of skips? | Intentional, Unintentional, False |
| What is an intentional skip? | Refers to someone who avoids paying bills by changing his or her residency and failing to leave a forwarding address, purposely changing his or her name, or intentionally giving false information. |
| What is an unintentional skip? | Refers to someone who moves or changes residence and fails to notify creditors. However, a forwarding address is normally available. |
| What is a false skip? | Generally caused by clerical error at the time of registration. The cause could be because of a transposed number, incorrect zip code, or incomplete info. |
| What are some resources available to trace skips? | Patient accounting system, Post Office, Internet sites, Credit reports, Employers, Previous employers, neighbors, and relatives. |
| What does GAAP stand for? | Generally Accepted Accounting Principles |
| What is GAAP? | Common set of accounting principles, standards, adn procedures that companies must follow when they compile their financial statements. |
| What GAAP standards apply to the cashier functions? | -Endorse checks immediately with "For Deposit Only" -issue receipts on all cash pmts -make deposit daily -separate petty cash from cash box -store pmts in fireproof safe -maintain a duplicate-number receipt log -designated, locked cash drawer -payment log -segregate duties -do not share passwords |
| What is Average Daily Revenue? | The average amount of revenue or charges generated each day over a specified period of time. |
| What is formula for Average Daily Revenue? | Total Revenue or Charges for the Period / Number of Days = Average Daily Revenue |
| What is Average Days of Revenue in Accounts Receivable (ADRR) | Also known as Accounts Receivable Days Outstanding, an estimate, using average current rev, of the days required to turn over the AR under normal operating conditions. Simple terms: estimate of the time needed to collect the accounts receivable. |
| What is the formula for ADRR? | Accounts Receivable at Specific Time / Average Daily Revenue = ADRR |
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