Term | Definition |
posting | accounting term used to represent the act of recording transactions |
PMS software | Practice Management System.
-Electronic computer systems used to manage patients' accounts.
-every PMS provides similar functions but are usually set up slightly differently. |
Accounts Receivable | AR, refers to amounts owed by patients and their third party payers (insurance) |
AR increases | each time a service is provided or bill is issued |
AR decreases | each time a payment is received |
adjustment | -original charge minus approved or allowed amount
-positive or negative change to a patient's account balance that does not involve the exchange of money.
-Usually a credit, write-off, discount, or insurance contractual allowance |
employees must have 2 things in PMS | 1. user name
2. password |
manual bookkeeping system | -pegboard system
-write-it-once system |
numbered receipt | should be generated for each patient payment received |
Explanation of Benefits | -EOB
-paper form explaining insurance payment info
-can be mailed in bulk |
Electronic Remittance Advice | -ERA
-electronic EOB form explaining insurance payment info |
allowed / approved amount | -amount insurance is willing to pay
-if provider is participating, they must accept this amount |
copay | -should be collected by the provider at the time of service
-is a set $ amount from the insurance company |
co-insurance | -set % from the insurance company |
balance billing patients | -billing the patient for the amount left over after the insurance company has paid bill
-provider cannot bill patients for this amount if they are PAR w/ insurance (illegal) |
cycle billing | -25% of bills are sent out each week
-allows for even cash flow distribution throughout the month. |
telephone collections | -only talk with person legally responsible for payment
-don't leave message w amount owed
-obtain a firm commitment to pay with date and amount
-Only call Mon-Sat from 8a-9p.
-No Sundays or holidays |