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Ch.13 business prac.

Chapter 13 bankruptcy, federal ACTS, collections, medicare

Credit To believe or to trust
Trust one ones integrity and ability to meet financial obligations Credit
Red flag rule Use 2 pt identifiers
Quantum me rite As much as he deserves
Concierge fees Retainer medicine- charge on annual fee for service
Medicare fees Non participating, participating, limited
Participating Amount paid to the physician who has contracts
Non-participating Amount paid to phyicisians who do not have contracts
Limiting Highest amt a non participating physician can charge a Medicare pt
Charges Fees for professional services rendered
Hill-Burton Act 1946, establish hospitals in communities throughout the U.S.; federal governments first contribution to health care system; mainly AIDS patients
Fee for service Set dollar amount for professional services; increases collections and decreases number of billing statements sent
DEADBEAT Skips out on paying bills
Cycle billing Portions of A/R are billed certain times of the month;continuous cash flow, and relieves pressure of sending out statements
Individual responsibility Program Physicians accepted all pt's but refuse to accept reimbursement from third party, private or government programs
Debit card/check card Used to withdrawal cash- offline and online
Credits card Used in speciality practices, entail major expenditures
Billing services Ensures prompt and concise billing, pt questions about charges are limited because it is broken down; the service answers questions about charges
Fair Debtt Collection Practices Act Rules for the rights of debtors
Equal Credit Opportunity Act 1975 Physician extends credit to one pt, same financial arrangement must be offered can to all pt's
Federal Truth In Lending Act 1960 Governs anyone who charges interest or agrees to more than four payments (fill out regulation Z form)
Truth in lending consumer credit cost disclosure Requires that providers disclose all costs including interest, late charges and so on prior to the time of service; interest is charged on a monthly bill
Fair credit billing act
Fair credit reporting act 1971, amended 1996 Consumer reporting agency's gather in a simple information on private individuals to evaluate and determine credit standing and credit capacity of consumers
Collections Statute of limitations very state to state next time which legal collection on a delinquent account maybe rendered
Collections NY 2 years
A good collection rate for our agency is approximately 30-60%
Open account Open book record of business transactions, represents an unsecured account receivable were credit has been extended w/oformal written contract
Written contract account Agreement a patient signs to pay the bill and more than four installments under the truth in lending provisions
Single entry account Account with only one charge listed and generally for a small amount
DUN Remind a patient with a delinquent account about payment
Fee splitting And illegal practice between physicians usually gatekeeper and specialty where physician office to pay another one for the referral of patients
The revenue cycle Includes the life of the patient account from creation to collection action
The accounts receivable is The total amount of money owed to the medical practice
Fee schedules Some practices may have more than one fee schedule, the doctor may charge for something that is not on the fee schedule
Physicians giving cash discounts Must offer a cash discounts to all patients
Certain hospitals receive federal construction grants to larger facilities to exchange for caring for indention patients falls under the Hill Burton Act
The most important collection practice to increase collections, improve public relations, and reduce patient complaints turn over accounts receivable and write off amount is Stating fee-for-service and collecting fees at the time services are given
What is the name of the credit law that states collectors must identify themselves and the medical practice they represent must not mislead the pt FDCPA
Allows billing at certain times of the month based on alphabetical breakdown, account number insurance type or data first service; continuous cash flow Cycle billing
If a physician denies credit to a patient according to the ECOA, how many days does the patient have to request the reason in writing 60
Regulation Z of the FTLA applies to Patient to agree to pay and more than four installments
Breaking down accounts into links of time that money is owed is called Aging accounts
Collections The longer an account remains delinquent the harder it will be to collect
Garnishment is Limited to 25% of disposable earnings in any work week
After a judgment is made in favor of the medical practice in small claims court The physician still has to pursue the money
Skip A debtor who moves and does not leave a forwarding address
Capitation Method used by managed-care plans which pays a fixed per capita amount every month for each patient and rolled
Medicare fee schedule Resource-based relative value system
How often should patient information form be updated Regularly, every visit
Participating physicians receive what percentage of the allowable feed paid by Medicare 20%
If a patient signs an assignment of benefits statement where is the insurance payment sent Physician
Historically healthcare providers have been paid on a fee-for-service model rewards number patient seen testing performed and hospital missions this is referred to as Value-based medicine
New payment model emerging which is centered around providing minimum number of services necessary to improve the patient's condition is called Value based reimbursement
Every patient coming to the Medical office should've heard about the practices financial policy how many times at the very least Three
A document from the insurance company that arise with a check for payment of an insurance claim is called an Explanation of benefits form
And itemized billing statement is usually Every 30 days
If credit is refuse to a patient, what federal legislation must be complied with Federal credit reporting act
If interest is charged on a monthly billing statement what law requires the disclosure of these cost before the time of service Truth in lending consumer credit cost disclosure
Which law states the requirements and limitations for the patient and the medical practice when a complaint as registered about a billing statement error Fair credit billing act
If a patient has called about a delinquent bill at 10 PM what federal laws being violated Fair debt collection practices act
And a Medicare program the document that arrives with a check for payment of an insurance claim is called a Medicare remittance advice
And a Medicare program you'll be sent to Patience is called a Medicare summary notice
He's just remember waited value, unit value of each procedure code Relative value scale
When is a managed care co- payment usually collected At time of service
Two types of bankruptcy in medical practice Ch 7 & 13
Chapter 7 Straight petition
Chapter 13 Wage earners
Created by: Gmtassa23
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