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Ch.13 business prac.
Chapter 13 bankruptcy, federal ACTS, collections, medicare
| Question | Answer |
|---|---|
| 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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