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MED112 CODE/BILL
MED112 CH 14 PATIENT BILLING AND COLLECTIONS SB
| Question | Answer |
|---|---|
| MED112 CH 14 | |
| Sound financial policies and procedures that clearly explain the patient's responsibility for payment aid the issue of which of the following? (MAY BE MORE THAN ONE) A. Sending patient statements B. Withholding patient statements C. Following up on patient payments D. Denial of claims E. Poor relationships with physicians | A. Sending patient statements C. Following up on patient payments |
| Financial policies address which of the following issues? (MAY BE MORE THAN ONE) A. Financial arrangements B. Patient's medical conditions C. Payments not covered by insurance D. Payment plans E. Treatment plans | A. Financial arrangements C. Payments not covered by insurance D. Payment plans |
| Which of the following are payment procedures completed by patients? (MAY BE MORE THAN ONE) A. Medication history forms B. Preauthorized credit card forms C. Forms to arrange payments for professional services rendered D. Patient's personal budget spreadsheet | B. Preauthorized credit card forms C. Forms to arrange payments for professional services rendered |
| After an encounter, the transactions for the visit charges and payments are entered in the ________. A. Patient's ledger B. Master planner C. Insurance carrier's website D. Patient chart | A. Patient's ledger |
| What type of billing divides patients with current balances into groups to equalize monthly statement printing and mailing? A. AR billing B. Guarantor billing C. Cycle billing D. Cash-flow billing | C. Cycle billing |
| Effective patient billing begins with which of the following? (MAY BE MORE THAN ONE) A. Physician treatment plans B. Clear explanations of patient payment responsibilities C. Developing a good rapport with pharmacy staff D. Sound financial policies | B. Clear explanations of patient payment responsibilities D. Sound financial policies |
| Collection activities should achieve a balance between which of the following goals? (MAY BE MORE THAN ONE) A. Getting more business B. Reducing cash flow C. Generating cash flow D. Maintaining patient satisfaction | C. Generating cash flow D. Maintaining patient satisfaction |
| Which of the following apply to the importance of an effective financial policy? (MAY BE MORE THAN ONE) A. Practices must clearly explain their financial policies so that administrative staff members know what is expected of patients. B. A financial policy should not be disclosed to staff members or patients. C. A good financial policy is one that both staff members and patients can follow. D. Practices must clearly explain their financial policies so that patients understand their obligations. | A. Practices must clearly explain their financial policies so that administrative staff members know what is expected of patients. C. A good financial policy is one that both staff members and patients can follow. D. Practices must clearly explain their financial policies so that patients understand their obligations. |
| Why would patients complete preauthorized credit card forms? A. For payment purposes B. To authorize disclosure of information C. For scheduling of patient procedures D. To have funds debited from a savings account | A. For payment purposes |
| Large practices may have separate collections departments with which of the following job functions? (MAY BE MORE THAN ONE) A. Patient account representative (bookkeeper) B. X-ray technician representative C. Collection specialist D. Billing/collections manager | A. Patient account representative (bookkeeper) C. Collection specialist D. Billing/collections manager |
| Which of the following are signs that money is overdue? (MAY BE MORE THAN ONE) A. The amount the patient owes for each reported procedure is calculated. B. A charge that has been written off is not entered on the patient's ledger. C. The payer's payment for each reported procedure is entered. D. If any part of a charge has not been paid within 90 weeks. | A. The amount the patient owes for each reported procedure is calculated. C. The payer's payment for each reported procedure is entered. |
| A common organizing principle when finances are involved is to divide tasks among several people with different responsibilities to reduce the chances of A. Boredom B. Losing employees C. Overworking employees D. Embezzlement | D. Embezzlement |
| Which of the following apply to the purpose of cycle billing? (MAY BE MORE THAN ONE) A. Cycle billing is only used at the end of each month. B. It is used to assign patient accounts to a specific time of the month. C. Cycle billing is only used at the beginning of each month. D. It is used to standardize the times when statements will be mailed and payments will be due. | B. It is used to assign patient accounts to a specific time of the month. D. It is used to standardize the times when statements will be mailed and payments will be due. |
| Collections from patients or businesses as consumer collections are regulated by which of the following? (MAY BE MORE THAN ONE) A. Local regulations B. Consumer groups C. State laws D. Federal laws | C. State laws D. Federal laws |
| The term ________ refers to all the activities that are related to patient accounts and follow-up. A. Cycle billing B. Generating C. Collections D. Statements monitoring | C. Collections |
| Which of the following apply to the patient aging report? (MAY BE MORE THAN ONE) A. The patient aging report includes the patient's name, the most recent payment, and the remaining balance. B. The report is for internal use only. C. Aging begins on the date of the bill. D. The patient aging report includes the diagnosis. | A. The patient aging report includes the patient's name, the most recent payment, and the remaining balance. C. Aging begins on the date of the bill. |
| What are typically the first notices to patients that their bills are past due? A. Income withholding B. Accounts being sent to collection agencies C. Collection letters D. Repossession of property | C. Collection letters |
| Which of the following may be true in regard to staff assignments and collections in a medical office? (MAY BE MORE THAN ONE) A. Collection duties are never assigned to coders or billers. B. Small offices may assign collection duties to coders or billers. C. Staff assignments don't vary between practices. D. Staff assignments vary between practices. | B. Small offices may assign collection duties to coders or billers. D. Staff assignments vary between practices. |
| After a collection specialist has completed a phone call, the conversation is ________. A. Documented B. Repeated C. Explained D. Recorded | A. Documented |
| Most practices have at least two or more people involved in which of the following areas of collections? (MAY BE MORE THAN ONE) A. Closing out the day's financial records B. Opening mail and posting payments C. Calling patients for collections D. Meeting with patients for collections | A. Closing out the day's financial records B. Opening mail and posting payments |
| A plan that lets patients pay bills over time rather than in a single payment is called a(n) ________ plan. A. Interest B. Extension C. Payment D. Credit | C. Payment |
| Which of the following guidelines apply to collection under the Fair Debt Collection Practices Act of 1977? (MAY BE MORE THAN ONE) A. Voicemails can be left only if the patient does not answer. B. Contact patients once daily only. C. Do not threaten the patient or use profane language. D. If the patient requests calls be sent to an attorney, the collections can call both the patient and the attorney. E. Do not call a patient before 8 a.m. or after 9 p.m. | B. Contact patients once daily only. C. Do not threaten the patient or use profane language. E. Do not call a patient before 8 a.m. or after 9 p.m. |
| Which of the following types of reports determine which patients are overdue on their bills and group them into categories for efficient collection efforts? A. Patient collections reports B. Collection reports C. Patient aging reports D. Insurance aging reports | C. Patient aging reports |
| Which act prohibits discrimination on the basis of race, color, religion, national origin, sex, marital status, age, or receipt of public assistance? A. Equal Credit Opportunity Act (ECOA) B. Equal Employment Opportunity Act C. Equal Opportunity Act D. Fair Credit and Lending Act | A. Equal Credit Opportunity Act (ECOA) |
| Which of the following apply to collection letters? (MAY BE MORE THAN ONE) A. Aggressive letters are never sent to a patient. B. Accounts that are further past due will receive more aggressive letters. C. Generally professional, courteous, brief, and to the point. D. Review the patient of the practice's payment options and the patient's responsibilities. | B. Accounts that are further past due will receive more aggressive letters. C. Generally professional, courteous, brief, and to the point. D. Review the patient of the practice's payment options and the patient's responsibilities. |
| When reviewing documentation done by a collection specialist, the abbreviation LM means ________. A. Latest notification B. Lowest method C. Left message D. Lost money | C. Left message |
| Patients must sign off on the terms of a ________ form that the collections specialist negotiates. A. Truth-in-lending B. Consumer credit C. Negotiated credit D. Collections | A. Truth-in-lending |
| Practices sometimes ________ on payment plans. A. Charge additional services B. Charge interest C. Issue credits D. Involve lawyers | B. Charge interest |
| Which of the following apply to credit counseling? (MAY BE MORE THAN ONE) A. Patients make one monthly payment to the service. B. Collect information on income and unpaid bills. C. Contact creditors to work out payment plans at reduced costs. D. Credit counseling is a free service. | A. Patients make one monthly payment to the service. B. Collect information on income and unpaid bills. C. Contact creditors to work out payment plans at reduced costs. |
| Which of the following are examples of a schedule for a payment plan? (MAY BE MORE THAN ONE) A. $50-$500 balance due: $50 minimum monthly payment B. $500 balance due: Entire balance due the next month C. Patient seeks payment plan following visit D. $500-$1,000 balance due: $100 minimum monthly payment | A. $50-$500 balance due: $50 minimum monthly payment B. $500 balance due: Entire balance due the next month D. $500-$1,000 balance due: $100 minimum monthly payment |
| The ECOA mandates that a patient be notified as to which of the following factors if they are denied credit? (MAY BE MORE THAN ONE) A. Income B. Expenses C. Debts D. Marital history E. Credit history F. Health history | A. Income B. Expenses C. Debts E. Credit history |
| Which of the following are steps in setting up a prepayment plan? (MAY BE MORE THAN ONE) A. The patient makes arrangements for possible postoperative monthly payments. B. The insurance carrier is contacted for an estimate of the patient's financial responsibility. C. The patient pays the entire cost of the procedure after the procedure is done. D. The patient makes a down payment. | A. The patient makes arrangements for possible postoperative monthly payments. B. The insurance carrier is contacted for an estimate of the patient's financial responsibility. D. The patient makes a down payment. |
| Which guideline must a collection agency follow? A. FCA B. FDCA C. FDCPA D. FOIA | C. FDCPA |
| The Truth in Lending Act governs which of the following? (MAY BE MORE THAN ONE) A. When a collection call is made B. If payments are scheduled for more than four installments C. When any amount is billed to the patient D. When a practice applies finance charges or late fees | B. If payments are scheduled for more than four installments D. When a practice applies finance charges or late fees |
| When a practice attempts to collect money owed by a debtor more than it is owed, it hires a ________. A. Billing specialist B. Collection agency C. Billing agency D. Billing manager | B. Collection agency |
| Consumer credit counseling services and debt management programs are nonprofit organizations that do which of the following? (MAY BE MORE THAN ONE) A. Wipe debt away for patients B. Assist patients who have a great number of different bills C. Assist patients who are struggling to pay their bills D. Assist patients who are slightly behind on a payment | B. Assist patients who have a great number of different bills C. Assist patients who are struggling to pay their bills |
| Practices generally prefer to use collection agencies that specialize in handling ________. A. Government accounts B. Small client volumes C. Large client volumes D. Medical office accounts | D. Medical office accounts |
| Practices have guidelines on payment plans for which of the following? (MAY BE MORE THAN ONE) A. Credit worthiness B. Age determinations C. Minimum payment amounts D. Health history E. Appropriate time frames | C. Minimum payment amounts E. Appropriate time frames |
| Under a national 2015 agreement by the major credit reporting agencies, which of the following statements are correct? (MAY BE MORE THAN ONE) A. The 2015 agreement was designed to protect primarily the creditors. B. The 2015 agreement is designed to provide an increase in protection for consumers. C. There is a six-month waiting period before medical debts will be reported on consumer credit reports. D. Credit agencies will remove medical debts from an individual's report after the debt is paid. | B. The 2015 agreement is designed to provide an increase in protection for consumers. C. There is a six-month waiting period before medical debts will be reported on consumer credit reports. D. Credit agencies will remove medical debts from an individual's report after the debt is paid. |
| When patients schedule to have major, expensive procedures, the practice policy may be to set up a ________ plan. A. Credit counseling B. Postpayment C. Satisfaction D. Prepayment | D. Prepayment |
| When standard attempts to contact a patient are unsuccessful, it may become necessary to ________ the debtor. A. Release B. Mortgage C. Skip trace D. Lien | C. Skip trace |
| When internal office collections are not always successful, the practice may use a ________. A. Debt agent B. Automated collection service C. Collection agency D. Billing service | C. Collection agency |
| Which of the following apply to collection payment posting? (MAY BE MORE THAN ONE) A. Money is collected according to the terms of the business associate (BA) contract. B. The agency receives a statement showing which patient accounts have been paid. C. The payments collected by the collection agency are made up of amounts collected from various patients with various account ages. D. The agency sends a lump-sum amount for the practice to apply as it decides. | A. Money is collected according to the terms of the business associate (BA) contract. B. The agency receives a statement showing which patient accounts have been paid. C. The payments collected by the collection agency are made up of amounts collected from various patients with various account ages. |
| Which of the following reasons could force the practice to send a patient to a collection agency early? (MAY BE MORE THAN ONE) A. The patient does not tell the patient moves or provides no previous address. B. Patient states they will not pay. C. The patient is employed with a payment plan. D. Patient checks are returned for lack of funds with no attempt to resolve. E. Contact information for debtor is outdated, and attempts to locate patient have failed. | B. Patient states they will not pay. D. Patient checks are returned for lack of funds with no attempt to resolve. E. Contact information for debtor is outdated, and attempts to locate patient have failed. |
| Identify all of the correct statements related to collection accounts. (MAY BE MORE THAN ONE) A. Patients do not expect to be able to cancel. B. Accounts with unpaid balances. C. Accounts that are not worth the time and cost to pursue. D. Accounts are put into a collection cycle of contacts. E. Nearly everybody can pay their bills if given enough time. | B. Accounts with unpaid balances. D. Accounts are put into a collection cycle of contacts. |
| Which of the following would a practice review or consider when deciding on a collection agency? (MAY BE MORE THAN ONE) A. Some agencies only use letters and do not pursue further follow-up. B. Good collection agencies can clearly explain their procedures. C. Practices are required to use only a handful of collection agencies. D. The practice can see if the agency actively pursues payment. | A. Some agencies only use letters and do not pursue further follow-up. B. Good collection agencies can clearly explain their procedures. D. The practice can see if the agency actively pursues payment. |
| The most common reason an account becomes uncollectible is that a patient ________. A. Changes physicians B. Moves C. Cannot pay the bill D. Is unsatisfied with service | C. Cannot pay the bill |
| One of the advantages of using a collection agency is its ability to use ________ as a collection tool. A. Credit reporting B. Managers C. Telemarketers D. Threatening letters | A. Credit reporting |
| Which of the following describe a dismissal letter sent to a client by the physician? (MAY BE MORE THAN ONE) A. Offers to continue care for a specified period of time B. Provides contact information for recommended referrals C. States the patient has disappointed the physician by not paying medical bills D. Does not state a specific reason for the dismissal and must be tactful | A. Offers to continue care for a specified period of time B. Provides contact information for recommended referrals D. Does not state a specific reason for the dismissal and must be tactful |
| If a practice is still treating a patient, an overpayment may be ________. A. Converted to free services B. Offered for future service C. Overlooked D. Applied as a credit | D. Applied as a credit |
| Which of the following apply to the posting and processing of payments? (MAY BE MORE THAN ONE) A. Each patient account is located, and the payment is posted to the correct charge. B. The PMP subtracts the amount due from the account. C. Often a practice accepts an amount less than what is due as payment in full and writes off the uncollected difference. D. A practice never accepts a payment less than what is due. | A. Each patient account is located, and the payment is posted to the correct charge. B. The PMP subtracts the amount due from the account. C. Often a practice accepts an amount less than what is due as payment in full and writes off the uncollected difference. |
| An account for which the practice has exhausted all of its collection efforts and the patient's balance is still unpaid is labeled a(n) ________ account. A. Delinquent B. Bad C. Unpaid D. Uncollectible | D. Uncollectible |
| The use of ________ helps a practice decide whether patients are indigent. A. Background searches B. Questionnaires C. Means tests D. Interviews | C. Means tests |
| Which of the following apply when a patient's medical and financial records are retained? (MAY BE MORE THAN ONE) A. No federal or state laws or regulations apply. B. State regulations apply. C. The practice manager or providers set the retention policy. D. HIPAA and FACTA regulations apply. | B. State regulations apply. C. The practice manager or providers set the retention policy. D. HIPAA and FACTA regulations apply. |
| Which of the following apply to dismissing patients who do not pay? (MAY BE MORE THAN ONE) A. The physician may decide to dismiss a patient who does not pay medical bills. B. A physician cannot by state law dismiss a patient who has not paid medical bills. C. If the patient is dismissed, the action should be documented in a letter to the patient. D. A physician has the right to terminate the physician-patient relationship for any reason under the regulations of each state. | A. The physician may decide to dismiss a patient who does not pay medical bills. C. If the patient is dismissed, the action should be documented in a letter to the patient. D. A physician has the right to terminate the physician-patient relationship for any reason under the regulations of each state. |
| When a practice has overcharged a patient for service, it needs to issue ________. A. A coupon for the next visit B. Insurance refunds C. Patient refunds D. Free services | C. Patient refunds |
| Which of the following apply to collection payment posting? (MAY BE MORE THAN ONE) A. The agency includes a statement showing which patient accounts have been paid. B. Money is collected according to the terms of the business associate (BA) contract. C. The agency sends a lump-sum amount for the practice to apply as it decides. D. The payments collected by the collection agency are made up of amounts collected from various patients with various account ages. | A. The agency includes a statement showing which patient accounts have been paid. B. Money is collected according to the terms of the business associate (BA) contract. D. The payments collected by the collection agency are made up of amounts collected from various patients with various account ages. |
| Identify all of the correct statements related to uncollectible accounts. (MAY BE MORE THAN ONE) A. Accounts over a year old have a better chance of collection. B. Practices do not expect to be able to collect. C. Accounts that are not worth the time and cost to pursue. D. Accounts with unpaid balances. | B. Practices do not expect to be able to collect. C. Accounts that are not worth the time and cost to pursue. D. Accounts with unpaid balances. |
| A list of the items from a record that are retained and for how long is summarized in a ________ schedule. A. Record B. HIPAA C. FACTA D. Retention | D. Retention |
| The retention schedule protects both the provider and the ________. A. Patient B. Insurance company C. Clearinghouse D. Billing service | A. Patient |
| When talking with someone other than the patient about an overdue bill, collections specialists will A. reveal the purpose of the phone call. B. be unprofessional. C. mislead the person they are talking with. D. not discuss the patient’s debt. | D. not discuss the patient’s debt |
| The day sheet produced by the practice management program shows A. the payments and charges that occurred on that date. B. what each patient owes the practice as of that date. C. the overdue accounts on that date. D. what each payer owes the practice as of that date. | A. the payments and charges that occurred on that date. |
| During collections, most practices use A. local police and state police. B. audit reports and tax returns. C. e-mail messages and faxes. D. letters and calls. | D. letters and calls |
| Credit bureaus keep records about a patient’s A. disposable income. B. salary. C. medical history. D. credit information. | D. credit information |
| Collection calls are regulated by the guidelines set by A. FDCPA. B. FACTA. C. HIPAA. D. FCRA. | A. FDCPA RATIONALE: FDCPA = Collection practices FACTA = Identity theft and credit report protections FCRA = Fair Credit Reporting Act (credit reporting and credit bureaus) |
| Accounts might be considered uncollectible when a patient A. files for bankruptcy. B. has not responded to the first bill. C. needs a payment plan. D. directs phone calls to an attorney. | A. files for bankruptcy. |
| Skip tracing increases the practice’s chances of A. following FDCPA guidelines. B. locating a patient with an overdue bill. C. successfully using the patient aging report. D. avoiding embezzlement. | B. locating a patient with an overdue bill. |
| The practice will need to pay patient refunds if it has A. miscalculated its accounts receivable. B. only received a payment from a third-party payer. C. used information from a credit bureau. D. overcharged the patient for a service. | D. overcharged the patient for a service. |
| The patient aging report is used to A. track overdue claims from payers. B. enter payments in the patient billing system. C. collect overdue accounts from patients. D. enter write-offs to a patient’s account. | C. collect overdue accounts from patients. |
| Bad debt is defined as A. collectible A/R. B. payer refunds. C. uncollectible A/R. D. patient refunds. | C. uncollectible A/R. |
| Billing system that sends one statement to the guarantor for a number of different accounts. | Guarantor billing |
| Theft of funds by an employee or contractor. | Embezzlement |
| Shows which patients are overdue on their bills and groups them into distinct categories for efficient collection efforts. | Patient aging report |
| Summary of the practice's policies about keeping records, including the type of information that is retained and the length of time it is kept. | Retention schedule |
| Check that the bank does not honor because the account lacks funds to cover it. | Nonsufficient funds (NSF) check |
| Patient balance that the practice has not collected and does not expect to be able to collect. | Uncollectible account |
| Program set up to accommodate the patient's schedule and ability to pay while ensuring that the practice receives the money it is owed. | Payment plan |
| Process that assigns patient accounts to a specific time of the month and standardizes the times when statements will be mailed and payments will be due. | Cycle billing |
| Process by which potential creditors can view unpaid medical bills on a person's record. | Credit reporting |
| External company that performs specialized collection efforts on difficult debtors. | Collection agency |
| Report summarizing the business day's charges and payments. | Day sheet |
| Shows services provided to a patient; total payments made; total charges; adjustments; and balance due. | Patient statement |
| All activities related to patient accounts and follow-up. | Collections |
| Laws regulating collection practices. | Fair Debt Collection Practices Act of 1977 (FDCPA) |
| Law regulating consumer collections to ensure fair and ethical treatment of debtors. | Telephone Consumer Protection Act of 1991 (TCPA) |
| Prohibits credit discrimination on the basis of race, color, religion, national origin, sex, marital status, age, or because a person received public assistance. | Equal Credit Opportunity Act (ECOA) |
| Law requiring disclosure of finance charges and late fees for payment plans. | Truth in Lending Act |
| Payment before medical services are provided. | Prepayment plan |
| Analysis of a person's credit standing during the collections process. | Credit reporting |
| Organizations that supply information about consumers' credit history. | Credit bureaus |
| Law requiring consumer-reporting agencies to have reasonable and fair procedures. | Fair Credit Reporting Act (FCRA) |
| Laws designed to protect the accuracy and privacy of credit reports. | Fair and Accurate Credit Transactions Act (FACTA) |
| Account deemed uncollectible. | Bad debt |
| Process of fairly determining a patient's ability to pay. | Means test |
| Declaration that a person is unable to pay his or her debts. | Bankruptcy |
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