Office and Ins. Collection Strategies
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| Third-party payers are comprised of what? | Private insurance, government plans, managed care contracts and workers' compensation
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| The unpaid balance due from patients for professional services rendered is known as what? | accounts receivable
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| An important document that provides demographic and identifying data for each patient and assists in billing and collection is called what? | patient registration form
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| Courtesy adjustment | term preferrable to "write-off" when used in a medical practice
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| to verify a check, ask the patient for what? | driver's license and copy of one other form of ID
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| Age analysis | procdure of systematically arranging the A/R by age, from the date of service
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| What is the formula for calculating the office A/R ratio? | Divide the month-end A/R balance by the monthly average charges for the prior 12-month period.
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| What is the collection rate is a total of $40,300 was collected for the month and the total of teh A/R is $50,670? | divide the total amount collected for the month by total A/R = collection ratio;
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| Are physicians' patient accounts single-entry accounts, open-book accounts or written contract accounts? | open book
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| A court order attaching a debtor's property or wages to pay off a debt is known as what? | lien / garnishment
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| An individual who owes on an account and moves, leaving no forwarding address is called what? | skip
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| NSF | non-sufficient funds
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| WCO | will call office
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| PIF | paid in full
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| NLE | no longer employed
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| T | telephoned
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| SK | skip
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| FN | final notice
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| UE | unemployed
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| A straight petition in bankruptcy or absolute banruptcy is also know as what? | Chapter 7
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| A wage earner's bankruptcy is sometimes referred to as what? | Chapter 13
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| State three bonding methods | position-schedule blanket-schedule personal bond
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| A system of billing accounts at spaced intervals during the month on the basis of a breakdown of accounts by alphabet, account #, ins. type or date of service is known as what? | cycle billing
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| discounts | reductions of the normal fee based on a specific amount of money or a percentage of the charge
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| dun message | phrase to remind a patient about a delinquent account
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| debit card | item that permits bank customers to withdraw cash at any hour from an automated teller machine
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| debtor | person owing money
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| lien | claim on the property of another as security for a debt
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| financial account record (ledger) | individual record indicating charges, payments, adjustments, and balances owed for services
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| itemized statement | detailed summary of all transactions of a creditor's account
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| creditor | person to whom money is owed
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| fee schedule | listing of accepted charges or established allowances for specific medical procedures
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| What act is involved in regards to a law stating that a person has 60 days to complain about an error from the date that a statement is mailed? | Fair Credit Billing Act
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| What agency is involved with a consumer protection act that applies to anyone who charges interest or agrees on payment of a bill in more than four installments, excluding downpayment? | Truth in Lending Act
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| What act regulates collection practices of third-party debt collectors and attorneys who collect debts for other? | Fair debt collection practices act
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| What act has federal law prohibiting discrimination of all areas of granting credit? | Equal Credit Opportunity Act
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| What act regulates agencies that issue or use credit reports on consumers? | Fair Credit Reporting Act
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| Signing another person's name on a check to obtain money or pay off a debt without permission is called what? | forgery
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| When sending monthly statements to patients for balances due, the postal service can forward mail if the addressed envelopes contain what statement? | Forwarding Service Requested
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| When accepting a credit card as payment on an account, the proper guideline(s) to follow are what? | ask for photo ID, accept a card only from the person whose name is on the card, get approval from the credit card company
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| A service offered by a nonprofit agency assisting people in paying off their debts is known as what? | credit counseling
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| Insurance payment checks should be stamped in the endorsement area on the back "For Deposit Only", which is called what? | restrictive endorsement
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| True or False: Insurance companies and the federal overnment do not recommend waiving copayments to patients. | True
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| True or False: REgulation Z of the Truth in Lending Consumer Credit Cost Disclosure law applies if the patient is making three payments. | False
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| True or False: Most state collection laws allow telephone calls to the debtor between 8am and 9pm. | True
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| True or False: when a patient has declared bankruptcy, it is permissible to continue to send monthly statements for a balance due. | False
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| True or False: A collection agency must follow all the laws stated in the Fair Debt Collection Practices Act. | True
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| What are 4 types of third-party payers? | private insurance, government plans, managed care contracts and workers' compensation
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| Accounts receivable | include the unpaid balances due from patients and third-party payers for services that have been rendered.
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| Cash flow | the ongoing availability of actual cash in the medical practice
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| By monitoring the A/R the insurance billing specialist is able to what? | evaluate the effectiveness of the collection process
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| What is best way to keep A/R down? | verify insurance benefits before sending claims, collect copayments and deductibles at the time of service, obtain authorizations for noncontracted HMO patients and monitor A/R weekly.
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| How does one calculate the collection rate for a one month period? | divide the amount of monies collected during the current month by the total amount of the A/R.
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| Both private insurers and the federal government ban the waiving of what? | copayments
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| All NC (no charge) visits mus be fully documented where? | in the clinical portion of the patient's medical record and the finanacial record
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| Why should precaution be taken in reducing the fee of a patient that dies? | could be misinterpreted and result in a malpractice suit. Should never be based on a poor result in the treatment of a patient.
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| True or False: A medical practice can refuse to let an established patient see the doctor because of a debt. | False
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| Age analysis | procedure of systematically arranging the A/R by age from the date of service.
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| Age analysis does what? | helps collection follow-up by providing easy recognition of overdue accounts
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| Truth in Lending Act requires what? | also referred to as regulation Z; full written disclosure about the finance charges for large payment plans involving four or more installments, excluding a downpayment.
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| True or False: the physician is required to accept any amount of payment from the patient and can not take any additional action | False
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| Equal Credit Opportunity Act | prohibits discrimination in all areas of granting credit
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| Fair Debt Collection practices act | addresses the collection practices of third-party debt collectors and attorneys who regularly collect debts for others.
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| An insuraed person may not initiate legal action against the insurer until when? | 60 days after the initial claim has been submitted
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| Small claims court does what? | allows lay people to have access to a court system without the use of an attorney.
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| In small claims, the person filing the petition is called________ and the party being brought to suit is called________. | plaintiff; defendant
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| A patient who owes a balance on his or her account and moves but leaves no forwarding address is called what? | skip
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| True or False: the insurance specialist should no longer send statements, make phone calls, or attempt to collect the account after a patient files for bankruptcy. | True
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| Chapter 13 bankruptcy is also known as what? | wage earner's bankruptcy
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| Anyone who handles cash should be what? | bonded or insured
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| bonding | an insurance contract by which a bonding agency guarantees payment of a certain sum to a physician in case of financial loss caused by employee
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