Ch 28 Patient Billings, Posting Patient Payments, and Collecting Fees

An accurate patient account statement

A required document in the patient billing process.

Outsourcing

Contracting out a specific business function to another company rather than managing it internally; usually results in cost savings and higher quality.

Monthly billing cycle

The billing method typically more efficient in smaller medical practices.

Cycle billing

The billing method commonly used in large medical practices to distribute the workload throughout the month.

Practice management (PM) system

The computerized system most commonly used today to manage day-to-day financial operations by pulling data from the EMR into patient financial accounts.

Posting patient payments

Requires three pieces of information: the date of the payment, the payment amount, and the form of payment (cash, credit card, or check).

NSF

Nonsufficient funds; indicates a patient's check was returned by the bank because there wasn't enough money to cover it.

Credit balance

An overpaid account that requires a refund to be made back to the patient or the health insurance company.

At the time of service (ATOS)

The single best opportunity for collecting a patient payment.

Written communication

The least effective means of collecting patient fees.

Telephone contact

The best collection opportunity after face-to-face contact has failed.

Aging the account

The process of identifying and dividing delinquent accounts according to the length of time they have been unpaid (usually 60, 90, and up to 120 days).

Federal Trade Commission (FTC)

The federal agency that enforces both the Fair Debt Collection Practices Act (FDCPA) and the Truth in Lending Act (TILA).

Fair Debt Collection Practices Act (FDCPA)

A law enforced by the FTC that protects the consumer by outlining guidelines for the debt collector to follow during the collection process.

Truth in Lending Act (TILA)

A law requiring providers to disclose finance charges if they agree to let a patient pay in more than four installments.

Statutes of limitations

Laws that establish the maximum number of years legal collection procedures may be filed against a patient.

Collection agency

An outside service usually used for accounts delinquent more than six months; they charge a significant portion of the bill for their services.

Collection agency rule

Once an account is turned over to this agency, the medical office cannot attempt to collect from the patient and must forward all account info to the agency.

Skip patient

A patient who has moved to avoid payments ("skipped town"), often identified when statement mailings are returned marked with no forwarding address.

Bankruptcy

A legal petition to a court by an individual stating that they cannot pay any debt incurred, including medical bills.

Estate claim

The process of sending a bill owed by a deceased patient to any known next of kin at the patient’s last known address.

What is a third-party check?

A third-party check is generally one made out to the patient by someone unknown to the medical office.

Describe the use of an alpha search.

An alpha search involves typing the first few letters of the name with the screen automatically listing all names of patients starting with those letters.

What should you do when a credit balance is discovered on a patient account?

When a credit balance is identified, the medical assistant should issue a refund check to the patient.

List both the positive and negative terms that should or should not be used in a collection letter

Positive collection letter:

• missed

• overlooked

• forgotten

Negative terms to avoid:

• neglected

• ignored

• failure

Clearinghouse

A hub that collects and edits medical claims and then distributes them electronically to the appropriate payers for processing