Patient Billing and Collections

These flashcards cover essential vocabulary and key concepts related to patient billing and collections in medical practices.

Patient Billing

The process of generating statements and collecting payments from patients for medical services rendered.

Collections

Activities related to obtaining payment from patients for services provided.

Payer Adjudication

The process by which an insurance company reviews a claim to determine payment.

Patient Statement

A document that details services provided, payments made, charges, and balance due for a patient.

Financial Policy

The structure outlining a medical practice's billing and payment procedures.

Guarantor Billing

A billing system that consolidates patient bills under the insurance policyholder.

Cycle Billing

A billing method that groups patients to equalize monthly statement printing and mailing.

Aging Report

A report that shows outstanding patient accounts categorized by how long the balances have been overdue.

Uncollectible Account

Funds that cannot be collected and need to be written off.

Bad Debt

An account that has been deemed uncollectible.

Fair Debt Collection Practices Act

A federal law regulating the practices of debt collectors.

Retention Schedule

A policy dictating how long patient records should be kept by a medical practice.

Credit Arrangements

Financial agreements that allow patients to pay their bills over time.

Equal Credit Opportunity Act (ECOA)

A federal law that prohibits discrimination in lending.

Truth in Lending Act

A law requiring clear disclosure of financing costs and terms to credit holders.

Charity Care

Medical services provided to patients who cannot afford to pay.

Prepayment Plan

An agreement by a patient to pay for services in advance of receiving them.

Skip Trace

The process used to locate a patient with a past-due account.

Credit Counseling

Services provided to help individuals manage their debts.

Patient Refund

Money owed to patients due to overcharges or credit balances.

Embezzlement

The theft of funds by an employee or contractor.

Collection Agency

An external firm that is hired to collect overdue accounts.

Financial Arrangements

Agreements made to manage unpaid balances from patients.

Payer

An entity that pays for medical services, often an insurance company.

Deductibles

The amount a patient must pay out of pocket before insurance coverage begins.

Coinsurance

The percentage of costs a patient is responsible for after deductibles are met.

Patient Account Representative

A staff member who manages billing and payment records.

Collections Specialist

An employee trained to work with patients on overdue bills.

Fair Credit Reporting Act (FCRA)

A law that regulates consumer reporting agencies to ensure reasonable procedures.

Patient Ledger

A record that summarizes all financial transactions for a patient.

Regulation F

A regulation that provides clarification to the Fair Debt Collection Practices Act.

Overdue Accounts

Accounts that have not been paid by the due date.

Collections Letters

Formal correspondence sent to inform patients of outstanding balances.