Chapter 18: Revenue Cycle

Which legislation specifies that if a business (medical practice) agrees to extend credit to one customer (patient), the same financial arrangement must be extended to all who request it?

Equal Credit Opportunity Act

What is the term for a phrase used to remind a patient of delinquent balance?

Dun message

What is the name of a large company that keeps records on individual borrowers and their payment history?

Credit bureau

What is a phrase on a billing statement that reminds a patient about a delinquent balance?

Dun message

When should fees be discussed with a patient for the first time?

When the appointment is scheduled

What term is used when a debtor’s property or wages are attached by court order to pay debts?

Garnishment

How should a check presented by a patient be verified?

Ask to see two types of identification

Which of the following may physician offer to patients paying cash, as long as he or she offers it to all patients?

Discount

What does the collection abbreviation “PP” stand for?

Promise to pay

What type of payment system requires that the patient pay for medical services directly to the provider and then files a claim for insurance reimbursement?

Individual responsibility program

If the “assignment of benefits” has been signed by the patient, what should be done if the insurance check is sent to the patient? SKIP

READ THE TEXTBOOK *SKIP *

Where can a physician’s office obtain information about a patients’s address, employment, salary, bankruptcy, and payments made on accounts?

Credit bureau

Which fee schedule involves three components: a participating fee, a non participating fee, and a limiting charge?

Medicare fee schedule

Requires the minor, but additional, step of adding a pin pad to a credit terminal (pro or con)

Con

Because the debit process is similar to a cash transaction, the fees that a business pays on debit transaction are smaller than credit card or check fees (pro or con)

Pro

When a patient has moved and left no forwarding address, what method can be used to trace them?

Searching databases on the internet

Adds another layer of detail to your business’s bookkeeping practices (pro or con)

Con

A business that accepts credit cards gives customers another payment option (pro or con)

Pro

When applying an insurance adjustment to a patient’s account, you are not typically required to post the

Name of the secondary insurance company that might be billed later

Which type of fee discount may be offered to income-eligible uninsured patients

Sliding fee schedule

Which credit or collection law has guidelines to follow when a debt needs to be collected

Fair Debt Collection Practice Act

How soon should a “skip” begin to be traced

As soon as possible

Businesses see small processing fees for each credit card transaction (pro or con)

Con

Easy to use and makes paying bills or making store purchases hassle free for customers (pro or con)

Pro

When communicating the cost of a future procedure with a patient, what should be done prior to this discussion

The insurance company should be contacted for information about how much the patient’s policy will pay for the procedure

Why is it a good practice to obtain a complete registration from the patient at the time of the first visit, securing accurate personal and financial history

To secure the information needed to begin the revenue cycle

Meting face to face with a patient at the time of service regarding an outstanding balance is often more successful than telephoning sending statements T/F

True

Which of the following is a range of usual fees among physicians in the same geographic are for the same service?

Customary

Which chapter of the bankruptcy laws protects wage earners from bill collectors and allow them to pay bills over time

Chapter 13

Which service may be used by a medical practice to prepare and send monthly statements and to place collection calls

Billing service

Which law protects an employee from being dismissed if their wages have been garnished

Consumer Credit Protection Act

Which type of business can be used to pursue payment on delinquent accounts

Collection agency

According to the Far Debt Collection Practices Act, how many times in one day can a debtor be contacted. SKIP

• READ FROM THE TEXTBOOK* SKIP

Which of the following components would you find on a Remittance Advice from

All of the above (which claims were paid, remaining patient responsibility, and any adjustments or denials)

As soon as cash money is received in the office, it should be

Placed out of sight in a secure location

How can a decision be made to deny credit to a patient

The patient’s information from a credit bureau

Which legislation applies to any business that charges interest or agrees to more than four payments for a given service

Federal Truth in Lending Act

When establishing a written financial agreement with a patient, what is the document called

Truth in lending form

Which term refers to dividing patient accounts by alphabet, or some other criteria, to send out portions of the monthly statements at certain times during the month

Cycle billing

Managing the revenue cycle begins with obtaining complete and accurate demographic and insurance data on which form

Patient registration

Administrative and clinical functions that contribute to the capture, management, and collection of payment are all part of which process

Revenue cycle

What does the collection abbreviation “L1” stand for

Letter 1 (sent)

A __ check is a check presented too long after it was written to be honored by the bank

State

Which term refers to a list of services or procedures and the dollar amount that will be paid by an insurance company for each

Fee schedule

Which document is a combination form that can be used as a bill, an insurance claim form, and a routing document

Multipurpose billing form

Which phrase could be used as a dun message

“Please remit the balance immediately; it is overdue”

Which document from the insurance company provides information to the patient about amounts paid or denied on an insurance claim

Explanation of benefits

The Remittance advice form, is similar to the EOB but, is a document provided by the insurance company to the provider along with a check for services rendered T/F

True

If you are unable to locate a patient who owes a balance, how soon should the account be turned over to a collection agency

Immediately

Number that identifies or refers to the claim that either the patient or the health provider submitted to the insurance company

Claim number

Beginning and end dates of the health-related service a patient received from a provider

Date of service

Amount of money that a patient’s insurance company did not pay the provider

Not allowed amount

Amount of money a patient owes as a share of the bill

Coinsurance co-payment amount

Amount a provider billed the patient’s insurance company for a service

Charge

Number assigned to a patient by the insurance company, which should match the number on the patient’s insurance card

Insured ID number

Code and brief description of the health-related service a patient received from a provider

Type of service

Name of the person who received the service

Patient

Which form. sent with an insurance payment to the physician’s practice, explains payments, allowed amounts, and write-offs

Remittance Advice

Which type of fee discount is no longer allowed by private insures and the federal government

Copayment waiver

Which statement usually shows a breakdown of the amounts that are due or delinquent, and how many days they are delinquent

Aging analysis