Chapter 15: Credit and Collections

The Fair Debt Collection Act prohibits all of the following in attempting to collect a debt EXCEPT:

Mailing a bill to the patient's residence

In addition to the UCR concept, this is also a consideration when setting fees:

RBRVS

True or False: A computerized office can include a separate message on a patient's balance statement such as "Happy Holidays."

True

True or False: According to the American Medical Association, physicians should not charge patients finance charges or late payment fees.

True

True or False: Adjustments are changes in a posted account.

True

True or False: In an uncomputerized medical office, billing entries are made on a patient's medical record folder or ledger.

True

True or False: Patients are required to sign an authorization form for release of information at their first visit to a medical office. This form can be designed to give permission to leave a message on their answering machines.

True

True or False: The patient co-payment should be paid at the time of service.

True

True or False: You must have authorization from the patient before leaving a message on his or her answering machine requesting a return call.

True

True or False: You should collect the total amount due for office visits from a new patient on their first visit.

True

Your medical office has decided to change its billing cycle. At what point should you notify patients of the changes that may affect them?

3 months before the change takes effect

Good billing practices in a medical office will have 80% of fees collected within:

30 days

A credit score is a number between:

300 and 850

Select the time closest to when nearly all patient fees should be collected:

30::thirty days

Collection experts estimate that it costs ___________ dollars per month to bill one patient.

8

Which of the following is NOT a legitimate credit score?

900

When calling a patient about an overdue account, never:

All of the above

You can obtain a patient's credit rating from which the following?

All of the above

Which of the following statements regarding reimbursement schedules of insurance companies is true?

All of the above are correct.

At a patient's office visit, you hand the patient a copy of his most recent overdue bill notice. This is:

An acceptable billing reminder

To collect an unpaid debt left by a patient who has died, a medical office can:

Contact the next of kin to ask for the executor's name

A patient hands you his insurance card. You should:

Copy both sides and file the copy in the chart

To cover payment in full or a medical copay, most practices allow patients to use cash, a personal check, or a(n):

Credit card

Another term for credit rating is:

Credit score

Which of the following payment plans arranges for the patient to receive a bill that lists the amount due for that month,third party payments or adjustments, the total amount due, and the amount the patient owes?

Installment plan

Most of the payments made to a medical practice come from:

Insurance companies

True or False: If a patient does not pay a bill on time, you should speak to them sternly and refuse further treatment.

False

True or False: It is a violation of HIPAA to request photo identification from a patient.

False

True or False: The majority of fees paid to a medical office come from credit card companies.

False

True or False: When the patient writes off a debt, it means the medical practice has accepted a lower payment than the original fee.

False

This form is the patient's signed acknowledgement that the medical office has disclosed that fees or interest may be charged on any unpaid balance if they extend credit to the patient.

Truth-in-lending statement

Fees collected on the UCR concept are considered:

Usual, customary, and reasonable

What question should be asked when making a collection call to a patient with an overdue account?

When will payment be forthcoming?

This type of adjustment can be claimed as a deduction on a practice's federal taxes:

Write-off

A specified amount of money paid by the patient at the time of service as outlined by the insurance carrier is called

a co-payment

A participating provider

agrees to accept patients covered by a certain insurance carrier

Which of the following is considered when establishing a physician's fee schedule?

all of the options

The administrative medical assistant managing the financial aspect of the practice should be

aware of state and federal laws

Which of the following actions is a good idea before extending credit to a patient?

checking the patient's credit history

Three common options for debt collection are collection agencies, small claims court, and

credit bureaus

The first step to managing patient accounts is to

determine the age of the account

Allowing a patient to make payments on a bill that cannot otherwise be paid in full is known as

extending credit

What is the most important part of collecting on a patient account?

following up on collection attempts and promises

Other than guidance provided in the Fair Debt Collection Act, when is it inadvisable to contact someone regarding overdue bills?

immediately after a patient's death

Most fees paid to a medical office are paid by

insurance companies

Why are medical offices willing to pay the added percentage for accepting payment via credit card?

it is more cost effective to receive payment by credit card than to wait

On a statement sent to a patient for payment of an overdue account, an office manager indicates that the account will be placed with a collection agency if payment is not made within a certain period. This statement is

legal as long as the action is taken if needed

An aging schedule is a document that

monitors unpaid patient accounts for the office

One of the easiest methods used by medical practices to collect a debt is by

monthly billing

What is the formula for determining the collection percentage?

monthly revenue received divided by monthly production

To maintain adequate cash flow, when is the best time to collect a patient payment?

on the first visit

Many medical practices ______________ their billing to companies specializing in billing and debt collection.

outsource

A medical assistant who attempts to collect payment from a patient by telephone may not

provide false or misleading information to collect the debt

Which of the following is a recommended way to initiate discussion of fees with a new patient?

providing an office brochure that lists office polices regarding fees, collections, and third-party payments

When writing a collection letter, what information should be included in the first paragraph?

that the letter is an attempt to collect a debt

What scale is used to set physician fees?

the resource-based relative value scale

Collecting unpaid debt is

time consuming and may be costly to the practice

Regarding fee setting, what does UCR stand for?

usual, customary, reasonable

Who of the following people can best provide information about your state's laws limiting the amount of interest that can be charged to a patient who receives credit?

Accountant

Your office's rate for a procedure is higher than the insurance company's rate for that service. To account for the difference, you make this change to the patient's account known as a(n):

Adjustment

When posting a professional courtesy fee, record the regular fee, then note the change in the:

Adjustments column

A patient paying on the installment plan receives a monthly bill that lists:

All of the above

The process of acquiring funds that are owed is known as:

Collection

This process may be used by medical offices to collect overdue fees when other attempts to collect have not been successful:

Collection agency

Which of the following will help you determine the monthly production from the first day to the last?

Collection percentage = monthly revenue received ÷ monthly production

On the first visit, the medical assistant should obtain a copy of the patient's insurance card and:

Driver's license

This shows how much an insurance company will pay for a particular service:

EOB

When doing the office's accounting, the medical assistant uses an aging schedule to:

Monitor unpaid and overdue accounts

Which of the following messages should NOT be left on a patient's answering machine regarding an unpaid debt?

Mr. Jones, you still owe Dr. Elliot money for your skin cancer biopsy.

Mary Martinez, CMA(AAMA), is calling Louise Jones about a bill for her recent needle biopsy. A $500 balance is 120 days past due. Which of the following messages should the medical assistant leave on the answering machine?

Mrs. Jones, this is Mary. Please call me at 555-5555.

It is legal to deny a patient credit on the following grounds:

None of the above

When a physician charges other health professionals a reduced rate, it is called a:

Professional courtesy

A doctor who agrees to work with managed care contracts and other third-party payers is called a:

Participating provider

Which term means that doctors agree to participate with managed care contracts and other third-party payers in exchange for building a solid patient base?

Participating providers

Insurance and managed care companies often require that the patient pay a certain share of the bill as a set amount of money. This is known as the:

Patient co-pay

Who is responsible for making the decision to extend credit to a patient?

Physician

Most physicians today will commonly accept the following forms of payment EXCEPT:

Trade