Chapter 13 Review - Fees, Credit, and Collection
What is concierge medicine also known as? What does it mean?
Retainer-based medicine, primary care physicians opt out of insurance programs, decrease their patient load, and charge an annual fee for service.
What does the common-law principle Quantum Meruit mean?
"As much as he deserves", translates as the promise by the patient to pay the doctor as much as he or she deserves for labor.
What are realistic good collection rates for a collection agency?
30% - 60%
What is cycle billing?
A method in which certain portions of the accounts receivable are billed at specific times during the month on the basis of alphabetical breakdown, account number, insurance type, or the date of first service.
What is wage garnishment?
Attaching a debtor's property and wage by court order so monies can be obtained to pay debts.
Legal process of discharging or reorganizing a debt is known as
Bankruptcy
What should a patient registration form include?
Basic demographic information and patient's employment & insurance information.
Describe the Federal Truth in Lending Act
Became law on July 1, 1960; governs anyone who charges interest or agrees to more than 4 payments for a given service; applies to any business that charges interest.
Statement of services provided and fees owed
Bill
Device used to perform mathematic functions
Calculator
The Fair Debt Collections Practices Act states that telephone calls for collection activities should be placed at what times?
Calls may be placed after 8am and before 9pm on any day except Sunday or a Sabbath.
In most situations, private insurers and government-funded programs forbid the physician from waiving this, which is due at the time of service
Copayment
Large companies that keep records on individual borrowers and their payment history are known as
Credit bureaus
When did extending credit for medical services and the use of credit cards start?
Credit for medical services and credit cards grew out of the Depression of the 1930's
Used to make payments, withdraw cash, or transfer funds from a bank account
Debit card
Define credit
Extended payment terms or loan. Trust in a person's integrity & in his or her financial ability to meet all obligations when they come due.
Which legislation states debtors may be contacted only once a day, debtors may not be contacted on Sunday or on their Sabbath and postcards may not be used for collection purposes?
Fair Debt Collection Practices Act (FDCPA)
If a patient has a balance that the office is unsuccessful in collecting, when should the office turn the account over to a collection agency?
Immediately if the patient can't be contacted, maximum of 5-6 months after debt has occured.
What is a paper record for an individual account showing charges, payments, adjustments, and balance owed called?
Ledger card
What is a smart card?
Used as an ATM/Debit/Credit Card but embedded with a programable microchip that is able to hold much more information.
What is statute of limitations?
Varies from state to state, establishing maximum amount of time during which legal collection suit on a delinquent account may be rendered against a debtor.
What is fee splitting, is it legal?
When one physician offers to pay another physician for the referral of patients, it is considered unethical and a felony in several states.
Define receipt
Written acknowledgement of payment
What is a dun message?
A phrase used to remind a patient with a delinquent account about a payment.
What is open-book accounts?
AKA open accounts; record of business transactions on the books that represent an unsecured account receivable where credit has been extended without a formal written contract.
Total amount owed on account by patients for services rendered
Accounts receivable
Describe aging analysis
Aging accounts; a system that analyses accounts receivable indicating a breakdown of the length of time (30, 60, 90, and 120 days) the account is overdue.
For patients with no private or government insurance, what does charity care typically cover?
All hospital and outpatient services but not physician charges or prescription drugs.
What preventative measure may large medical facilities consider to avoid bad checks?
Check authorization system
Which legislation specifies that if a medical practice agrees to extend credit to one patient, the same financial arrangement must be extended to all who request it?
Equal Credit Opportunity Act
What is a list of services provided and the amounts charged?
Fee schedule
Fees for professional services rendered are also known as
Fee-for-service or charges
What should the office do if a patient sends an unsigned check for payment?
Have the patient come to the office to sign.
When tracing a skip, you should do what?
It is important to begin ASAP, move quickly in these efforts to locate the patient. If unable to trace and contact the patient, turn the skip over to a collection agency immediately.
What are characteristics of a deadbeat patient?
Many unfilled blanks on a patient registration form, questionable employment record, no business or home phone, many moves of residence, motel address, record of doctor hoping, no referral, no insurance.
Personal contact by telephone is important when an account remains delinquent for how long?
More than 60 days
What are the names of the document that is a combination form that can be used as a bill and a routing document?
Multipurpose billing form, charge slip, communicator, encounter form, fee ticket, patient service slip, routing form, superbill, and transaction slip.
What doe NSF stand for? What does it mean?
Nonsufficient funds, indicating a check drawn against an account is in excess of the account balance.
What are the three components of the Medicare Fee Schedule?
Participating fee - amount paid to physicians who have contracts with medicare; Nonparticipating fee - amount paid to physicians who don't have contracts; Limiting charge - highest amount a nonparticipating physician can charge a medicare patient.
Why would an office use a billing service?
Patient understanding of statements is improved, prompt billing is ensured, billing services save medical office money, collection calls to patients don't disrupt practice, patient questions regarding charges are answered by the service.
What is the Individual Responsibility Program?
Physicians choose to "opt out" of insurance programs and bill the patient directly; the patient then applies to the carrier or program for reimbursement.
Describe fee-for-service
Set dollar amount for professional services
What do we call a debtor who has moved and left no forwarding address?
Skip
