MDA Ch 62 and 63
Examples such as restorative and impression materials
Consumable Supplies
deposit slip
A bank form listing the cash and checks to be deposited.
Outguide
A bookmark for the filing system
Computerized inventory system
A computer software program that tracks inventory and then creates an automated replenishment order
Check
A draft or an order drawn on a specific bank account for payment of a specified sum of money to the payee or the bearer
Medicaid
A federal and state assistance program that pays for health care services for people who cannot afford them.
Medicare
A federal program of health insurance for persons 65 years of age and older
Reasonable fee
A fee that is considered justified for an extensive or complex treatment
Customary Fee
A fee that is within the range of the usual fee charged for the service
Cross-reference file
A file in which each item is listed in alphabetic order by name and its document number is provided.
release of information
A form completed by the patient that authorizes the medical office to release medical records to the insurance company for health insurance reimbursement.
packing slip
A form use in a warehouse operations that list the items to be shipped and the receipt of the shipment may also include the amount due for a credit order and any shipping and handling charges as well as a shipment control number
Want list
A list of supplies to be ordered and questions to be asked of the representative
Payee
A person to whom a check is written
Direct Reimbursement Plan
A self-funded program in which the individual is reimbursed on the basis of a percentage of dollars spend for dental care provided. This type of plan allows beneficiaries to seek treatment from the dentist of their choice.
Nonsufficient funds
A situation that occurs when a check is returned to a depositor because the writer of the check did not have a bank available balance equal to or greater than the amount of the check.
statement
A summary of all invoices payments credits and debits for the month
Individual Practice Association (IPA)
A type of HMO that contracts with groups of physicians who practice in their own offices and receive a per-member payment from participating HMOs to provide a full range of health services for members
warranty
A written statement that explains the manufactures responsibility for replacement and or repair of a piece of equipment over a limited time
Accounts Payable
All of the money that is owed by the practice
Dental Insurance
And assistance program that supports the patient or family with the cost of dental care
Transactions
Any charge payment or adjustment made to a financial account
chronological
Arranged in order of time of occurrence. Can be months, quarters, and years.
Fixed overhead
Business expenses that are ongoing; salaries, rent, mortgage, utilities
Variable overhead
Business expenses that change depending on the types of services needed; dental lab fees, stationary supplies
invoice
Detailed list of goods shipped or services rendered with an account of all cost on an itemized bill may be included with the shipment or it may be mailed separately
Examples such as local anesthetic agents, needles, a saliva ejector, and cotton rolls
Disposables
Numeric
Each patient record or document assigned a number
Examples such as mouth mirrors and burs
Examples of Expendable Items (Disposable)
Active files
Files of patients who have been seen within the past 2 to 3 years
Inactive files
Files of patients who have not been seen over the past 3 years.
W-2 Tax Form
Form submitted to the IRS that reports your earnings and your taxes withheld each year *January
registration form
Gathers all the basic financial information needed to manage the account history and complete the patient identification portion of an insurance claim form
Telephone calls, letters, collection agency, and small claims court
Give four ways that a business can follow through on the collection of fees
HIPPA
Health Insurance Portability and Accountability Act of 1996 Knowing state and federal law requirements
charge slip; routing slip; superbill
Hey slip used to transmit financial information from the treatment area to the business office the form contains information about the patient such as name account number in previous balance current charges and payments
shelf life
How long a product may be stored before use.
4 Inches
How many inches should be left between files?
6 months
How often should a recall patient be called to come in for an appointment?
Daily
How often should bank deposit be deposited?
15 Min
How soon should a new pt come in the dental office before their app?
In the patient record
If a patient does not keep an appointment where should this information be recorded?
Patient Dental Records
In which record would you look to find consent forms, exam findings, medical and dental history for a patient?
Patient of Record
Individual who has been examined and diagnosed by the dentist and has had treatment planned
Capitation Plans (HMO)
Involve an arrangement in which a dentist has contracted to provide dental services for the plans members the dentist is paid (usually monthly) a fixed amount per dental plan participant who has selected the dentist as their treatment provider
What is one of the business assistant's most important responsibility?
Maintenance of adequate records
Examples such as calculator or a curing light
Nonexpendable Items
Expenses
Overhead cost of a business that must be paid to keep operating
Disbursements
Payments on any outstanding accounts payable
restrictive endorsement
Prevents anyone from cashing a check if stolen
Assignment of benefits
Procedure by which the subscriber authorizes the carrier to make payment of allowable benefits directly to the dentist
Traditional insurance plan
Provides benefits for dental treatment that the covert individual has received from his or her own debtist these plans are considered fee for service and come with limitations in copayment options
Usual fee
Refers to the fee that the dentist charges private patients for a given service
non duplication of benefits
Requires a secondary carrier to reimburse only upto the level of reimbursement the primary carrier would have paid.
dependent
Someone who relies on someone else for income and care; spouse or child
Filing
The act of classifying and arranging records to be easily retrieved when needed
overhead
The actual cost of doing business
10,15,30 min
The amount of minutes used in units of time
Check Register
The book in which you keep records of checks, deposits, debit card transactions, and ATM withdrawals.
Provider
The dentist who provides the treatments
Office Hours
The hours out of practice is open for business this does not include the hours when the practices opening or closing the lunch hour in routine days are
Color Coding
The organization of files according to a system of colored file and the first two letters of the patients last name
Carrier
The party usually an insurance company who pays the claims and collect the premiums
Ledger
The patient statement that contains the financial information for each patient this information should never be found with patient clinical records
Coordination of Benefits (COB)
The patient will receive payment from both carriers but the total received may not be more than 100% of the actual dentist expenses
Business assistant
The person responsible for the business of the office
Subscriber
The person who receives the dental treatment
Rate of use
The quantity of a product that is used within a given time
Payroll
The sum of all financial records of salaries wages bonuses and the deductions
Group
The union or employment organization that has negotiated the dental insurance as part of its benefit package
Consolidated Omnibus Budget Reconciliation Act (COBRA)
This entitles the subscriber to continue the same coverage but her or she is responsible for paying the premiums
Alphabetic
This filing system is by far the easiest and most commonly used system for filing patient records and ledger cards.
Birthday Rule
This will stipulate that when a child is covered under both parents plans the plan of the parent whose birthday falls earlier in the calendar year (month and day not year) is billed first this does not apply to parents who are divorced
Units of time
Time increments used in planning appointments
Buffer time
Time reserved on the schedule for emergency patients; should not be scheduled more then 24 hours in advance
Cash, checks, credits cards, digital wallet
What are different types of ways patient can pay for treatment?
Office hours, buffer time, meetings, holidays
What are the four basic elements to be outlined?
Accounts receivable and accounts payable
What are the two types of bookkeeping systems use in a dentist practice?
Mail or Electronic
What are two ways that claim forms are filed?
Dental supplies sales representative, from a catalog, by telephone, fax, mail order or barcode scanning, and internet
What are ways that supplies can be ordered through?
Telephone calls, emails, letters, text messages
What are ways you can conform a pt's appointment?
Computers
What continues to replace handwritten operating procedures in the handling of business?
Cash on delivery
What does COD mean
All money owed to the practice
What is accounts receivable system?
Make the complete entry in the app book, write the app card for the pt, double check to ensure info is the same in both places
What is the proper sequence for recording entries?
30 days
What is the timeframe for an office to begin collection efforts?
1.) usual, customary, and reasonable (UCR) 2.) Schedule of benefits 3.) Fixed Fee Schedules
What three methods are commonly used to calculate fee for service insurance benefits?
backorder
a customer order that cannot be filled when promised or demanded but is filled later
walkout statement
a document listing charges and payments that is given to a patient after an office visit
PPO (Preferred Provider Organization)
a type of health insurance plan in which a company forms a contract with certain hospitals and doctors to provide health care at a reduced rate
petty cash
an amount of cash kept on hand and used for making small payments usually no more then $50
Personnel Manual
book that describes the staff job descriptions, attendance policy, dress code, and employer expectations
dual coverage
coverage under more than one insurance plan
Affordable Care Act
law passed in 2010 to expand access to insurance, address cost reduction and affordability, improve the quality of healthcare, and introduce the Patient's Bill of Rights
Current Dental Terminology (CDT)
medical code set maintained and copyrighted by the American Dental Association.
Pegboard system
most commonly used manual medical accounts receivable system
Bonding
obtaining insurance protection against theft by employees
one-write system
or Pegboard system. is a type of recording system designed to increase the efficiency of recording daily transactions
Reorder tags
placed when the supply of a certain item is close to being low and the item needs to be replaced
Accounting
planning, recording, analyzing, and interpreting financial information
a call list is used in the dental office for
scheduling patients on short notice
Guarantor
the person identified as responsible for payment of the bill
lead time
time interval between ordering and receiving the order
EPO (Exclusive Provider Organization)
very similar to an HMO requires members to have a designated PCP