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