Billing and Collections

False

"Days in AR" means the average number of days that money has been owed to the patient.

b. make assumptions about the relationships between patients.

A medical assistant should NOT: a. treat all patients courteously. b. make assumptions about the relationships between patients. c. use neutral language to avoid awkward situations. d. allow a patient to provide information relating to a minor.

False

A medical assistant should always be demanding when asking patients for payment.

True

A patient account is a record of the charges and payments for a specific patient.

False

All medical offices display a sign addressing fee policy.

True

An AR aging analysis is a report that categorizes a company's accounts receivable according to the length of time since it has been billed.

True

An internal control is a procedure that helps ensure all financial matters are handled properly and discourages unethical workers from stealing.

Patient ledgers

At the end of the day, which of the following does NOT have to be reconciled to a day sheet? a. Individual encounter forms b. Bank deposits c. Total charges from encounter forms d. Patient ledgers

False

Cash payments never carry the risk of being fraudulent.

adjustments

Changes made that affect the patient's balance but are not a new charge or payment are called ________.

25-50

Collection agencies charge ________ percent of the amount collected.

False

Cycle billing is a labor-intensive process that may require several days of full-time work.

collection

If the patient should contact the office after the account has been turned over for collection, the patient should be referred to the ________ agency.

credit

In accounting terms, a payment is also referred to as a ________.

week

In cycle billing, approximately 25% of patient accounts are billed each __________.

30

In order to prevent a claim from being denied or rejected submit an insurance claim within _________ days of the date of the procedure.

reason

Insurance ______ codes are used on the EOB to identify specific reasons for payment adjustments and denials.

invalid patient identification numbers

Medicare states that the number one reason for rejected claims is ________.

credits

Most adjustments are ________ that are subtracted from the account balance.

True

Mutual understanding of financial arrangements helps to minimize problems of collection for delinquent accounts.

True

Patient accounting software is referred to as a practice management system (PMS).

False

Patients' financial records are maintained together with their medical records.

False

Receipt of money that decreases the account balance is known as an adjustment.

True

Remark codes are used by insurance carriers to identify reasons for payment adjustments and denials.

Fair Debt Collection Practices Act of 1978

The ________ provides a guide for determining the fair collections practices for creditors.

Fair Credit Reporting Act

The ________ provides guidelines for collecting an individual's credit information.

balance

The amount of money the patient owes is called the _________.

AR

The average number of days that money has been owed to the practice is known as days in ________.

reconciled

To make sure the accounts and entries are correct, the day sheets need to be ________ at the end of the day.

Log in with your username and password.

What is the first thing you must do when using a computerized billing system?

deceased

When a patient dies, a bill should be sent to the estate of the ________. a. spouse b. relatives c. deceased d. living

contractual allowance

When a provider is contracted with an insurance company the amount disallowed by the insurer is the ___________.

True

When patients do not have health insurance, the medical office can offer a reasonable discount to patients who pay in full at the time of service.

Reduction

Which of the following is NOT a typical accounts receivable (AR) transaction? a. Charge b. Payment c. Adjustment d. Reduction

New patient solicitation

Which of the following is NOT a typical component of a patient management system (PMS)? a. Coding and charge entry b. Patient registration c. Billing and claims processing d. New patient solicitation

Minors

23. ________ are NOT responsible for bills unless they are declared emancipated.

rejected

A ________ claim is one that is never accepted into the payer's computer system because of invalid information, such as incorrect patient identification number.

ledger card

A ________ is a carryover from the days of manual billing.

skip

A ________ is a collection problem that requires immediate action because this individual has a balance due and has moved without leaving a forwarding address.

False

A bulk Explanation of Benefits (EOB) statement creates additional paperwork.

True

A charge is the monetary cost for services or supplies that increases the account balance.

True

A copayment is a fixed amount that patients' insurance policies may require them to pay for certain types of visits.

True

A day sheet is a running total of all patient account transactions each day and is an important tracking and monitoring tool.

True

A patient's account may become delinquent because he or she believes that the insurance will cover the bill.

AR Aging Analysis

A report that categorizes a company's accounts receivable according to the length of time since it has been billed is known as an ________.

False

Accounts less than 90 days old are considered current and are of minimal cause for concern.

30

Accounts less than _______ days old are considered current and of minimal cause for concern.

False

Accounts payable (AP) is money owed to a business by customers in exchange for goods and services that have already been provided.

True

The patient ledger is a chronological record of the charges, adjustments, payments, and current balance for a specific patient.

True

The pegboard system is a manual bookkeeping system for patient accounting.

write it once

The pegboard system is an antiquated but effective method of documenting patient bills and payment. This system is also called the ________ method.

True

The pegboard system is an old bookkeeping system that is efficient, but rarely used anymore.

customary

The prevailing fee is referred to by insurance companies as the ________ fee.

Procedure was performed on the wrong person.

Which of the following is NOT a typical reason for a denied claim? a. Patient age or gender does not match the procedure. b. Information on the claim is missing. c. Diagnosis code does not match procedure performed. d. Procedure was performed on the wrong person.

A debit

Which of the following is NOT considered an adjustment? a. A discount b. A write-off c. A contractual allowance d. A debit

Patient's medical history

Which of the following is NOT included on an office day sheet? a. Charges for patient services b. Patient payments received in the mail c. Insurance payments received in the mail d. Patient's medical history

Gross salary of patient

Which of the following is NOT listed on the Explanation of Benefits (EOB) form? a. Name of the patient b. Name of the insured c. Amount paid d. Gross salary of patient

Double-entry

Which of the following is NOT one of the four components of the pegboard system of bookkeeping? a. Day sheets b. Double-entry c. Ledger cards d. Encounter forms

Telephone calls to the local police

Which of the following is NOT one of the usual collection techniques? a. Reminder notices b. Collections letters c. Collection agency d. Telephone calls to the local police

Posted

________ information regarding payment policies and fees helps patients become aware of office procedures.

Professional courtesy (PC)

________ is a discount that physicians may opt to offer to other physicians, staff, family members, or clergy.

financial hardship

________ refers to a patient's inability to pay.

Debit

________ refers to the monetary cost for services or supplies that increases the account balance.

Managed care

_________ contracts may require that the copayment be paid at the time of the visit and may not allow providers to bill patients at a later time.

Monthly billing payments

_________tend to arrive in the mail in one large wave, requiring extra time to post payments.