Medical Billing Chapter 10 Study Guide

Questions and Answers

What does 'cash flow' refer to?

The ongoing availability of cash

What effect does delayed payment of claims by insurance carriers have on a medical practice?

Decreased copayments

What does the insurance billing specialist need to monitor to evaluate the effectiveness of the collection process?

Accounts receivable

What is the average amount of accounts receivable should be?

1.5-2 times the charges for one month of services Signup and view all the answers

Accounts that are 90 days or older should not exceed what percentage of total accounts receivable?

15-18% Signup and view all the answers

What should be done to inform a new patient of office fees and policies?

All of the above Signup and view all the answers

When is the patient likely to be the most cooperative in giving details?

Before any services are provided Signup and view all the answers

The reason for a fee reduction must be documented in the patient's:

Financial accounting record and medical record Signup and view all the answers

What is 'professional courtesy'?

Making no charge to anyone for medical care Signup and view all the answers

What is your goal when collecting fees?

Collect the full amount Signup and view all the answers

When a patient states 'just bill me', how should the medical assistant respond?

State the office policy and ask for full fee Signup and view all the answers

What is the first thing to do when the physician's office receives notice that a check was not honored?

Call the bank or patient Signup and view all the answers

Accounts receivables are usually aged in time periods of?

30, 60, 90 and 120 days Signup and view all the answers

What are messages included on statements to promote payment called?

Dun messages Signup and view all the answers

What is it called when contracting a medical billing service for claim submission?

Outsourcing Signup and view all the answers

The first patient account statement should be?

Presented at time of service Signup and view all the answers

The first telephone call to a patient to collect on an account should be made after what?

There is no response from the 3rd statement Signup and view all the answers

What is a card that permits bank customers to make cashless purchases without fees called?

Debit card Signup and view all the answers

How many installments must a payment plan have to require full written disclosure?

Four or more Signup and view all the answers

What percentage of total office accounts receivable should patient accounts that are 90 days or older not exceed?

15-18% Signup and view all the answers

What is the name of the federal act that prohibits discrimination in granting credit?

Equal Credit Opportunity Act Signup and view all the answers

What is the name of the act that addresses collection practices of third party collectors and attorneys?

Fair Debt Collection Practices Act Signup and view all the answers

When should all collection calls be placed?

After 8 AM and before 9 PM Signup and view all the answers

Which group of accounts would a collector target when they begin making phone calls?

60 to 90 day accounts Signup and view all the answers

How should accounts be organized when making phone calls for collections?

According to the number of days past date of service Signup and view all the answers

When writing a collection letter, how should the tone be?

Use a friendly tone and ask why payment hasn't been made Signup and view all the answers

If an insurance company seems to be ignoring all efforts to trace a claim, what should be sent?

History of the account Signup and view all the answers

What is the part of the legal system that allows laypeople to settle a legal matter without an attorney?

People's court, justice court, small claims Signup and view all the answers

In a bankruptcy case, most medical bills are considered?

Unsecured debt Signup and view all the answers

Which type of bankruptcy is considered wage earners?

Chapter 13 Signup and view all the answers

What is the biggest change medical offices can expect from the ACA?

Number of self-pay patients will decrease Signup and view all the answers

What is not an example of why accepting credit/debit cards is beneficial?

They charge a service fee Signup and view all the answers

The amount expected based on physician charges from third-party insurance companies and patients for services rendered is called?

Accounts receivable Signup and view all the answers

What is the relationship of the amount of money owed and the amount collected called?

Collection ratio Signup and view all the answers

The patient information sheet is also known as?

Patient registration info form Signup and view all the answers

How often should the patient registration form be updated?

At least every 6 months Signup and view all the answers

All discounted fees need to be noted on the patient's?

Financial accounting record ledger card Signup and view all the answers

Assets or debts that have been determined uncollectible and are therefore taken off the books as a loss are called?

Write off courtesy adjustments/ bad debt Signup and view all the answers

What does the amount due listed on a patient's accounting record refer to?

Balance Signup and view all the answers

If the endorsement doesn't match the name on the front of the check, it is called?

Forgery Signup and view all the answers

The statement 'This bill is now 30 days past due, please remit payment' is called a?

Dun message Signup and view all the answers

The term ____ is used when accounts are billed at spaced intervals.

Cycle billing Signup and view all the answers

The Truth in Lending consumer credit cost disclosure requires businesses to disclose all _ and __ costs related.

Direct, indirect Signup and view all the answers

A formal regulation setting time limits on legal action is called?

Statute of limitations Signup and view all the answers

According to FDCPA, do not contact a third party more than?

Once Signup and view all the answers

Collection term TTA means?

Turned to agency Signup and view all the answers

Collection OOT means?

Out of town Signup and view all the answers

When dealing with managed care contracts, do not sign contracts that use the ________ clause.

Hold harmless Signup and view all the answers

Patients accounts turned over to a collection agency should have a ______ sent by mail.

Letter of withdrawal Signup and view all the answers

In filing a claim in small claims court, the physician's office is referred to as the?

Plaintiff Signup and view all the answers

A patient who owes a balance on account and moves with no forwarding address is called a?

Skip Signup and view all the answers

In dealing with an estate claim, a call to the ____ can be made.

Executor Signup and view all the answers

________ are another way of offering the patient a way of paying off an account by spreading the amount over a period of time.

Payment plans Signup and view all the answers

Study Notes

Cash Flow and Accounts Receivable

Cash flow refers to the ongoing availability of cash essential for operations.
Accounts receivable must be monitored for evaluating the collection process's effectiveness.
Average accounts receivable should be 1.5 to 2 times the charges for one month's services.
Accounts aged 90 days or older should not exceed 15-18% of total accounts receivable.

Patient Relations and Communication

New patients should be informed of office fees and policies in various ways.
Patients are likely to provide detailed information before receiving services.
Documentation is necessary for fee reductions in both the financial accounting record and medical record.
Medical assistants should explain office policies and request full fees when patients suggest "just bill me."

Collection Practices

The first account statement should be presented during the service.
Collection calls should begin after no response from the third statement, primarily targeting 60 to 90-day accounts.
Dun messages on statements can encourage payment by promoting a friendly tone while inquiring about missed payments.

Legal and Financial Framework

The Equal Credit Opportunity Act prohibits discrimination in credit granting.
The Fair Debt Collection Practices Act governs the practices of third-party collectors.
Bankruptcy cases often categorize most medical bills as unsecured debt, with Chapter 13 considered “wage earner” bankruptcy.

Payment and Fees

Accepting credit/debit cards can be beneficial despite associated service fees.
A formal regulation limits the period for legal action known as the statute of limitations.
Payments from third-party insurance companies and patients create accounts receivable, which directly relate to the collection ratio.

Documentation and Record Keeping

Patient registration forms should be updated every six months for accuracy.
Discounts offered should be recorded in the financial accounting ledger.
Write-offs involve accounts deemed uncollectible and are documented as bad debt or courtesy adjustments.

Additional Practices

Patients' accounts sent to a collection agency require a letter of withdrawal to be mailed.
Cycle billing is a method where accounts are billed at spaced intervals.
In small claims court, the physician’s office represents the plaintiff in legal matters.

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Description

This quiz focuses on key concepts from Chapter 10 related to medical billing practices. Understand essential terms like cash flow and the importance of monitoring the collection process for effective billing. Perfect for students looking to enhance their knowledge in medical insurance and billing.