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Chap 10 Collections

Office and Ins. Collection Strategies

Question	Answer
Third-party payers are comprised of what?	Private insurance, government plans, managed care contracts and workers' compensation
The unpaid balance due from patients for professional services rendered is known as what?	accounts receivable
An important document that provides demographic and identifying data for each patient and assists in billing and collection is called what?	patient registration form
Courtesy adjustment	term preferrable to "write-off" when used in a medical practice
to verify a check, ask the patient for what?	driver's license and copy of one other form of ID
Age analysis	procdure of systematically arranging the A/R by age, from the date of service
What is the formula for calculating the office A/R ratio?	Divide the month-end A/R balance by the monthly average charges for the prior 12-month period.
What is the collection rate is a total of $40,300 was collected for the month and the total of teh A/R is $50,670?	divide the total amount collected for the month by total A/R = collection ratio;
Are physicians' patient accounts single-entry accounts, open-book accounts or written contract accounts?	open book
A court order attaching a debtor's property or wages to pay off a debt is known as what?	lien / garnishment
An individual who owes on an account and moves, leaving no forwarding address is called what?	skip
NSF	non-sufficient funds
WCO	will call office
PIF	paid in full
NLE	no longer employed
T	telephoned
SK	skip
FN	final notice
UE	unemployed
A straight petition in bankruptcy or absolute banruptcy is also know as what?	Chapter 7
A wage earner's bankruptcy is sometimes referred to as what?	Chapter 13
State three bonding methods	position-schedule blanket-schedule personal bond
A system of billing accounts at spaced intervals during the month on the basis of a breakdown of accounts by alphabet, account #, ins. type or date of service is known as what?	cycle billing
discounts	reductions of the normal fee based on a specific amount of money or a percentage of the charge
dun message	phrase to remind a patient about a delinquent account
debit card	item that permits bank customers to withdraw cash at any hour from an automated teller machine
debtor	person owing money
lien	claim on the property of another as security for a debt
financial account record (ledger)	individual record indicating charges, payments, adjustments, and balances owed for services
itemized statement	detailed summary of all transactions of a creditor's account
creditor	person to whom money is owed
fee schedule	listing of accepted charges or established allowances for specific medical procedures
What act is involved in regards to a law stating that a person has 60 days to complain about an error from the date that a statement is mailed?	Fair Credit Billing Act
What agency is involved with a consumer protection act that applies to anyone who charges interest or agrees on payment of a bill in more than four installments, excluding downpayment?	Truth in Lending Act
What act regulates collection practices of third-party debt collectors and attorneys who collect debts for other?	Fair debt collection practices act
What act has federal law prohibiting discrimination of all areas of granting credit?	Equal Credit Opportunity Act
What act regulates agencies that issue or use credit reports on consumers?	Fair Credit Reporting Act
Signing another person's name on a check to obtain money or pay off a debt without permission is called what?	forgery
When sending monthly statements to patients for balances due, the postal service can forward mail if the addressed envelopes contain what statement?	Forwarding Service Requested
When accepting a credit card as payment on an account, the proper guideline(s) to follow are what?	ask for photo ID, accept a card only from the person whose name is on the card, get approval from the credit card company
A service offered by a nonprofit agency assisting people in paying off their debts is known as what?	credit counseling
Insurance payment checks should be stamped in the endorsement area on the back "For Deposit Only", which is called what?	restrictive endorsement
True or False: Insurance companies and the federal overnment do not recommend waiving copayments to patients.	True
True or False: REgulation Z of the Truth in Lending Consumer Credit Cost Disclosure law applies if the patient is making three payments.	False
True or False: Most state collection laws allow telephone calls to the debtor between 8am and 9pm.	True
True or False: when a patient has declared bankruptcy, it is permissible to continue to send monthly statements for a balance due.	False
True or False: A collection agency must follow all the laws stated in the Fair Debt Collection Practices Act.	True
What are 4 types of third-party payers?	private insurance, government plans, managed care contracts and workers' compensation
Accounts receivable	include the unpaid balances due from patients and third-party payers for services that have been rendered.
Cash flow	the ongoing availability of actual cash in the medical practice
By monitoring the A/R the insurance billing specialist is able to what?	evaluate the effectiveness of the collection process
What is best way to keep A/R down?	verify insurance benefits before sending claims, collect copayments and deductibles at the time of service, obtain authorizations for noncontracted HMO patients and monitor A/R weekly.
How does one calculate the collection rate for a one month period?	divide the amount of monies collected during the current month by the total amount of the A/R.
Both private insurers and the federal government ban the waiving of what?	copayments
All NC (no charge) visits mus be fully documented where?	in the clinical portion of the patient's medical record and the finanacial record
Why should precaution be taken in reducing the fee of a patient that dies?	could be misinterpreted and result in a malpractice suit. Should never be based on a poor result in the treatment of a patient.
True or False: A medical practice can refuse to let an established patient see the doctor because of a debt.	False
Age analysis	procedure of systematically arranging the A/R by age from the date of service.
Age analysis does what?	helps collection follow-up by providing easy recognition of overdue accounts
Truth in Lending Act requires what?	also referred to as regulation Z; full written disclosure about the finance charges for large payment plans involving four or more installments, excluding a downpayment.
True or False: the physician is required to accept any amount of payment from the patient and can not take any additional action	False
Equal Credit Opportunity Act	prohibits discrimination in all areas of granting credit
Fair Debt Collection practices act	addresses the collection practices of third-party debt collectors and attorneys who regularly collect debts for others.
An insuraed person may not initiate legal action against the insurer until when?	60 days after the initial claim has been submitted
Small claims court does what?	allows lay people to have access to a court system without the use of an attorney.
In small claims, the person filing the petition is called________ and the party being brought to suit is called________.	plaintiff; defendant
A patient who owes a balance on his or her account and moves but leaves no forwarding address is called what?	skip
True or False: the insurance specialist should no longer send statements, make phone calls, or attempt to collect the account after a patient files for bankruptcy.	True
Chapter 13 bankruptcy is also known as what?	wage earner's bankruptcy
Anyone who handles cash should be what?	bonded or insured
bonding	an insurance contract by which a bonding agency guarantees payment of a certain sum to a physician in case of financial loss caused by employee

Created by: mpeoples

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