2Patient FeesUsually the responsibility of the medical assisting staff.Discussion of FeesFees vary depending on type of medical facility, needs of practice, and the professional services rendered.If possible, try and approximate cost of procedure(s)/treatment for patient.
3Patient FeesAdvanced Beneficiary Notice approved by Medicare should indicate type of procedure(s), the total responsibility of patient, and the reason why this is the patient’s responsibility.Adjustment of FeesIf an office accepts assignment with Medicare and Medicaid, they are mandated to charge every patient the same amount for similar services rendered.Adjustments may be made for patients experiencing hardships or with limited income.Assist with payment planning
4Managing Patient Accounts Accounts receivable – money owed to the office by patients.Track patient accounts via the “pegboard” system or “one-write” method.Always work with care and accuracyKeep work currentDouble check all entriesUse consistent ink colorAlign columns carefullyWrite small enough to stay within columns
5Managing Patient Accounts Pegboard System – consists of day sheets, ledger cards, encounter forms or charge slips, and receipt forms.Posting – entering charges, credits or adjustments onto the day sheet, encounter form, or receipt and patient’s ledger card.Day sheet provides complete up-to-date information about accounts receivable status.
6Managing Patient Accounts Computerized systemsBeing used by more and more medical facilitiesSeveral software packages availableMay hire consultantMake sure system will meet current and future needs of practice.Adopt a system that allows the practice to start with one component and add another component at a later date.
7Recording Patient Transcations Encounter form – charge slip, superbill, or multipurpose billing form.Use in manual and computerized bookkeeping systems.Provides patients one copy with a record of account activity for the dayProvide a second copy for possible need to submit to insurance.Provides third copy that serves as the office’s permanent copy of account activity.
8Patient Account or Ledger Ledger – where patient accounts are recorded (accounts receivable ledger)Lists services, payments and balances due.Guarantor – the one responsible for payment of the account.Debit – used for entering charges, services and procedure codes.Credit – used for entering payments.Balance – record difference between debit and credit.
9Patient Account or Ledger AdjustmentsIndicate any insurance paymentsPersonal discounts, write-offsOther adjustmentsIndicated by the credit column and will generally reduce entries.Day SheetAll financial transactions posted here daily.Legibility and accuracy are critical.Balances carry over day-to-day.
10Patient Account or Ledger ReceiptsUsed for payments on accountsWhen patient makes payment on account on day when no services were rendered.Month-End ActivitiesRequired when last day sheet for month has been balanced, verify month-end figures to make sure agree with patient accounts.Computerized Patient AccountsSoftware management programs for patient accounts; automatically calculates/creates billing statements.
11Banking ProceduresOnline banking – allows individuals to check account balances, transfer funds between accounts, pay bills electronically, check credit card balances, view images of check and deposits.Types of AccountsChecking – primary typeSavings – may or may not pay interestMoney-Market – pay a higher rate of interest
12Types of ChecksCashiers Check – often used when check must be guaranteed for amount written.Certified Check – depositor’s own check that bank has “certified” with date/signature and check is “good.”Money Order – purchased with cashVoucher Check – check with a stub attached to indicate dates, services provided.Traveler’s Checks – safer than cash when traveling. Written in specific denominations.
13DepositsUsually made daily since they serve as another proof of postingUnwise to leave large sums of money in the office overnightChecks should be stamped immediately upon receiptVerify all checks have been endorsed before depositing themAll deposits should be 100% Accurate
14Accepting Checks Inspect for date, amount and signature. Do NOT accept a third-party check.If a deposited check is returned and marked “insufficient funds” (NSF), call the bank and verify availability of funds.
15Writing and Recording Checks Accounts payable – refunds of overpayment, replenish petty cash.Rules for preparing checksConfirm numeric and written amountsConfirm spellingFollow proper office procedureDetermine check has been signed by proper authorityConfirm check is payable to correct payee and current date is used.
16Purchasing Supplies/Equipment Avoid purchase of unnecessary items.Avoid duplication of items purchased.Provide a system for payment of only those items properly ordered and received.Nothing is ordered or paid for without a purchase order or purchase order number.A copy of the purchase order should be retained by the office.
17Petty CashMoney kept in the office for minor, routine, or unexpected expenses.Postage dueCoffee suppliesPatients that may pay co-payment with cashAmount on hand is usually $75 to $100Be sure to track your petty cash by completing a receipt
18Accepting ChecksInspect the check for the correct date, amount, and signatureDo not accept a third-party check unless it is from the insurance carrierLost or Stolen ChecksReport ImmediatelyStop Payment
19Monthly Reconciliation Balance the checking accountCompare cleared checks to uncleared checks to bank depositsCompare and balance bank deposits to month end payment reports
20DocumentationFinancial and ongoing billing records should not be maintained in the patient’s chart.Keep financial information separate from medical information to ensure that the physician’s care is not influenced by the patient’s ability to pay