1. C H A P T E R 8 8 Collecting Fees

2. Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 8 - 2 Paying for Medical Services 1 1 U N I T

3. Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 8 - 3 Factors Used in Determining Fees The physician considers:  Time spent with the patient  The complexity of the diagnosis  The treatment  Fees of similar specialists in the area  Cost of running and staffing the office

4. Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 8 - 4 Information Obtained from Every New Patient Patient data sheet  Demographic information  Referral information  Insurance information  Insurance cards copied  Additional coverage

5. Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 8 - 5 When to Discuss Payment Planning The Truth in Lending Act specifies that when there is an agreement between the physician and the patient to accept payment in more than four installments, the physician is required to provide disclosure of finance charges.

6. Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 8 - 6 Credit Arrangements Developing a payment plan  Helps ease patient’s mind  Patient can concentrate on getting well The Truth in Lending Act

7. Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 8 - 7 Reasons for Accepting Credit Cards Credit cards make it convenient for the patient. Carrying cash can place the patient at risk if the cash is lost or stolen. Credit card payments can be accepted over the phone.

8. Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 8 - 8 Unit Summary What information is required from all new patients? When would you use the federal Truth in Lending Act in the medical office?

9. Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 8 - 9 Bookkeeping Procedures 2 2 U N I T

10. Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 8 - 10 Transferring Charges Transferring information from one record to another is called posting. Charges are transferred from the billing slip to the daily log and to the patient ledger.

11. Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 8 - 11 Itemized Statements A detailed listing that includes:  Date of service  Description of the service  Charge for the service  Payments or adjustments  Balance on the account

12. Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 8 - 12 Exceptions to Usual Billing Procedures When the patient is applying for insurance, physical exams may be billed to the insurance company. Bills may be sent to the estate of deceased patients. (continued)

13. Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 8 - 13 Exceptions to Usual Billing Procedures Legal consultations may be billed to the physician. No further statements or attempts to collect a debt can occur after you receive official notice of bankruptcy.

14. Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 8 - 14 Pegboard/Write-It-Once System Entries are made simultaneously on the ledger, daysheet, and charge slip.

15. Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 8 - 15 Unit Summary How would you describe an itemized statement? What are three exceptions to the usual billing procedures in the medical office?

16. Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 8 - 16 Billing and Collections 3 3 U N I T

17. Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 8 - 17 Advantages of Computerized Billing Software can perform the following:  Post charges  Provide a variety of statistical information regarding patients, diagnoses, charges, and payments  Provide monthly and year-to-date billing information

18. Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 8 - 18 Locating Accounts in a Computer System Patients can be located by:  Entering the account number  Performing an alpha search using the first few letters of the last name

19. Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 8 - 19 Account History This feature automatically shows the balance on the account and the number of days the account has been due. The account history can be printed and given to the patient.

20. Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 8 - 20 Reasons to Withhold Billing Statements Patients who would not receive a bill include:  Government-assisted patients (Medi-Cal or Medicare)  Patients seen for workers compensation  Families of patients who have recently died

21. Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 8 - 21 Aging of Accounts Accounts begin to age the day the service is posted. Accounts are divided into groups based on the length of time that has passed since the last payment. Accounts with payments within the last 30 days are considered current.

22. Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 8 - 22 Statute of Limitations States set guidelines that establish the number of years during which legal collection procedures may be filed against a patient.

23. Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 8 - 23 Unit Summary What is an alpha search? How would you describe an account history?

24. Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 8 - 24 Keys to Career Success The successful medical assistant realizes the importance of the business aspects of the medical office. Billing in the office, whether done by hand or by a computerized system, generates the revenue necessary to keep the office open.

25. Copyright © 2008 Thomson Delmar Learning, a division of Thomson Learning Inc. All rights reserved. 8 - 25 Hot Links to Career Success www.medicalbillingandcoding.net  Medical Billing and Coding information