Daily Financial Practices Chapter 17 ICBS 120

Patient Fees Usually the responsibility of the medical assisting staff. Discussion of Fees Fees 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.

Patient Fees Advanced 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 Fees If 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

Managing 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 accuracy Keep work current Double check all entries Use consistent ink color Align columns carefully Write small enough to stay within columns

Managing 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.

Managing Patient Accounts Computerized systems Being used by more and more medical facilities Several software packages available May hire consultant Make 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.

Recording 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 day Provide a second copy for possible need to submit to insurance. Provides third copy that serves as the office’s permanent copy of account activity.

Patient 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.

Patient Account or Ledger Adjustments Indicate any insurance payments Personal discounts, write-offs Other adjustments Indicated by the credit column and will generally reduce entries. Day Sheet All financial transactions posted here daily. Legibility and accuracy are critical. Balances carry over day-to-day.

Patient Account or Ledger Receipts Used for payments on accounts When patient makes payment on account on day when no services were rendered. Month-End Activities Required when last day sheet for month has been balanced, verify month-end figures to make sure agree with patient accounts. Computerized Patient Accounts Software management programs for patient accounts; automatically calculates/creates billing statements.

Banking Procedures Online 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 Accounts Checking – primary type Savings – may or may not pay interest Money-Market – pay a higher rate of interest

Types of Checks Cashiers 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 cash Voucher Check – check with a stub attached to indicate dates, services provided. Traveler’s Checks – safer than cash when traveling. Written in specific denominations.

Deposits Usually made daily since they serve as another proof of posting Unwise to leave large sums of money in the office overnight Checks should be stamped immediately upon receipt Verify all checks have been endorsed before depositing them All deposits should be 100% Accurate

Accepting 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.

Writing and Recording Checks Accounts payable – refunds of overpayment, replenish petty cash. Rules for preparing checks Confirm numeric and written amounts Confirm spelling Follow proper office procedure Determine check has been signed by proper authority Confirm check is payable to correct payee and current date is used.

Purchasing 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.

Petty Cash Money kept in the office for minor, routine, or unexpected expenses. Postage due Coffee supplies Patients that may pay co-payment with cash Amount on hand is usually $75 to $100 Be sure to track your petty cash by completing a receipt

Accepting Checks Inspect the check for the correct date, amount, and signature Do not accept a third-party check unless it is from the insurance carrier Lost or Stolen Checks Report Immediately Stop Payment

Monthly Reconciliation Balance the checking account Compare cleared checks to uncleared checks to bank deposits Compare and balance bank deposits to month end payment reports

Documentation Financial 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