1 1 Fees, Billing, Collections, and Credit Lesson 1: Fees, Billing, Collections, and Credit
Lesson Objectives Upon completion of this lesson, students should be able to … Discuss how fees are determined and be able to discuss this with patients. Describe the various billing methods and preparation of billing statements. Identify the patient information required at the time of registration and thereafter to maintain the records needed for billing.
Lesson Objectives Explain credit policy. List the steps in the collection process and identify the legalities involved. List the benefits of using electronic medical records.
1. How do physicians set their fees? 2. What factors might they consider?
Services Time Going rate
Usual fee Customary Reasonable fee
Inform prior to first appointment Info. should include costs, office policies, and credit procedures Via Phone and mail Post fees in the office
Collect $ at the time of the service Bill collection agency
to bill the insurance carrier on behalf of the pt permission to forward info to the ins. company placed in file and updated annually
View pearson’s DVD Chp. 15 Fees, billing, collections, credit
charge slip or statement or insurance reporting form Two- or three- part carbonized form
comprehensive list of pt services w/ codes and fees one is attached to the chart. The physician marks the services provided. A copy is then provided to the patient used to report services to the ins. carrier
View pearson’s DVD ◦ Chp 19 Insurance coding
Be sure and update this information every 6 to 12 months. name of patient Date of birth address (no PO Box) Telephone numbers Address and telephone of nearest relative Insurance information Driver’s license number
Manual billing Computerized billing
Once-a-month Cycle billing
Third-party payers Assignment of benefits ensures direct payment to the physician Minors can be billed if emancipated
remind patients of their obligation to pay obtain payment at the time of service Provide a billing statement
immediate payment Use charge slips or superbills Secure accurate information about the pt Inform pts of their responsibilities Outline all fees and finance charges to the pt Confirm if third-party responsibility exists
Be consistent in following office policies on billing Establish collection procedures as needed Follow up on all commitments made by pts
Pt is unable to pay pt does not understand the bill
Loss of revenue
1. What collection techniques do you think would be most effective, and why?
Personal interview Reminder notices placed on bills mailed to patients
Telephone calls Collection letters inserted with monthly statements Use of a collection agency
Never threaten Do not call the patient’s workplace Identify the person Never show anger Be honest
Do not harass Ask when payment should be expected and document Politely thank the patient
An individual who owes money but has moved and left no forwarding information
pt who files for bankruptcy is protected by the court all collection attempts must cease the medical office must file a claim for payment with the courts
Upon death, outstanding bill should be sent to the estate
aging accounts that are more than two or three years old, investigate the statute of limitations