PowerPoint® to accompany
Medical Assisting
Chapter 17
Second Edition
Ramutkowski Booth Pugh Thompson Whicker
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
1
Patient Billing and Collections
Objectives:
171 Discuss the importance of accounts
receivable to a medical practice.
172 Explain how to accept and account for
payment from patients.
173 Prepare an invoice.
174 Manage a billing cycle efficiently
2
Patient Billing and Collections
Objectives (cont.)
175 Describe standard collection techniques.
176 Explain how to perform a credit check.
177 Identify credit arrangements.
178 Recognize common collection problems.
3
Introduction
Medical Assistants
will take on duties
that are
administrative in
nature
Customers have
various payment
options
Third party payers
(insurance carriers)
Payment plans
Some have large
outstanding balances
A proper understanding and administration of billing
as well as payment collection methods is required
4
Basic Accounting
Managing accounts
receivable (money
owed to the business)
and accounts payable.
Converts practice’s
account receivable
delete into readily
available income.
5
Standard Payment Procedures
Prefer to collect
payments from patients
at each office visit
Determine appropriate
fees
Relative Value Unit
(RVU)
Doctor’s skill and time
Professional liability
expenses
Overhead costs
This methodology has reduced the growth rate of spending for
doctors’ professional services, related services and supplies, and
other Medicare B services.
6
Processing Charge Slips
Charge slips are also called fee slip or
transaction slips
Numbered consecutively
Preprinted with common services and charges
Give each patient one when entering the
office that includes date and patient’s name.
7
Accepting Payment
As the patient leaves you
will ask for payment
Most practices accept:
cash
check
credit cards
insurance
8
Pegboard System
Each transaction on four different forms
Reduces errors and saves time
Called “onewrite” system
Uses lightweight board with pegs
Daily log sheets
Patient ledger card
Charge slips
Deposit slips
9
Determining Payment Responsibility
Third party – responsibility to pay
by insurance company
Minors – Parents or legal custody
Professional courtesy – doctor
charges for what the insurance will
pay or free
10
Standard Billing Procedures
Preparing Invoices
Using codes on the invoice
Using ledger cards
Generating computer invoice
Using independent billing
services
Sending invoices electronically
Prepare an invoice to mail to the patient who does not pay when
services are rendered or who makes only a partial payment.
11
Managing Billing Cycles
Cycle billing is a
common billing system
that bills each patient
only once a month but
spreads the work of
billing over the month.
Invoice groups of
patients every few days
12
Standard Collection Procedures
Statue of limitations – set time limit on when a
collection suit on a past due account can
legally be filed.
Open book account –open to charges made
occasionally
Written contract account – contract with
patient to pay over four installations
Single entry account account with only one
charge
13
Using Collection Techniques
Initial telephone calls
or letters
Do not call patients at
work or leave a
message on an
answering machine.
Call the patient at
home
14
Preparing Statements
A statement is an invoice that contains a
courteous reminder that payment is due.
Collection letter
60 days – nice but firm
90 days – stronger wording
120 days send a final letter about payment or
giving the account to a collection agency.
15
Preparing an Age Analysis
The process of classifying and reviewing
past due accounts by age from the first
date of billing.
List all patients account balances when the
charges originated.
Use patient ledger cards and color coded
tags to indicate the number of days past due.
Click for Sample
Age Analysis
16
Sample Age Analysis
Back
17
Laws of Debt Collection
Fair Debt Collection Practices Act of 1977
Do not call before 8 a.m. or after 9 p.m.
Do not make threats or use profane language.
Do not discuss patient’s debt with anyone else.
Do not use any form of deception or violence to
collect a debt.
Telephone Consumer Protection Act of 1991
Do not use an automated dialing device for calls
to patients.
18
Observing Professional
Guidelines
Appropriate to assess finances charges or late
charges on past due accounts if the patient is
notified in advance.
Must adhere to federal and state guidelines
that govern these charges.
The physician should use compassion and
discretion when assigning charges in hardship
cases.
19
Using Outside Collection Agencies
Select a collection agency to manage the
account.
Must be careful to avoid collection agencies
that use harsh or harassing collection
practices.
Give agency only needed information about
nonmedical information.
20
Performing a Credit Check
Employment Verification
Credit Bureau Reports – a company that
provides information about the credit
worthiness of a person seeking credit.
21
Laws Governing Credit
Equal Credit Opportunity Act
May not deny credit based on patient’s sex, race,
religion, national origin, martial status, or age.
Truth in Lending Act
Covers credit agreements that involve more than
four payments
Must sign, discuss, and retain copies of a
disclosure statement
22
Common Collection Problems
Hardship cases
Patients may be poor,
uninsured, or underinsured
Patient relocation and
address changes
Remember not to discuss a
debt with anyone except the
person responsible for the
charge
23
Apply Your Knowledge Answer
What is cycle billing ?
Cycle billing is a common billing system that bills
each patient only once a month but spreads the
work of billing over the month
24
Summary
Medical Assistant
Obtain payments by cash, check, or credit cards at
the time medical services are provided.
You may assign the fee for these services and collect
payment.
25