Kinns chapter 18


Terms in this set (...)

recording, classifying, summarizing financial transactions -- summarizes activities of bookkeeping
Stark Law --- professional curtesy
eliminates fraud for treating friends / family medical care -- anti-kickback statute
Truth In Lending Act (TILA)
annual % rate , terms of the loan, total costs to borrower
when is a TILA needed / not needed?
need -- charging a % rate, more than 4 payments will be made to provider, when extending credit to a patient

not needed -- no interest, less than 4 payments will be made to provider
what 2 things can decrease what is owed to the provider?
credit balances
when is a final letter required before the account is sent to a collection agency?
90-120 days delinquent -- final letter with date of payment due before sent to collections (certified letter)
what is the most professional / effective collection strategy?
a professional phone call -- appropriate time and manner.
what is forbidden by law when tracing "SKIPS"?
to communicate with third party more than once -- unless the third party states that you may contact them again.
what is not required when sending claims to SMALL CLAIMS COURT?
attorney and a lot of money
what happens when a patient writes a check that does not clear the bank?
nonsufficient funds check -- add a charge line to the patients record and reverse the posted payment
Accounts Recievable
money that is owed to you (money that the office expects to receive but hasn't yet)
Accounts Payable
bills accrued from the office (salaries, invoices, mortgage/rent)
what is the best use of an interest bearing account?
To leave the money in the account as long as possible in order to accrue the most interest as possible for the dollar amount.
who does the bank charge for a check that was returned due to insufficient funds?
the practices bank account -- the last endorser of the check
when does an MA have to decide where the bill for a patient goes?
STD, pregnancy, BC -- Minors
in writting - 2 copies with witness signature, time frame of discount applied
Patient account record should include....
name and address of the guarantor
insurance ID information
home & business phone #'s
name of employer
any special instructions for billing
emergency contact info -- alternative contact information
third party payments equation --
Total charge = insurance payment amount + amount adjusted + patient responsibility / secondary insurance responsibility
the returned payment made to the insurance company or patient for over payment on patient account
Advance Beneficiary of Noncoverage (ABN)
gives options of what you want to do if medicare might not cover procedure
releases liability from medicare
rules for telephone collections
DO -- call only between 8am-9pm, only done in private and in a respectful mannor

DO NOT -- call between 9pm-8am , do not call more than once in a day
making the decision to sue
patient can afford to pay but is not
provider can produce office records that support the bill
provider can justify the price of the services with other doctors charges
the patients general condition after procedure is satisfacactory
Managing funds in the healthcare facility
how much money was earned, collected, owed, and distribution of all operational expenses
types of collections
sue -- 100% loss (warned before sued)
send to collection agency
write off loss
when reducing fee
do without prejudice, not because of poor result or to avoid the use of a collection agency