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Ch 16 and 18


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Ch 16 and 18

  1. 1. UNIT 8: CH. 16 AND 18Billing and Payment for Medical Services
  2. 2. BOOKKEEPING PROCESS Recording the financial transactions of a business  Several methods: manual or computerized Bookkeeping is different than accounting Accuracy in bookkeeping is essential!
  3. 3. BASIC TERMINOLOGYAccounts receivable DaysheetAccounts payable PostingAccount or ledger BalanceDebit Debit balanceCredit Credit balanceAdjustment
  4. 4. POSTING PROCEDURES Charges are entered on the encounter form by the provider  Also called a superbill  List of procedures performed in that office Charges are recorded to the patient’s ledger  Record of all charges, payments, and adjustments
  6. 6. COMPUTERIZED SYSTEMS Function of practice management software  Electronic health records software can integrate with practice management software, eliminating the need for encounter forms Provides up-to-date financial information Charges can be entered into the practice management software by front office personnel or billing department
  7. 7. SINGLE-ENTRY BOOKKEEPING Similar to a checkbook register  Journal for each transaction is recorded in one column Revenue and expenses are totaled
  8. 8. DOUBLE-ENTRY BOOKKEEPING Each transaction is recorded in two columns  Includes both assets and liabilities  Allows for balance in the accounting equation Each debit has an each and opposite credit The total of all debits must equal the total of all credits
  9. 9. COMMUNICATING FEES The MA commonly answers patient questions about accounts Cost estimate sheets are used when fees are anticipated to be high Assisting patients in payment planning encourages compliance Discounts are authorized by the provider only
  10. 10. METHODS OF BILLING Monthly billing Cycle billing Computerized billing
  11. 11. PRACTICE MANAGEMENT SOFTWARE Billing and practice management software  Ability to post procedures and payments to patient accounts  Ability to generate encounter forms and claims  Ability to generate reports  Daily journal  Year to date  Aging account reports  Account history
  12. 12. PATIENT PAYMENTS At time of service (ATOS): best opportunity for collection
  13. 13. VERIFYING AND ACCEPTING CHECKS Check if valid and no corrections have been made When received stamp it with the office’s deposit endorsement Do not accept third party checks, unless from insurance company
  14. 14. POSTING PATIENT PAYMENTS Date of payment Payment amount Form of payment (cash, credit card, or check)
  15. 15. SPECIAL ADJUSTMENTS Nonsufficient funds Collection agency payments Credit balances and refunds
  16. 16. COLLECTIONS LAWS Truth in Lending Act Fair Debt Collection Practice Act Statute of limitations laws
  17. 17. STRATEGIES FOR COLLECTION Phone calls Letters Collection agencies