Payment type
cash, credit card, travelers checks, checks, debit card, money orders, cashiers check
Large Checks
Suspicious
When checks are suspicious or for large amounts, administrative assistants should call the issuing banks to ensure funds are available.
Payment in Full
When checks are marked "Payment in Full," administrative assistants should verify that the checks are for the full amount owed by the patient. When they are not, patients may later argue that no additional payment is required.
insufficient funds
When patients provide "bounced" or nonsufficient funds (NSF) checks, which are checks drawn on insufficient funds, most banks charge the medical office a fee. As a result, offices can legally charge patients a fee in return. Most banks redeposit NSF check
other types of payment
Health savings accounts (HSAs)
The Health Insurance Portability and Accountability Act (HIPAA) permits eligible individuals to establish a medical savings account (MSA).
Flexible spending accounts (FSA), also called healthcare reimbursement accounts (HCRA
Health Savings Aaccounts (HSAs)
personal savings accounts that can be used along with a high-deductible health plan to help pay for unreimbursed medical expenses. These accounts offer certain tax advantages to the individual in that the employee places pretax dollars into the savings ac
Medical Savings Account (MSA).
accounts may be used to pay for medical expenses along with a high-deductible health insurance plan. In order to be eligible for a medical savings account an individual must be employed by a small employer that provides a high-deductible health insurance
Flexible Spending Accounts (FSA), also called healthcare reimbursement accounts (HCRA)
allow individuals to set aside a portion of their pre-taxed wages to pay for certain out-of-pocket healthcare expenses. Money from flexible spending accounts can be used to pay for expenses not covered by health insurance such as:
- Deductible and copays
day sheet
The day sheet documents the charges for services and a payment received throughout the day, and is often an important part of the internal audit system. Once payment is collected, the medical administrative assistant records the information on the day she
Patient ledger cards
which carry information including patients' current and previous balances, are placed on the day sheet under superbills, also known as encounter forms.
Superbills or encounter forms
indicate the services performed for a patient on a given visit. The office staff writes patients' charges and payment information on the ledger card, being sure to press hard enough on the No Carbon Required (NCR) paper to impact all copies.
fee schedule
is the specific dollar amount to be charged by the provider for each service offered. Some managed care plans also dictate the type of specialist referrals those providers are allowed to make.
Omnibus Budget Reconciliation Act (OBRA),
In 1989, the U.S. Congress passed act in part to require that physician reimbursement for Medicare services be based on a fee schedule. Fee schedules set maximum amounts for services using the resource-based relative value scale (RBRVS),
resource-based relative value scale (RBRVS)
designed to reduce Medicare costs and establish a national standard for physician payment. This national standard is itself based on the Current Procedural Coding (CPT�) codes used for patient visits.
Medicare service fees are calculated based on the following factors:
Physician's location
Intensity of the service
Time needed for the service
Skills needed to perform the service
Practice's overhead
Practice's malpractice premiums
geographical practice cost index (GPCI)
Physician's fees are adjusted according to a GPCI, which factors in the differing healthcare costs across the United States. Together, these factors determine a healthcare provider's relative value unit (RVU). The RVU was devised by the Centers for Medica
provider's relative value unit (RVU)
Each year, Medicare assigns a national conversion factor that is added to the RVU. The national conversion factor is a number released by Medicare each year that determines fee schedules for all healthcare services. The national conversion factor is multi
Deductable
a monetary amount patients must pay to the provider for healthcare services before health insurance benefits begin to pay.
Copayments
are set dollar amounts that patients pay at the time of service (after deductable met)
Coinsurance
is a set percentage of charges that patients pay ie 80/20
adjustment
difference between actual charge and the allowed amount.
balance billing
when the provider is not participating or contracted with an insurance company, the patient is responsible for the entire balance not covered by insurance.
accounts receivables (AR)
the money owed the office from all sources, including patients, insurance companies, worker's compensation, Medicare, and Medicaid.
Aging Reports (AR management)
entails documenting how much money is owed the office, by whom, and for how long, must be done regularly and thoroughly.
cash discount
If a patient does not have insurance, a healthcare provider may offer an incentive for the patient to pay their bill in full on the day of their visit.
overdue bill
Traditionally, providers expect patients, businesses, and organizations to pay bills within 30 days.
tickler file
a tool for tracking future events, such as patient appointments. It serves as a reminder and facilitates follow-up should payment fail to arrive when expected.
withdrawal letter
When patients are chronically late with payments or refuse to pay at all, providers can dismiss them from care via certified letter. Providers must give patients at least 30 days to receive care, but after that period providers are no longer bound to prov
hardship
when patients cannot pay their bills and physicians agree to treat them for lesser or no fees, those patients must sign and date hardship agreement letters for their file. Hardship letters should contain language such as, "Due to my financial hardship, Dr
professional courtesy
Physicians who treat other physicians for free or at greatly reduced fees
Collection agencies
are companies that pursue overdue accounts for a fee. Such agencies must also abide by federal guidelines for debt collection. The Fair Debt Collection Act was enacted to eliminate abusive, deceptive, and unfair collection practices. This law applies to a
The Fair Debt Collection Act dictates that medical offices must:
Threaten to only take action that is legal or intended to come to fruition
Accurately represent themselves and the amounts patients owe.
Make collection calls before 9:00 pm or after 8:00 am unless directed by patients.
Stop calling about accounts upon pa
write off
remove a balance from, accounts deemed uncollectible to maintain patient relations. copies of write off stays with patients file