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The learning objectives for this chapter include: Describe accounts receivable and accounts payable and the common payment methods accepted in medical practices today; identify the different types of documents used as statements to bill patients and how these documents are used in cycle billing; compare open book, writtencontract, and singleentry accounts, and purpose of creating an accounts receivable aging;...
CHAPTER 20 Patient Billing and Collection 20-2 Learning Outcomes (cont.) 20.1 Describe accounts receivable and accounts payable and the common payment methods accepted in medical practices today 20.2 Identify the different types of documents used as statements to bill patients and how these documents are used in cycle billing 20.3 Compare open book, written-contract, and singleentry accounts, and purpose of creating an accounts receivable aging 20-3 Learning Outcomes (cont.) 20.4 Explain the purposes of the following credit and collections acts: ECOA, FCRA, and FDCPA, and TLA 20.5 Relate the required components of a Truth in Lending statement 20.6 Summarize two common types of problem collection accounts in the medical office 20-4 Introduction • Payment arrangements – Third-party payers – Balance billing – Payment plans – Outstanding balances • You must understand and administer billing as well as payment collection methods 20-5 Patient Payments in the Office • Management of – Accounts receivable (A/R) – Accounts payable (A/P) • Billing and collections – vital tasks • Copayment – immediate collection 20-6 Accepting Patient Payment • Enter charges for services provided • Most practices accept – – – – Cash Check Credit cards Insurance For today’s visit, the total charge is $50 How would you like to pay? 20-7 Accepting Patient Payment (cont.) • Cash – Count money carefully – Record payment – Give patient a receipt • Check – Check id – Check date and amount – Endorse it immediately • Debit card – Immediate transfer of funds – Processed like credit card 20-8 Accepting Patient Payment (cont.) • Credit card – Check expiration date – Keep signed receipt, give patient a copy – Transaction fee ~ adjust patient account – On-line payments 20-9 Payment Responsibility • Guarantor • Minors – Parents or person with legal custody – Emancipated minor – Divorce • Elderly patients and patients with disabilities – Consent – Proof of guardianship 20-10 Payment Responsibility (cont.) • Professional courtesy – Waived charges or accept amount that the insurance pays – Must collect copayments 20-28 Apply Your Knowledge What law governs the methods that can be used to collect unpaid debts? ANSWER: The Fair Debt Collection Practices Act of 1977 Right! 20-29 Credit Arrangements • Credit – extended by physician • Equal Credit Opportunity Act – Reasons for not denying credit – Must tell patient why credit was denied – Perform a credit check 20-30 Credit Arrangements (cont.) • Performing a credit check – Verify employment – Credit bureau report • Creditworthiness of person seeking credit • Payment history • Fair Credit Reporting Act 20-31 Credit Arrangements (cont.) • Unilateral Agreement – Physician agrees to patient offer – Not subject to Truth in Lending Act • Mutual Agreement – Between patient and physician – Subject to Truth in Lending Act • Finance charges • More than four payments 20-32 Truth in Lending Act • Consumer Credit Protection Act • Credit agreements of more than four payments • The practice must – Discuss agreement with patient – Sign and retain disclosure statement 20-33 Truth in Lending Act (cont.) • Disclosure statement – Truth in Lending Statement – Agreement on payment terms • • • • Total amount of debt Down payment and payment amount Final due date Interest rate and total finance charges 20-34 Apply Your Knowledge Excellent! Match: ANSWER: C Credit cannot be denied based on sex, race, religion, etc B Provides a credit history D Not regulated by the Truth in Lending Act F Bilateral agreement between the patient and physician E Covers credit agreements of more than four payments A Description of agreed terms of payment A Disclosure statement B Credit bureau C Equal Credit Opportunity Act D Unilateral agreement E Truth in Lending Act F Mutual agreement 20-35 Common Collection Problems • Hardship cases – ECOA – all patients in the same circumstances must be afforded the same consideration – May refer to clinics that provide free or reduced-fee services 20-36 Common Collection Problems (cont.) • Patient relocation and address changes – Skips – Telephone or e-mail – Ask post office for forwarding address – Keep all returned statements and envelopes as proof of reasonable attempts to collect 20-37 Apply Your Knowledge What is a “skip”? ANSWER: A patient who moves without leaving a forwarding address to which the office can sent a statement of unpaid charges Yes Yes! 20-38 In Summary 20.1 Accounts Receivable refers to the money that is owed to the practice Accounts Payable refers to the money that the practice owes other vendors Common payment methods include cash, check, and debit and credit cards 20.2 Common statement documents include the use of superbills, typed or computer-produced itemized statements, and copies of ledger cards In cycle billing the accounts are split in groups and statement mailing dates are staggered 20-39 In Summary (cont.) 20.3 An open-book account consists of periodic charges and payments added as needed when patients are seen in the practice A written-contract account is used when the physician and patient sign a contract for a specific service or procedure A single-entry account is one used for patients when it is expected they will be seen only once, such as for a relative visiting the area on vacation An age analysis is the process of classifying and reviewing past-due accounts by age from the first date of billing 20-40 In Summary (cont.) 20.4 ECOA is the Equal Credit Opportunity Act It prohibits discrimination against loan applicants The Fair Credit Reporting Act (FCRA) requires credit bureaus supply correct and complete information to businesses to use in evaluating a person’s application for credit, insurance, or a job The Fair Debt Collections Practices Act or FDCPA requires debt collectors to treat debtors fairly and prohibits certain collection tactics The Truth in Lending Act requires creditors to provide applicants with accurate and complete credit costs and terms 20-41 In Summary (cont.) 20.5 The Truth in Lending Statement must include the following elements: amount of total debt, amount of the down payment, amount of each payment and date due, due date for the final payment, interest rate, expressed as an annual percentage rate, and total finance charges 20.6 The two most common types of collection problems in the medical office are hardship cases, who simply cannot afford to pay their debt, and accounts known as skips, where the debtor moved and left no valid forwarding information so it is not possible to bill the patient 20-42 End of Chapter 20 Remember that credit is money ~ Benjamin Franklin ... medical practice 20- 12 Standard Billing Procedures • Preparing statements – Practice contact information – Patient name and address – Guarantor’s name – Balance – Itemized list of services and. .. due 20- 13 Standard Billing Procedures (cont.) • Manual statements • Ledger card • Computer generated statements • Independent billing service • Superbill 20- 14 Managing Billing Cycles • Cycle billing. .. patients are billed every few days It spreads the work of billing over the month Excellent! 20- 16 Standard Collection Procedures • Collection of payment is guided by – Laws – Professional standards