computers in the medical office

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McGraw-Hill Career Education © 2009 by The McGraw-Hill Companies, Inc. All rights reserved. Chapter 10: Chapter 10: Collections in the Medical Collections in the Medical Office Office Computers in Computers in the Medical Office the Medical Office

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Computers in the Medical Office. Chapter 10: Collections in the Medical Office. Importance of Collections. Patients are paying a greater share of their medical bills Not all patients pay on time Practices must collect monies owed in a timely manner to maintain cash flow. - PowerPoint PPT Presentation

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Page 1: Computers in the Medical Office

McGraw-Hill Career Education

© 2009 by The McGraw-Hill Companies, Inc. All rights reserved.

Chapter 10:Chapter 10:Collections in the Medical OfficeCollections in the Medical Office

Computers inComputers inthe Medical Officethe Medical Office

Page 2: Computers in the Medical Office

10-10-22

McGraw-Hill Career Education

© 2009 by The McGraw-Hill Companies, Inc. All rights reserved.

Importance of CollectionsImportance of Collections

Patients are paying a greater share of Patients are paying a greater share of their medical billstheir medical bills

Not all patients pay on timeNot all patients pay on timePractices must collect monies owed in Practices must collect monies owed in

a timely manner to maintain cash flowa timely manner to maintain cash flow

Page 3: Computers in the Medical Office

10-10-33

McGraw-Hill Career Education

© 2009 by The McGraw-Hill Companies, Inc. All rights reserved.

Patient Collection ProcessPatient Collection Process

Financial policy spells out how the Financial policy spells out how the practice handlespractice handles Colleting copaymentsColleting copayments Collecting prepayment Collecting prepayment Overdue accountsOverdue accounts Payment plansPayment plans Payment for services not covered by Payment for services not covered by

insuranceinsurance Charity casesCharity cases

Page 4: Computers in the Medical Office

10-10-44

McGraw-Hill Career Education

© 2009 by The McGraw-Hill Companies, Inc. All rights reserved.

Laws Governing CollectionsLaws Governing Collections

Patient collections regulated by federal Patient collections regulated by federal and state lawsand state laws

Insurance collections considered Insurance collections considered business collectionsbusiness collections

Page 5: Computers in the Medical Office

10-10-55

McGraw-Hill Career Education

© 2009 by The McGraw-Hill Companies, Inc. All rights reserved.

Laws Regulating Patient CollectionsLaws Regulating Patient Collections

Fair Debt Collection Practices Act of Fair Debt Collection Practices Act of 19771977

Telephone Consumer Protection Act of Telephone Consumer Protection Act of 19911991

General guidelinesGeneral guidelines No calls before 8 am or after 9 pmNo calls before 8 am or after 9 pm No threats or profane languageNo threats or profane language Respect patient privacyRespect patient privacy No deception or violenceNo deception or violence

Page 6: Computers in the Medical Office

10-10-66

McGraw-Hill Career Education

© 2009 by The McGraw-Hill Companies, Inc. All rights reserved.

Collection AgenciesCollection Agencies

Used by some practices to collect on Used by some practices to collect on large overdue accountslarge overdue accounts

Once account is turned over to Once account is turned over to collection agency, the billing specialist collection agency, the billing specialist no longer contacts the patientno longer contacts the patient

Usually paid on the basis of what they Usually paid on the basis of what they collectcollect

Page 7: Computers in the Medical Office

10-10-77

McGraw-Hill Career Education

© 2009 by The McGraw-Hill Companies, Inc. All rights reserved.

Payment PlansPayment Plans

Agreement between a patient and the Agreement between a patient and the practicepractice Patient makes regular payments over a Patient makes regular payments over a

specific period of timespecific period of time Finance charges may be appliedFinance charges may be applied

Page 8: Computers in the Medical Office

10-10-88

McGraw-Hill Career Education

© 2009 by The McGraw-Hill Companies, Inc. All rights reserved.

Uncollectible AccountsUncollectible Accounts

If collection attempts are exhausted, If collection attempts are exhausted, practice may write-off debtpractice may write-off debt

Amount owed is known as uncollectible Amount owed is known as uncollectible debt, or bad debtdebt, or bad debt

Medicare and Medicaid forbid the write-Medicare and Medicaid forbid the write-off of certain debts, unless a set of rigid off of certain debts, unless a set of rigid steps has been followedsteps has been followed

Page 9: Computers in the Medical Office

10-10-99

McGraw-Hill Career Education

© 2009 by The McGraw-Hill Companies, Inc. All rights reserved.

Laws Regulating Insurance ClaimsLaws Regulating Insurance Claims

Most states have prompt payment lawsMost states have prompt payment laws Mandate a time period within which clean Mandate a time period within which clean

claims must be paid or financial penalties claims must be paid or financial penalties may be leviedmay be levied

Page 10: Computers in the Medical Office

10-10-1010

McGraw-Hill Career Education

© 2009 by The McGraw-Hill Companies, Inc. All rights reserved.

Collection Activities in aCollection Activities in aPractice Management ProgramPractice Management Program

Aging report provides information on Aging report provides information on status of patient accountsstatus of patient accounts Current 0-30Current 0-30 31-60 days overdue31-60 days overdue 61-90 days overdue61-90 days overdue 91+ days overdue91+ days overdue

Page 11: Computers in the Medical Office

10-10-1111

McGraw-Hill Career Education

© 2009 by The McGraw-Hill Companies, Inc. All rights reserved.

Collection Activities in aCollection Activities in aPractice Management ProgramPractice Management Program

To create collection lettersTo create collection letters1.1. Patient responsible tickler must be added Patient responsible tickler must be added

to Collection Listto Collection List

2.2. Collection Letter report must be createdCollection Letter report must be created

Page 12: Computers in the Medical Office

10-10-1212

McGraw-Hill Career Education

© 2009 by The McGraw-Hill Companies, Inc. All rights reserved.

Collection Activities in aCollection Activities in aPractice Management ProgramPractice Management Program

Collection ListCollection List Tracks activities on overdue accountsTracks activities on overdue accounts TicklersTicklers

Page 13: Computers in the Medical Office

10-10-1313

McGraw-Hill Career Education

© 2009 by The McGraw-Hill Companies, Inc. All rights reserved.

Collection Activities in aCollection Activities in aPractice Management ProgramPractice Management Program

Tickler Item dialog boxTickler Item dialog box

Tickler TabTickler Tab Office Notes TabOffice Notes Tab

Page 14: Computers in the Medical Office

10-10-1414

McGraw-Hill Career Education

© 2009 by The McGraw-Hill Companies, Inc. All rights reserved.

Collection Activities in aCollection Activities in aPractice Management ProgramPractice Management Program

Patient Collection ReportPatient Collection Report Lists status, responsible party, chart Lists status, responsible party, chart

number, balance owed, and important number, balance owed, and important datesdates

Option to print collection letters appears Option to print collection letters appears after Collection Letter Report is closedafter Collection Letter Report is closed

Page 15: Computers in the Medical Office

10-10-1515

McGraw-Hill Career Education

© 2009 by The McGraw-Hill Companies, Inc. All rights reserved.

Collection Activities in aCollection Activities in aPractice Management ProgramPractice Management Program

Collection LettersCollection Letters If a collection letter has been sent, an If a collection letter has been sent, an

account alert appears in several Medisoft account alert appears in several Medisoft dialog boxes:dialog boxes:• Transaction EntryTransaction Entry• Appointment EntryAppointment Entry• Quick LedgerQuick Ledger

Page 16: Computers in the Medical Office

10-10-1616

McGraw-Hill Career Education

© 2009 by The McGraw-Hill Companies, Inc. All rights reserved.

Collection Activities in aCollection Activities in aPractice Management ProgramPractice Management Program

Collection LettersCollection Letters Account alerts include:Account alerts include:• IC – in collectionsIC – in collections• RB – remainder balanceRB – remainder balance• DP – delinquent on payment planDP – delinquent on payment plan

Page 17: Computers in the Medical Office

10-10-1717

McGraw-Hill Career Education

© 2009 by The McGraw-Hill Companies, Inc. All rights reserved.

Collection Activities in aCollection Activities in aPractice Management ProgramPractice Management Program

Collection Tracer ReportCollection Tracer Report Used to follow-up on collection letters Used to follow-up on collection letters

that were sentthat were sent Lists responsible party, chart number, Lists responsible party, chart number,

balance owed, date letter sent, and balance owed, date letter sent, and reason account is in collectionsreason account is in collections