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

10-2 © 2009 by The McGraw-Hill Companies, Inc. All rights reserved. McGraw-Hill Career Education 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

10-3 © 2009 by The McGraw-Hill Companies, Inc. All rights reserved. McGraw-Hill Career Education Patient Collection Process  Financial policy spells out how the practice handles  Colleting copayments  Collecting prepayment  Overdue accounts  Payment plans  Payment for services not covered by insurance  Charity cases

10-4 © 2009 by The McGraw-Hill Companies, Inc. All rights reserved. McGraw-Hill Career Education Laws Governing Collections  Patient collections regulated by federal and state laws  Insurance collections considered business collections

10-5 © 2009 by The McGraw-Hill Companies, Inc. All rights reserved. McGraw-Hill Career Education Laws Regulating Patient Collections  Fair Debt Collection Practices Act of 1977  Telephone Consumer Protection Act of 1991  General guidelines  No calls before 8 am or after 9 pm  No threats or profane language  Respect patient privacy  No deception or violence

10-6 © 2009 by The McGraw-Hill Companies, Inc. All rights reserved. McGraw-Hill Career Education Collection Agencies  Used by some practices to collect on large overdue accounts  Once account is turned over to collection agency, the billing specialist no longer contacts the patient  Usually paid on the basis of what they collect

10-7 © 2009 by The McGraw-Hill Companies, Inc. All rights reserved. McGraw-Hill Career Education Payment Plans  Agreement between a patient and the practice  Patient makes regular payments over a specific period of time  Finance charges may be applied

10-8 © 2009 by The McGraw-Hill Companies, Inc. All rights reserved. McGraw-Hill Career Education Uncollectible Accounts  If collection attempts are exhausted, practice may write-off debt  Amount owed is known as uncollectible debt, or bad debt  Medicare and Medicaid forbid the write- off of certain debts, unless a set of rigid steps has been followed

10-9 © 2009 by The McGraw-Hill Companies, Inc. All rights reserved. McGraw-Hill Career Education Laws Regulating Insurance Claims  Most states have prompt payment laws  Mandate a time period within which clean claims must be paid or financial penalties may be levied

10-10 © 2009 by The McGraw-Hill Companies, Inc. All rights reserved. McGraw-Hill Career Education Collection Activities in a Practice Management Program  Aging report provides information on status of patient accounts  Current 0-30  days overdue  days overdue  91+ days overdue

10-11 © 2009 by The McGraw-Hill Companies, Inc. All rights reserved. McGraw-Hill Career Education Collection Activities in a Practice Management Program  To create collection letters 1.Patient responsible tickler must be added to Collection List 2.Collection Letter report must be created

10-12 © 2009 by The McGraw-Hill Companies, Inc. All rights reserved. McGraw-Hill Career Education Collection Activities in a Practice Management Program  Collection List  Tracks activities on overdue accounts  Ticklers

10-13 © 2009 by The McGraw-Hill Companies, Inc. All rights reserved. McGraw-Hill Career Education Collection Activities in a Practice Management Program  Tickler Item dialog box Tickler Tab Office Notes Tab

10-14 © 2009 by The McGraw-Hill Companies, Inc. All rights reserved. McGraw-Hill Career Education Collection Activities in a Practice Management Program  Patient Collection Report  Lists status, responsible party, chart number, balance owed, and important dates  Option to print collection letters appears after Collection Letter Report is closed

10-15 © 2009 by The McGraw-Hill Companies, Inc. All rights reserved. McGraw-Hill Career Education Collection Activities in a Practice Management Program  Collection Letters  If a collection letter has been sent, an account alert appears in several Medisoft dialog boxes: Transaction EntryTransaction Entry Appointment EntryAppointment Entry Quick LedgerQuick Ledger

10-16 © 2009 by The McGraw-Hill Companies, Inc. All rights reserved. McGraw-Hill Career Education Collection Activities in a Practice Management Program  Collection Letters  Account alerts include: IC – in collectionsIC – in collections RB – remainder balanceRB – remainder balance DP – delinquent on payment planDP – delinquent on payment plan

10-17 © 2009 by The McGraw-Hill Companies, Inc. All rights reserved. McGraw-Hill Career Education Collection Activities in a Practice Management Program  Collection Tracer Report  Used to follow-up on collection letters that were sent  Lists responsible party, chart number, balance owed, date letter sent, and reason account is in collections