1. Comprehensive Medical Assisting, 3rd Ed Part II: The Administrative Medical Assistant Unit Three: Managing the Finances in the Practice Chapter 11 – Credit and Collections

2. Fees Fee Schedules Set by the physician
UCR – usual, customary, and reasonable
RBRVS – resource-based relative value scale
Vary with reimbursement schedules
Each payer has its own
Vary with participation status
Medicare schedule
Participating, nonparticipating, or limiting

3. Sample Medicare Fee Schedule

4. Fees Discussing Fees in Advance
Inform the patient of costs and payment policies
Identify the payer; determine whether the physician participates
With a new patient, establish identity and creditworthiness

5. Fees Forms of payment Insurance company Cash
Personal check – get two forms of ID
Credit or debit card – the company charges, but payment is prompt and risk is transferred
Insurance company
Largest portion of revenue
Check the insurance card at each visit
Copy both sides of the card and keep the copies in the chart

6. A discount or adjustment is not a write-off.
Fees
Adjusting fees – Always show the office’s full fee with any discount as a credit
Insurer's discount
Show the difference between full and insurer's rates as a credit
Professional courtesy
Show the amount as a credit
Full payment discount
Show the percentage as a credit
A discount or adjustment is not a write-off.

7. Credit Extending Credit Legal Considerations
Credit cost – About $8/month
Credit source – In-house or third-party financing
Legal Considerations
Interest and charges are legal but must be disclosed
Discrimination is not permitted

8. Collections Monthly Billings Aging Accounts
Keep schedule consistent; change requires notice
Include the previous balance, payments (by patient or third party), and the current balance
Installment billing includes the current amount due
Aging Accounts
Age runs from billing, not service
Measures general collection efficiency
80% of fees should be collected within 30 days
Flags overdue accounts

9. Manual Aging Schedule

10. Computerized Aging Schedule

11. Collections Collecting Overdue Accounts
Mailed notice – Overdue stamp or
– Form letter
Telephone call – Document the call
– Be careful in leaving messages
In-office reminder – It’s not a concern if you don’t
make it a concern
Third parties – Collection agency
– Small claims court

12. End of Presentation