1. 1 1 Fees, Billing, Collections, and Credit Lesson 1: Fees, Billing, Collections, and Credit

2. Lesson Objectives Upon completion of this lesson, students should be able to …  Discuss how fees are determined and be able to discuss this with patients.  Describe the various billing methods and preparation of billing statements.  Identify the patient information required at the time of registration and thereafter to maintain the records needed for billing.

3. Lesson Objectives  Explain credit policy.  List the steps in the collection process and identify the legalities involved.  List the benefits of using electronic medical records.

4. 1. How do physicians set their fees? 2. What factors might they consider?

5.  Services  Time  Going rate

6.  Usual fee  Customary  Reasonable fee

7.  Inform prior to first appointment  Info. should include costs, office policies, and credit procedures  Via Phone and mail  Post fees in the office

8.  Collect $ at the time of the service  Bill  collection agency

9.  to bill the insurance carrier on behalf of the pt  permission to forward info to the ins. company  placed in file and updated annually

10. View pearson’s DVD Chp. 15 Fees, billing, collections, credit

11.  charge slip or  statement or  insurance reporting form  Two- or three- part carbonized form

12.  comprehensive list of pt services w/ codes and fees  one is attached to the chart. The physician marks the services provided.  A copy is then provided to the patient  used to report services to the ins. carrier

14.  View pearson’s DVD ◦ Chp 19  Insurance coding

15. Be sure and update this information every 6 to 12 months.  name of patient  Date of birth  address (no PO Box)  Telephone numbers  Address and telephone of nearest relative  Insurance information  Driver’s license number

16.  Manual billing  Computerized billing

17.  Once-a-month  Cycle billing

18.  Third-party payers  Assignment of benefits ensures direct payment to the physician  Minors can be billed if emancipated

19.  remind patients of their obligation to pay  obtain payment at the time of service  Provide a billing statement

21.  immediate payment  Use charge slips or superbills  Secure accurate information about the pt  Inform pts of their responsibilities  Outline all fees and finance charges to the pt  Confirm if third-party responsibility exists

22.  Be consistent in following office policies on billing  Establish collection procedures as needed  Follow up on all commitments made by pts

23.  Pt is unable to pay  pt does not understand the bill

24.  Loss of revenue

25. 1. What collection techniques do you think would be most effective, and why?

26.  Personal interview  Reminder notices placed on bills mailed to patients

27.  Telephone calls  Collection letters inserted with monthly statements  Use of a collection agency

28.  Never threaten  Do not call the patient’s workplace  Identify the person  Never show anger  Be honest

29.  Do not harass  Ask when payment should be expected and document  Politely thank the patient

30.  An individual who owes money but has moved and left no forwarding information

32.  pt who files for bankruptcy is protected by the court  all collection attempts must cease  the medical office must file a claim for payment with the courts

33.  Upon death, outstanding bill should be sent to the estate

34.  aging accounts that are more than two or three years old, investigate the statute of limitations