Financial Recordkeep

Question Answer
What is a fee-schedule? List of services and costs.
What is a Relative Value Unit? RVU; numeric value assigned to services by CMS
What does CMS stand for? Center for Medicare and Medicaid Services
Can RVUs change? Yes, by geographical location
Why do RVUs change? They take into account the cost of malpractice insurance
What is a write-off? A subtraction of a patients balance
What is a Professional Courtesy? A discount for a physicians colleagues, family, and/or friends
What is EOB? Explanation of Benefits
What is Statute of Limitations? The length of time a healthcare debt can be pursued
How long is Michigan's statute of limitations? 6 years
What is the Red Flag Rule? An extension of credit to patients
What is needed to verify a patients identification? Drivers license and the front/back of insurance card(s)
What are collection agencies? Agencies that pursue overdue accounts for a fee.
When making a collection call you MUST: 1. call from a private location
2. call between 8a-9p
3. verify patients identity
4. be respectful, polite, and professional
5. indicate the reason for the call
6. keep to the point
7. document every conversation
8. follow up on a patients promise
What you should NOT do during a collection call: 1. call from a public location
2. call a patient that has told you not to call
3. speak to anyone but the patient
4. become angry
5. make threats
6. call repeatedly and harass patient
7. neglect to document conversation
8. make promises
Most effective way to collect payment is… face-to-face
What is Fair Debt Collection Practices? the act that was enacted to eliminate abusive and unfair collection practices
What is Accounts Receivable? money owed to the medical office from all sources
What is an Aging Report? document that indicates the amount of money owed to the office and for how long its been owed
What do Computerized Billing Systems do? allow for payment posting
Patients are responsible for… co-insurance, deductibles and co-payments
What is co-insurance? portion of cost of services
Co-insurance, deductibles, and co-payments are considered… out of pocket expenses
HIPAA Health Insurance Portability and Accountability Act; passed by Congress in 1996, this law addresses patient privacy and insurance carrier rules
HIPAA requires a patients statement to be sent in what? a security envelope to protect patient privacy
What is a Certified Letter? requires the recipients signature of receipt
What must an office do when a patients balance has been "forgiven"? send a forgiveness letter indicating the write-off
What is a Tickler-File? a follow-up reminder service
What do Community property laws do? protect patient spouses from having to pay the bills; this occurs in ALL states

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