English

14

PATIENT BILLING

AND COLLECTIONS

Ste p 1

KEY TERMS

ep

10

ep

Establish

financial

responsibility

St

Follow up

payments

and collections

p2

3

Step

9

Generate

patient

statements

Check in

patients

Monitor

payer

adjudication

S te

Review coding

compliance

p8

Prepare and

transmit claims

Ste

p7

Check out

patients

Review billing

compliance

Ste

p5

Ste p 6

Learning Outcomes

After studying this chapter, you should be able to:

14.1 Explain the structure of a typical financial policy.

14.2 Describe the purpose and content of patients’ statements and

14.3 Compare individual patient billing and guarantor billing.

14.4 Classify the responsibilities for each position that is typically part

of billing and collections.

outstanding balances.

14.6 Name the two federal laws that govern credit arrangements.

14.7 Discuss the tools that can be used to locate unresponsive or

missing patients.

14.8 Describe the procedures for clearing uncollectible balances.

14.9 Analyze the purpose of a retention schedule.

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the procedures for working with them.

14.5 Describe the processes and methods used to collect

460

p4

Medical Billing Cycle

Ste

bad debt

bankruptcy

collection agency

collection ratio

collections

collections specialist

credit bureaus

credit reporting

cycle billing

day sheet

embezzlement

Equal Credit Opportunity Act (ECOA)

Fair and Accurate Credit Transaction Act (FACTA)

Fair Credit Reporting Act (FCRA)

Fair Debt Collection Practices Act (FDCPA)

of 1977

guarantor billing

means test

nonsufficient fund (NSF) check

patient aging report

patient refunds

patient statement

payment plan

prepayment plan

retention schedule

skip trace

Telephone Consumer Protection Act of 1991

Truth in Lending Act

uncollectible accounts

St

Preregister

patients

Ste

“Patients are responsible for payment of...