11Fees, Billing, Fees, Billing, Collections, and Collections, and CreditCreditLesson 1:Lesson 1:Fees, Billing, Collections, Fees, Billing, Collections, and Creditand Credit

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.

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.

1. How do physicians set their fees?

2. What factors might they consider?

Services

Time

Going rate

Usual fee

Customary

Reasonable fee

Inform prior to first appointment

Info. should include costs, office policies, and credit procedures

Via Phone and mailPost fees in the office

Collect $ at the time of the service

Billcollection agency

to bill the insurance carrier on behalf of the pt

permission to forward info to the ins. company

placed in file and updated annually

View pearson’s DVDChp. 15

Fees, billing, collections, credit

charge slip or statement or insurance reporting form

Two- or three-part carbonized form

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

View pearson’s DVD◦ Chp 19

Insurance coding

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

Manual billing Computerized billing

Once-a-month

Cycle billing

Third-party payers

Assignment of benefits ensures direct payment to the physician

Minors can be billed if emancipated

remind patients of their obligation to pay

obtain payment at the time of service

Provide a billing statement

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

Be consistent in following office policies on billing

Establish collection procedures as needed

Follow up on all commitments made by pts

Pt is unable to pay

pt does not understand the bill

Loss of revenue

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

Personal interview

Reminder notices placed on bills mailed to patients

Telephone calls Collection letters inserted with monthly statements

Use of a collection agency

Never threaten Do not call the patient’s workplace

Identify the personNever show anger Be honest

Do not harass

Ask when payment should be expected and document

Politely thank the patient

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

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

Upon death, outstanding bill should be sent to the estate

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