Deck 22: Professional Fees, Billing, and Collecting

Question 1

One of the most valuable tools for tracing skips is the Internet.

Answer 1

True

Question 2

Giving a patient an encounter form is not a billing procedure.

Answer 2

False

Question 3

When accounts are grouped together according to the length of time they have been open or held a balance, the process is called aging the accounts receivable.

Answer 3

True

Question 4

When a patient is classified as a "skip," the office should wait 1 month before initiating collection efforts.

Question 5

Repeated telephone collection calls are acceptable if the patient owes a balance.

Question 6

Patients appreciate discussion of fees before a procedure is performed.

Question 7

The physician is the only person who should sign collection letters.

Question 8

The medical assistant does not need to know anything about outside credit services for which patients can apply.

Question 9

A credit balance exists when a patient has overpaid.

Question 10

The Fair Debt Collection Practices Act requires that debt collectors act fairly in their collection efforts and places restrictions on how and when a patient can be contacted.

Question 11

The medical assistant cannot sign a collection letter; the physician's name must be the signature at the bottom.

Question 12

A physician's fee profile is used in determining the amount of third-party liability for services under the contracted program.

Question 13

Most physicians prefer that patients pay at the time of service.

Question 14

The staff of the physician's office is not responsible for discussing additional fees the patient might incur.

Question 15

Physicians usually refuse to allow patients to arrange to make more than four payments on an account.

Question 16

The guarantor is not always the patient.

Question 17

All payments that come to the office after an account has been placed with a collection agency must be accepted and added to the patient's account.

Question 18

Credit information is not as confidential as patient medical information.

Question 19

In the physician's office, the accounts payable is the amount of money that all patients owe the physician.

Question 20

If a patient can pay a medical bill without incurring hardship but still refuses to pay, litigation to collect is acceptable.

Question 21

It is not recommended that physicians charge for the following situations except:

A)late payments
B)no-show appointments
C)emergency walk-ins
D)telephone consultations

Question 22

What information is gathered to determine an individual physician's fee profile?

A)The economic status of his or her patients
B)The physician's actual charges over a given period
C)The type of specialty practiced
D)The average fees of other physicians in the area

Question 23

The medical assistant may help with all of the following tasks related to the physician's fees for services rendered except:

A)determine the amounts charged for procedures
B)inform patients about the fees
C)collect payments from patients
D)make arrangements for long-term payments

Question 24

Who should be billed for the treatment of an emancipated minor?

A)The minor
B)The parent who came to the office with the minor
C)The parent who is financially responsible for the minor
D)The guardian

Question 25

Legal and appropriate procedures the medical assistant can use to try to locate patients with outstanding balances who move and leave no forwarding address include all of the following except:

A)informing the patient's employers that money is owed to the physician
B)calling the emergency contact listed on the patient information sheet
C)calling references listed on patient registration cards
D)asking neighbors for information about patients' new locations

Question 26

The purpose of a charge slip is to:

A)provide an itemized billing statement on which the physician notes charges
B)explain charges to patients before treatment
C)provide estimates of future treatments
D)allow patients to apply for credit

Question 27

Which is the best way to work with patients regarding financial matters?

A)Always apologize for having to ask them for payment.
B)Discuss billing policies only if the patient asks about them.
C)Be very firm about enforcing office payment policies.
D)Explain the office financial policies when patients make an appointment.

Question 28

If the physician believes that the insurance company will pay only $185 of the $255 fee, he should bill the insurance company:

A)$255 and advise the patient that he or she will be billed for the balance after the insurance pays the claim
B)ill the insurance company $185 and bill the patient $255
C)$185 and write off the $70
D)$295 and bill the patient $70

Question 29

Which factor is not usually considered by physicians when determining how much to charge for a procedure?

A)Time required
B)Amount of knowledge and decision making involved
C)Type of procedure
D)Patient's ability to pay

Question 30

When working under a managed care plan, physicians agree to:

A)base fees on national trends
B)charge fees that are based on local community averages
C)accept fees that are predetermined by the plan
D)set fees within certain ranges provided by the plan

Question 31

Which of the following is not true about the use of independent billing services?

A)It reduces calls to the office regarding billing matters.
B)It allows office staff more time to work with patients.
C)It depersonalizes billing disputes.
D)It drastically reduces the cost of billing and monitoring accounts.

Question 32

When preparing the first statements sent to patients to bill for medical services, the charges should be itemized:

A)if they were not explained to the patient before he or she received the services
B)on all first statements sent out
C)for bills that will also be submitted to an insurance carrier
D)if many patients call with billing questions

Question 33

Why might a physician receive only $185 for a procedure for which he billed the insurance company $255?

A)The physician's fee profile has increased since it was set by the company.
B)The insurance company's fee schedule allows only $185.
C)The fee of $225 is above the maximum range charged by the other physicians in the area.
D)All of the above are correct.

Question 34

The smallest percentage of people who do not pay their medical bills consists of people who:

A)are disorganized and irresponsible
B)are dissatisfied with the physician's services
C)spend more than they earn
D)never intend to pay

Question 35

Under which circumstances would a cycle billing system be most advantageous for the medical office?

A)Most companies in the area pay employees at the end of each month.
B)The patient load is moderate, and most of them pay at the time of their visits.
C)The physician wants to stabilize cash flow.
D)All billing is handled by an outside service.

Question 36

If a patient tells the medical assistant that a close friend will pay his medical bills if he is unable to do so, the medical assistant must:

A)orally verify this arrangement with the friend
B)request that the patient give his friend power of attorney
C)secure a written agreement from the friend
D)meet with the friend in person

Question 37

Which factor determines whether patients must sign a truth in lending disclosure as required by Regulation Z?

A)Their bill is divided into two payments.
B)The physician includes a finance charge.
C)The person has a poor credit history.
D)Payments will be made over a period longer than 6 months.

Question 38

Which of the following would be the least helpful for encouraging patients to make prompt payments?

A)Clearly itemized statements
B)Self-addressed envelopes included with statements
C)Sending collection letters to all patients with a balance due
D)Firmly stated policies about collection procedures

Question 39

Which statement about medical office credit policies is not a recommended practice?

A)Include billing, insurance, and collection procedures.
B)Write fairly detailed guidelines to follow when making credit decisions.
C)Develop very general policies so that each account can be considered individually.
D)Fully disclose these policies to patients.

Question 40

Which of the following statements best describes the concept of "professional courtesy"?

A)A referral system in which physicians send patients to colleagues for consultation and treatment
B)Charging reduced or no fee for services rendered to other medical professionals
C)Not undercharging for services and thus lowering the insurance company fee schedules
D)Reducing fees charged for treatment of friends and family members

Question 41

An organization under contract to the government as well as some private plans to act as financial representatives is a:

A)fiscal agent
B)fiscal augment
C)third-party payer
D)guarantor

Question 42

Which of the following types of billing sends statements at given times of the month, such as one quarter of the accounts receivable the first week, and so on through the month?

A)Monthly billing
B)Cycle billing
C)Third-party billing
D)Twice-a-month billing

Question 43

All of the following might be found in the adjustment column except:

A)professional discounts
B)write-offs
C)new charges
D)disallowances

Question 44

Which of the following examples would you enter in the credit column?

A)Payments received for medical services rendered
B)Additional charges placed on the patient's account
C)Fees for returned checks
D)None of the above

Question 45

The column in the pegboard system used to enter charges is the _____ column.

A)credit
B)debit
C)adjustment
D)balance

Question 46

__________ slips may help simplify the collection process, because there is no misunderstanding as to the fee agreed upon for a procedure.

Question 47

Transferring or carrying from a book of original entry to a ledger is called:

A)posting
B)paying
C)receiving
D)billing

Question 48

When a patient files for bankruptcy, the appropriate procedure is to:

A)attempt to collect from the patient's insurance company
B)bill the patient as usual
C)contact the patient directly and demand payment in full
D)file a creditor's claim with the court and/or write off the bill

Question 49

Which of the following statements does not describe an advantage of using small claims court to collect delinquent accounts?

A)It is faster than regular court action.
B)A lawyer must be hired to represent the physician.
C)The claim takes less time to prepare and present than a lawsuit.
D)Using the small claims courts is relatively inexpensive.

Question 50

All of the following are considered special bookkeeping entries except:

A)refunds
B)credit balances
C)payments
D)adjustments

Question 51

The __________ fee is a range of the usual fees charged for the same service by physicians with similar training and experience practicing in the same geographic area.

Question 52

Which of the following times is not acceptable for collection calls?

A)9 AM
B)11:30 AM
C)8 AM
D)9:30 PM

Question 53

An exchange or transfer of goods, services, or funds is called a(n) __________.

Question 54

The balances due to a creditor on an account is known as __________.

Question 55

Payment for medical services is accomplished in which of the following ways?

A)Internal insurance or other third-party billing
B)Payment at the time of service
C)Outside billing and collection assistance
D)All of the above

Question 56

When using the telephone to collect accounts, the medical assistant should:

A)call at whatever time the patient can be reached
B)try to get a definite commitment on a date that payment will be made
C)insist on payment within 2 weeks
D)apologize for calling and requesting payment

Question 57

Most medical offices accept which of the following forms of payment?

A)Debit cards
B)Credit cards
C)Checks
D)All of the above

Question 58

The slips attached to charts while the patient is in the office that are used for billing are called __________ forms.

Question 59

__________ paper does not require added carbon sheets to make a copy.

Question 60

Which of the following is (are) true about giving patient estimates for treatment?

A)It may help simplify collection by preventing misunderstandings.
B)It may help the patient remember that a fee was quoted.
C)It may help eliminate the possibility that the fee is misquoted later.
D)All of the above are true.

Question 61

Ms.Jackson paid $25 on her account, which had a balance of $248; $66 is written off the account.What is the remaining balance?

Question 62

The Truth in Lending Act is enforced by the Federal __________ Commission.

Question 63

Amy Moore pays $200 on her account, which had a previous balance of $652.What does she owe on the account?

Question 64

Funds paid out are called __________.

Question 65

Paula Bailey paid $50 on her balance of $450.If insurance pays $122 and Paula makes another $50 payment, what is her balance?

Question 66

A compilation of pre-established fee allowances for given services or procedures is called a fee __________.

Question 67

Ed Streep had a previous balance of $752.He has made nine payments of $25.After he makes six more payments of the same amount, what will his balance be?

Question 68

Janeen has a previous balance of $157 for an office visit.She wants to pay her part of the bill, which is 20%.What should her insurance pay?

Question 69

Judy Rogers paid $45 on her balance of $191.What is her new balance?

Question 70

Amounts paid on patient accounts are called __________.

Question 71

Patients who are unable to afford medical bills are sometimes said to be medically __________.

Question 72

The medical assistant should __________fees to patients so that they will understand their charges.

Question 73

The person who makes or gives a guarantee of payment for a bill is called a(n) __________.

Question 74

A statement of transactions during a fiscal period and the resulting balance is called a(n) __________.

Question 75

Mr.Angler comes in for an office visit and is charged $120.He pays his co-pay of $15, and his insurance pays $89.How much does he owe?

Question 76

Cassandra Lee has a previous balance of $86.She paid $5, and her insurance paid $71.What is her balance?

Question 77

Sandra Cox had a balance of $329.She wrote a check for $100, but the bank returned the check marked NSF.The NSF fee is $30.What is Sandra's new balance?

Question 78

Arnold Matthews had a previous balance of $465.He has paid $45 each week for 5 weeks.What is his current balance?

Question 79

Refunds after all payments are made on an account usually result in a patient balance of __________.

Question 80

Angela made a payment of $16 on her account.The next day an insurance check arrived for $88.Her previous balance was $92.What is her balance now?