Deck 10: Office and Insurance Collection Strategies

Question 1

Cash flow is

A) the amount of money available in the cash drawer.
B) the amount of money taken into the office in a given period of time.
C) the ongoing availability of cash in the medical practice.
D) the amount of money in accounts receivable.

Answer 1

the ongoing availability of cash in the medical practice.

Question 2

When the physician's office receives notice that a check was not honored, the first thing to do is to

A) send an NSF demand letter.
B) file a claim in small claims court.
C) call the bank or the patient.
D) notify the patient that future payments need to be in the form of cash or money orders.

Answer 2

call the bank or the patient.

Question 3

Professional courtesy means

A) applying a discount (percentage) to the entire fee.
B) applying a discount after the insurance company has paid its portion.
C) writing off the balance of an account after an insurance company has paid its portion.
D) making no charge to anyone, patient or insurance company, for medical care.

Answer 3

making no charge to anyone, patient or insurance company, for medical care.

Question 4

What does the insurance billing specialist need to monitor to be able to evaluate the effectiveness of the collection process?

A) Number of statements sent
B) Number of claims processed
C) Accounts payable
D) Accounts receivable

Question 5

A medical practice has a policy of billing only for charges in excess of $50. When the medical assistant requests a $45 payment for the office visit, the patient states, "Just bill me." How should the medical assistant respond?

A) Say "All right" and bill the patient.
B) State the office policy and ask for the full fee.
C) Indicate that because it is such a small sum, it can be paid later.
D) Ask that the payment be mailed to the office.

Question 6

The patient is likely to be the most cooperative in furnishing details necessary for a complete registration process

A) before any services are provided.
B) right after services are provided.
C) at the time of the first statement.
D) in a follow-up telephone call.

Question 7

Messages included on statements to promote payment are called

A) billing messages.
B) statement slogans.
C) dun messages.
D) payment prompters.

Question 8

Accounts receivable are usually aged in time periods of

A) 1, 4, 6, and 8 weeks.
B) 30, 60, 90, and 120 days.
C) 1, 2, 3, and 6 months.
D) 30, 60, 90, 120, and 180 days.

Question 9

What is a card called that permits bank customers to make cashless purchases from funds on deposit without incurring revolving finance charges for credit?

A) Private-label card
B) Credit card
C) Debit card
D) VeriFone card

Question 10

Accounts that are 90 days or older should not exceed

A) 5-11% of the total accounts receivable.
B) 10-15% of the total accounts receivable.
C) 15-18% of the total accounts receivable.
D) 20-25% of the total accounts receivable.

Question 11

What should be done to inform a new patient of office fees and payment policies?

A) Send a patient information brochure.
B) Send a confirmation letter.
C) Discuss fees and policies at the time of the initial contact.
D) All of the above.

Question 12

When insurance carriers do not pay claims in a timely manner, what effect does this have on the medical practice?

A) Increased cash flow
B) Decreased cash flow
C) Decreased accounts receivable
D) Decreased copayments

Question 13

Patient accounts that are 90 days or older should not exceed what percent of the total office accounts receivable?

A) 7-10%
B) 11-14%
C) 15-18%
D) 19-22%

Question 14

The average amount of accounts receivable should be

A) 1.5-2 times the charges for 1 month of services.
B) 2-2.5 times the charges for 1 month of services.
C) 2.5-3 times the charges for 1 month of services.
D) 3-3.5 times the charges for 1 month of services.

Question 15

The reason for a fee reduction must be documented in the patient's

A) financial accounting record.
B) medical record.
C) insurance file.
D) registration form.

Question 16

The first telephone call to the patient to try to collect on an account should be made

A) the month following the date of service.
B) after there is no response from the first statement.
C) after there is no response from the second statement.
D) after there is no response from the third statement.

Question 17

The first patient account statement should be

A) presented at the time of service.
B) mailed right after the date of service.
C) mailed 2 weeks after the date of service.
D) mailed 30 days after the date of service.

Question 18

Contracting a medical billing service for insurance claim submission is called

A) statement service.
B) centralized billing.
C) outsourcing.
D) cycle billing.

Question 19

When collecting fees, your goal should always be to

A) leave the impression that you are a nice person.
B) collect at least one half the fee.
C) collect the full amount.
D) collect as much as possible.

Question 20

How many installments (excluding a down payment) must a payment plan have to require full written disclosure?

A) Three or more
B) Four or more
C) Five or more
D) Six or more

Question 21

The amount due listed on the patient's financial accounting record is also referred to as the account ____________________.

Question 22

Medical offices can take the following steps to prevent missed appointments EXCEPT:

A) establish a missed appointment fee of $35-50.
B) set a 24- to 48-hour appointment cancellation policy.
C) call patients to confirm appointment the day before.
D) all of the above are acceptable strategies to prevent missed appointments.

Question 23

The patient registration form should be updated at least every ________________________________________.

Question 24

In making collection telephone calls to a group of accounts, how should the accounts be organized to determine where to begin?

A) Organize the accounts alphabetically and start with the letter A.
B) Organize the accounts by account number and start with number 1.
C) Organize the accounts according the number of days past the date of service the account is delinquent.
D) Determine which patient you think may be easier to collect from and start with that account.

Question 25

All discounted fees need to be noted on the patient's ____________________.

Question 26

All collection calls should be placed

A) after 9 AM and before 9 PM.
B) after 8 AM and before 9 PM.
C) after 8 AM and before 8 PM.
D) after 9 AM and before 8 PM.

Question 27

The amount expected based on physician charges from third-party insurance companies and patients for services that have been rendered is called ____________________.

Question 28

Which group of accounts would a collector target when he or she begins making telephone calls?

A) 30- to 60-day accounts
B) 60- to 90-day accounts
C) 90- to 120-day accounts
D) Accounts older than 120 days

Question 29

What is the biggest change medical offices can expect from the Affordable Care Act?

A) A reduction in the cost of medications
B) The number of self-pay patients will decrease
C) Young adults under 26 can remain under their parent's health care plan
D) The elimination of the preexisting condition barrier

Question 30

Assets or debts that have been determined to be uncollectible and are therefore taken off (debited) the accounting books as a loss are called ____________________.

Question 31

If an insurance company seems to be ignoring all efforts to trace a claim, send a copy of the

A) history and physical.
B) operative report.
C) claim.
D) history of the account.

Question 32

The relationship of the amount of money owed to a physician and the amount of money collected on the physician's accounts receivable is called the ____________________.

Question 33

In a bankruptcy case, most medical bills are considered

A) secured debt.
B) unsecured debt.
C) nonexempt assets.
D) exempt assets.

Question 34

All of the following are examples of why accepting credit/debit cards in the medical office is beneficial EXCEPT:

A) credit/debit terminals charge a per service fee to the medical office.
B) lower risk of embezzlement from medical office staff.
C) staff does not need to leave the office to deposit checks.
D) convenient for patients.

Question 35

Which type of bankruptcy is considered "wage earner's bankruptcy"?

A) Chapter 7
B) Chapter 11
C) Chapter 12
D) Chapter 13

Question 36

The part of the legal system that allows laypeople to settle a legal matter without use of an attorney is the

A) people's court.
B) justice court.
C) small claims court.
D) all of the above.

Question 37

When writing a collection letter

A) do not try to be friendly; just get to the point.
B) use a friendly tone and ask why payment has not been made.
C) do not suggest that the patient has overlooked a previous statement.
D) do not imply that the patient has good intentions to pay.

Question 38

What is the name of the act designed to address the collection practices of third-party debt collectors and attorneys who regularly collect debts for others?

A) Equal Credit Opportunity Act
B) Fair Credit Billing Act
C) Truth in Lending Act
D) Fair Debt Collection Practices Act

Question 39

What is the name of the federal act that prohibits discrimination in all areas of granting credit?

A) Equal Credit Opportunity Act
B) Fair Credit Reporting Act
C) Fair Credit Billing Act
D) Truth in Lending Act

Question 40

The patient information sheet is also known as the ______________________________.

Question 41

When no business or home telephone number is listed on the patient registration form, this may be an indication of a future nonpaying patient.

Question 42

The collection abbreviation TTA means ____________________.

Question 43

When dealing with managed care contracts, do not sign contracts that use the ____________________ clause because this is a way for one party to shift financial responsibilities to another party.

Question 44

A/An ____________________ is a claim on the property of another as security for a debt.

Question 45

According to the FDCPA, do not contact a third party more than ____________________ unless requested to do so by the party or the response was erroneous or incomplete.

Question 46

A large percentage of reimbursement in the physician's office is generated from third-party payers.

Question 47

In filing a claim in small claims court, the physician's office is referred to as the ____________________.

Question 48

Patients' accounts turned over to a collection agency should have a/an ____________________ sent by certified mail.

Question 49

Information provided on the patient registration form will prove critical to any billing and collection efforts.

Question 50

A patient who owes a balance on his or her account and moves but leaves no forwarding address is called a/an ____________________.

Question 51

In dealing with an estate claim, a call to the ____________________ can be made periodically to check on the status of the estate.

Question 52

The truth in lending consumer credit cost disclosure requires businesses to disclose all ____________________ and ____________________ costs related to granting credit.

Question 53

The term ____________________ is used when accounts are billed at spaced intervals during the month.

Question 54

The collection abbreviation OOT means ____________________.

Question 55

A formal regulation or law setting time limits on legal action is known as a ____________________.

Question 56

A/An ________________ is a patient payment option in which the check is deposited into the physician's account at the time of service.

Question 57

If the endorsement on the back of the payment check does not match the name on the front, there may be a case of ____________________.

Question 58

__________________ are another way of offering the patient a way of paying off an account by spreading out the amount due over a period of time.

Question 59

The statement "This bill is now 30 days past due. Please remit payment" is called a ____________________.

Question 60

All insurance billers, all claim assistance professionals, and anyone who handles checks or cash should be ___________.

Question 61

If a patient writes "paid in full" on a check against an account that will not be paid in full with the check, the acceptance of the check indicates an acceptance of the "paid in full" remark.

Question 62

One person or one department should handle all billing questions.

Question 63

The Fair Credit Reporting Act states that a patient has 60 days from the date a statement is mailed to complain about an error.

Question 64

According to the FDCPA, debtors can never be contacted at work.

Question 65

Standard policy should be to reduce fees of any patient who dies after receiving medical care.

Question 66

A personal check is a guarantee of payment.

Question 67

It is legal to offer patients a cash discount when the entire fee is paid at the time of service.

Question 68

When a physician offers a discount, it must apply to the total bill, not just the portion that is paid by the patient.

Question 69

A patient has a $600 balance and agrees to a payment plan of $100 in six installments. If he or she skips the third installment and sends in $25 the following month, the physician can send the account to a collection agency.

Question 70

Refunds may be made by check on accounts in which payment was made by credit card.

Question 71

Under federal regulations, a list of the most common services the physician offers, including procedure code numbers with a description of each service and its price, must be posted in the office waiting room.

Question 72

Most medical practices operate with a set of fees that must be applied to all patients in the practice.

Question 73

In most situations, both private insurers and the federal government ban waiving the copayment portion of the patient's fee.

Question 74

In a telephone collection call, the first 2 minutes will set the scene for your relationship with the patient.

Question 75

In trying to collect an unpaid balance, a telephone interview is preferred to a personal interview.

Question 76

When a physician continues to treat a patient with an overdue account, the courts have viewed this as an extension of credit; therefore, patients who fall into this delinquent status should be referred elsewhere.

Question 77

You should not give patients the option of whether they would like to pay now or have a bill sent.

Question 78

The best and most effective collection statements include a handwritten note.

Question 79

A medical practice cannot refuse to let an established patient see the doctor because of a debt.

Question 80

A collection rate of 80-85% should be a goal for the practice administrator in charge of collections in the physician's office.