Ann Reynolds has recently been hired as practice manager for Dr. LaRue. In reviewing the financial records of the practice, she notices that a substantial amount of money is owed by patients with outstanding balances. Further review finds that the practice has no written financial policies outlining the responsibility of patients in paying for their costs of medical care. Outline a set of basic financial policies to address patient responsibility for payment of charges.
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Ann Reynolds has recently been hired as practice manager for Dr. LaRue. In reviewing the financial records of the practice, she notices that a substantial amount of money is owed by patients with outstanding balances. Further review finds that the practice has no written financial policies outlining the responsibility of patients in paying for their costs of medical care. Outline a set of basic financial policies to address patient responsibility for payment of charges.
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- Students may wish to refer to the chapters on the introduction to the revenue cycle and patient encounter and billing information in this workbook for a review of math for the following problems. Dr. Augustino is a Medicare participating provider. Dr. Brunner is a Medicare nonparticipating provider who accepts assignment. Dr. Charles is a Medicare nonparticipating provider who does not accept the assignment. The following table shows the fees each doctor charges as well as the Medicare Fee. Dr. A Dr. B Dr. C Medicare 99201 OV New 45.00 42.50 48.00 36.00 99204 OV New 60.00 57.50 65.00 48.25 99212 OV Established 40.00 38.00 45.00 32.00 99213 OV Established 45.00 40.00 48.00 35.75 71046 Chest X-ray 165.00 162.50 174,00 73.25 36415 Venipuncture 17.00 12.00 20.00 8.00 Audrey Appel who is covered by Medicare, as well as a Medigap policy, is a new patient of Dr. Augustino. She is seen in the office for…Lucy and Sherri have been working through the accounts receiveable for unpaid debt owed to the facility. While reviewing the report Lucy notices there are several patient balances over 120 past due which could account for the decrease in revenue. Lucy and Sherrie begin the collections processfor the outstanding balances owed. by the patient. Describe the first step Lucy and Sheri should take to collect the debt owed by the patients.Explain how the patient debt could have been collected sooner than 120 days.Discuss why it is important to review the accounts receivable report regularly.Shadyside Insurance Company manages a medical insurance program for its clients. Employees of client firms submit claims for reimbursement of medical expenses. Shadyside processes these claims, checks them to ensure that they are covered by the claimant’s policy, notes whether the claimant has reached any limit on coverage, computes any deductible, and issues a check for the claimant’s refund. Three types of clerks work in the claims processing department: supervisors, senior clerks, and junior clerks. The supervisors are paid $42,000 per year, the senior clerks are paid $37,000 per year, and the junior clerks are paid $32,000 per year. For every 150,000 claims processed per year, Shadyside plans to use one supervisor, six junior clerks, and two senior clerks. Last year, the company processed 2 million medical claims and employed 14 supervisors, 30 senior clerks, and 83 junior clerks. Required Compute the excess costs or cost savings relating to the claims processing staff. How would…
- The basis for recognizing patient care revenue is not always obvious. In a particular month Northwest Medical Clinic reported the following: 1. It provided direct care services to patients, billing them $400,000. Of this amount it received $120,000 in cash, but as a consequence of bad debts it expects to collect a total of only $330,000. 2. It provided direct care to patients covered by insurance and who are members of various group health plans for which, at standard rates, it would have billed $650,000. However, owing to contractual arrangements with the payers, it actually billed them for, and expects to collect, only $480,000. 3. It provided charity care for which it would have billed, at standard rates, $82,000. 4. It received capitation fees of $1,400,000 from health care plans and provided services to members of those plans for which it would have billed, at standard rates, $1,600,000. Prepare appropriate journal entries to recognize revenue.Fill in the blank. The ____________ principle of accounting requires the revenues generated by providing care for a patient to be recorded in the same accounting period as the expenses incurred to provide that care.In the accounting for health care providers, what are third-party payors? Doctors who reduce fees for indigent patients. Charities that supply medicines to hospitals and other health care providers. Friends and relatives who pay the medical costs of a patient. Insurance companies and other groups that pay a significant portion of the medical fees in the United States.
- In the accounting for health care providers, what are third-party payors?a. Doctors who reduce fees for indigent patients.b. Charities that supply medicines to hospitals and other health care providers.c. Friends and relatives who pay the medical costs of a patient.d. Insurance companies and other groups that pay a significant portion of the medical fees in the United States.What is a contractual adjustment? An increase in a patient’s charges caused by revisions in the billing process utilized by a health care entity. A year-end journal entry to recognize all of a health care entity’s remaining receivables. A reduction in patient service revenues caused by agreements with third-party payors that allows them to pay a health care entity based on their determination of reasonable costs. The results of a cost allocation system that allows a health care entity to determine a patient’s cost by department.Which of these duties might a financial manager in a healthcare organization be responsible for? Prepare a year to date trial balance report for the annual tax filing Conduct data analysis to report to the board of directors on new revenue sources Complete a medical supply inventory and submit it to the purchasing department Submitting invoicing to an insurance company for payment
- Parktown Medical Center, Inc.. is a small health care provider owned by a publicly heldcorporation. It employs 7 salaried physicians, I0 nurses, 3 support stafl, and 3 clericalworkers. The clerical workers perform such tasks as reception, correspondence, cashreceipIs,billing, and appointment scheduling. All are adequately bonded. Most patients pay for services rendered by cash or check on the day of their visit.Sometimes.however, the physician who is to performservices apprcredit based on an interview. When credit is approved, the physician files a memo vone of the clerks to set up the receivable using data the physician generates.The servicing physician prepares a charge sup that 1s given to one or the clerKs IorDicing and preparation of the patient S bill. At the end of the dav.one of the clerks usesthe bills to preparea revenue summarv and. in cases of credit sales. to update thecounts receivable subsidiary ledger.The frontoffice clerks receive cash and checksdirectly from patients…When creating an Income Statement and calculating Net Patient Service Revenue, which of the accounts do you actually record as a line item on the Income Statement? O Discounts Charity Care Accounts Receivable Bad DebtGlencoe Medical Clinic operates a cardiology care unit and a maternity care unit. Colby Hepworth, the clinic’s administrator, is investigating the charges assigned to cardiology patients. Currently, all cardiology patients are charged the same rate per patient day for daily care services. Daily care services are broadly defined as occupancy, feeding, and nursing care. A recent study, however, revealed several interesting outcomes. First, the demands patients place on daily care services vary with the severity of the case being treated. Second, the occupancy activity is a combination of two activities: lodging and use of monitoring equipment. Since some patients require more monitoring than others, these activities should be separated. Third, the daily rate should reflect the difference in demands resulting from differences in patient type. Separating the occupancy activity into two separate activities also required the determination of the cost of each activity. Determining the costs…