Question

4. What are the pitfalls of fee adjustments? 5. What is professional courtesy and why is it less common now than in years past? 6. Briefly explain how "skips" can be traced 7. Match the following terms with the correct definition Terms Definitions A. Money that is expected but has not yet been received B. Fees applied to the patient account when services are rendered C.The management of debt incurred and not yet paid D. Money given to the provider in exchange for services E. Credits posted to the patient account when the provider's fee exceeds the amount allowed stated on the EOB . Accounts payableA 2 Accounts receivable C13. Adjustments C4. Charges 5. Payments 8. When a patient account is turned over to a collection agency, what adjustment is posted to the account? 9. When a patient has a credit balance on his or her account, what adjustment is posted to the account? WORKPLACE APPLICATION Complete this activity and share your results with the class, if appropriate Mr. Sanchez comes to the desk to check out after seeing the physician. When Brenda tells him that his bill is $95, fee is in accordance with evaluation and management guidelines. Explain the fees to Mr. Sanchez.

Answer 1

4. The pitfalls of fee adjustment are :-

- Patients may begin to expect all fees be reduced

-Patients may even doubt competency of a provider who habitually reduces fees

-Be sure to make negotiations "without prejudice"

-A fee should never be reduced on the basis of a poor result or as a means of obtaining payment to avoid use of collection agency

-Make fee reductions the exception rather than the norm.

-Take great care in reducing the fee for care of a patient who dies.

-A fee reduction for these reasons degrades the provider and the practice of medicine.

5. Professional courtesy is the professional behaviour or etiquettes between members of same profession.

In the past some providers did not charge professional colleagues or their close family members for medical care

-The Stark Law was passed to eliminate fraud related to not charging friends or family for medical care:

* Must be extended to all members of healthcare facility

*Services must be routine

*Must be set forth in writing

*Cannot be extended to Medicare patients

*Cannot violate an anti-kickback statute

6. Skips can be traced by the following :-

- examination of patient registration card

- call number listed on card

- internet search

7. The correct match the following are

1. Account payable - the management of debt incurred and not yet paid

2. Account receivable - money that is expected but has not yet been received

3. Adjustments - credits posted to the patient account when the provider fee exceeds the amount allowed stated on the EOB

4. Charges - fee applied to the patient account when services are rendered

5. Payment - money given to the provider in exchange for services