1. UNIT 8: CH. 16 AND 18
Billing and Payment for Medical Services

2. BOOKKEEPING PROCESS
 Recording the financial transactions of a business
 Several methods: manual or computerized
 Bookkeeping is different than accounting
 Accuracy in bookkeeping is essential!

3. BASIC TERMINOLOGY
Accounts receivable Daysheet
Accounts payable Posting
Account or ledger Balance
Debit Debit balance
Credit Credit balance
Adjustment

4. POSTING PROCEDURES
 Charges are entered on the encounter form by
the provider
 Also called a superbill
 List of procedures performed in that office
 Charges are recorded to the patient’s ledger
 Record of all charges, payments, and adjustments

5. PATIENT
LEDGER CARD

6. COMPUTERIZED SYSTEMS
 Function of practice management software
 Electronic health records software can integrate with
practice management software, eliminating the need
for encounter forms
 Provides up-to-date financial information
 Charges can be entered into the practice
management software by front office personnel or
billing department

7. SINGLE-ENTRY BOOKKEEPING
 Similar to a checkbook register
 Journal for each transaction is recorded in one
column
 Revenue and expenses are totaled

8. DOUBLE-ENTRY BOOKKEEPING
 Each transaction is recorded in two columns
 Includes both assets and liabilities
 Allows for balance in the accounting equation
 Each debit has an each and opposite credit
 The total of all debits must equal the total of all
credits

9. COMMUNICATING FEES
 The MA commonly answers patient questions
about accounts
 Cost estimate sheets are used when fees are
anticipated to be high
 Assisting patients in payment planning
encourages compliance
 Discounts are authorized by the provider only

10. METHODS OF BILLING
 Monthly billing
 Cycle billing
 Computerized billing

11. PRACTICE MANAGEMENT SOFTWARE
 Billing and practice management software
 Ability to post procedures and payments to patient
accounts
 Ability to generate encounter forms and claims
 Ability to generate reports
 Daily journal
 Year to date
 Aging account reports
 Account history

12. PATIENT PAYMENTS
 At time of service
(ATOS): best
opportunity for
collection

13. VERIFYING AND ACCEPTING CHECKS
 Check if valid and no corrections have been made
 When received stamp it with the office’s deposit
endorsement
 Do not accept third party checks, unless from
insurance company

14. POSTING PATIENT PAYMENTS
 Date of payment
 Payment amount
 Form of payment (cash, credit card, or check)

15. SPECIAL ADJUSTMENTS
 Nonsufficient funds
 Collection agency payments
 Credit balances and refunds

16. COLLECTIONS LAWS
 Truth in Lending Act
 Fair Debt Collection Practice Act
 Statute of limitations laws

17. STRATEGIES FOR COLLECTION
 Phone calls
 Letters
 Collection agencies