CS204 Week 7 Discussion

Week 7

· Describe various methods for effectively discussing financial matters with patients.

· 
Describe techniques for proper collections when using the telephone to contact patients about delinquent accounts.  List some “illegal” aspects of medical collections.

· 
List the steps involved in posting payments from secondary insurance companies.

· 
List the steps involved in posting payments from electronic Remittance Advices.

Expert Solution Preview

Introduction: This week’s topics focus on important aspects of medical practice management such as financial matters, collections, and insurance payments. As medical professionals, it is crucial for us to handle these aspects effectively and ethically to ensure the satisfaction of our patients and the success of our practice.

1. Various methods for effectively discussing financial matters with patients:
One effective method for discussing financial matters with patients is transparency. The medical staff can explain the fees associated with the services, any potential additional costs, and available payment options to the patient before the service is provided. This will help the patient in understanding the financial responsibility involved and make informed decisions. Additionally, the staff can provide financial counseling to patients who are experiencing financial hardships and offer payment plans that can make it easier for the patient to pay the bills.

2. Techniques for proper collections when using the telephone to contact patients about delinquent accounts and “illegal” aspects of medical collections:
When contacting patients about delinquent accounts, the staff should use polite and professional language and handle the situation with empathy. They should make sure to confirm the accuracy of the patient’s information, including the address and phone number, and inform the patient about the debt and the consequences of non-payment. However, medical staff should not resort to any illegal collection practices such as threatening, using abusive language, or making unauthorized debits from the patient’s account. Collection staff should be trained and knowledgeable about the rules and regulations regarding medical collections to avoid crossing legal boundaries.

3. Steps involved in posting payments from secondary insurance companies:
When posting payments from secondary insurance companies, the medical staff should follow a few steps. Firstly, they should compare the Explanation of Benefits (EOB) from the primary insurer with the secondary insurer’s payment. This will help in verifying the amount and details of the secondary payment. Secondly, they should enter the secondary insurer’s payment in the patient’s account and determine the amount that the patient owes. Lastly, they should inform the patient about the payment and any remaining balance that they owe.

4. Steps involved in posting payments from electronic Remittance Advices:
Electronic Remittance Advices (ERAs) are a form of electronic payment processing that allows claims payments to be sent directly to a healthcare provider’s practice management system. To post payments from ERAs, the medical staff should follow certain steps such as matching the ERA to the corresponding claim, verifying details such as payment amount, reason codes, and patient responsibility, and updating the patient’s account with the payment information. They should also ensure the accuracy and completeness of the ERA before posting it, as any errors can lead to claim denials and payment delays.

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