Accounts Receivable In Healthcare

Patient Accounting and Practice Management systems are designed to help health care medical practices are to improve the quality of care, cut cost, reduce risk, and increase revenues. When it comes to the size of a medical practice from small, or to a large medical practice, multi-location group this will feather the system to allow in creating and maintaining a patient billing information much faster and more efficiently then it was ever before. Medical Assistants are able to enter a patient information and post any changes much faster and more accurately with the use of a simplified medical billing software that promotes physician acceptance and much greater investment protection that provides faster insurance reimbursement and to improve

A current LCD for the regional Medicare intermediary (Michigan - Region V) is shown in the example below. This LCD is for Erythropoiesis Stimulating Agents, L25211. The LCD is active and became effective on 12/1/2007 with an date of 11/01/2013 for the 10/22/2013 revision (cms.gov, 2014b).

In Healthcare System the role of finance is an important aspect in healthcare. In the financial role of healthcare it involves handling operations such as negotiating contracts, making cash available for expenses such as payroll and cover cost for unexpected expenses. The role of finances also makes it capable for leadership to better make plans for the future, when finances are in order organizations can better equipped to make decisions such as is the organization financial able to expand test or treatments and are they able to buy new medical equipment.

The billing for services not rendered for are often done as a way of billing Medicare for things or services, that basically never occurred. This can involve forging the signature of those enrolled in Medicare or Medicaid, and the use of bribes or as Healthcare calls it, kickbacks to corrupt healthcare professionals. Upcoding of services is the act of billing Medicare programs for services that are more costly than the actual procedure that was done. Upcoding of items is also very similar to upcoding of services, but it involves the use of medical equipment. For example, billing Medicare for a highly sophisticated and expensive wheelchair, while only giving the patient a manual wheelchair is upcoding of items. Duplicating claims occur when a provider does not submit exactly the same bill, but alters small things such as the date in order to charge Medicare twice for the same service rendered. Therefore rather than a single claim being filed twice, the same service is billed two times in an attempt to receive payments from the government twice. Unbundling involves bills for particular services are submitted as fragmentary, which appear to be staggered out over time. Although, these services would normally cost less when bundled together, but by manipulating the claim, a higher charge is billed to Medicare resulting in a higher pay out to the party committing the healthcare fraud. Excessive services occur when Medicare is billed for something greater than what the level of

One financial problem the healthcare industry is facing right now is healthcare collections. Healthcare collections have always been a financial problem to healthcare industries because of nonpayment from the uninsured and individuals who are uneducated about their health plans. Nonpayment to healthcare industries means a loss of revenue. A loss of revenue means that health care industries may run the risk of exhausting their financial resources and become unstable. This financial problem is very typical in the healthcare industry.

With the current recession, health care organizations have seen in increase in the inability to collect debt from self-pay, uninsured, and underinsured patients. This has caused a struggle on the organization to meet operational margins, and profits. There are a number of reasons for this new increase in patient debts, the more common are, poor accounting practices, lack of patient information and correct patient demographics. Obtaining the correct patient information plays a large part on non collectable debt because patients are not able to be reached. Even though

The biggest problem that I have had is trying to fix mistakes. But that is just a temporary problem. Another issue is keeping the various terms straight for the columns. Also remembering to change the payment if it isn’t accurate. I’m confident that after some more practice it will become easier. But these issues are basically because I’m new to all this.

Some facilities outsource medical billing. ("Medical Billing," n.d.) Although this does cost the facility a certain percentage, the people handling the billing are already trained so there are no work hours lost to training the staff in the facility. This also almost completely stops the need for doctors and nurses to spend time on billing issues that come up. ("Medical Billing," n.d.) The hired medical billing specialists are also up to date in current standards, like HIPAA, so they are less likely to make errors in that regard. ("Medical Billing," n.d.) Then there are some facilities that choose to use in-house billing. The positive aspects of in-house billing are billing issues can be handled right away. ("Medical Billing," n.d.) Patients don't have to go through hoops to get their questions answered. The people who are in charge of the billing aspect in the office have direct contact with the doctor that provided the services. ("Medical Billing," n.d.) This eliminates the middle man and patients can possibly get their answers right away. Outsourcing may be easier for certain facilities, but in-house billing is more efficient for

The main thing that stood out to me in the process is Claim Adjunction; is a claim where the payer or insurance provider reviews the claim thoroughly. Adjunction has a series of steps designed to evaluate whether the entire bill, a portion of the bill, or not pay the bill at all. Once the claim goes through adjudication, the conclusion to pay entirely, selected, or nothing of the bill is sent back to the doctor or medical practice in the form of a report. I think reviewing the bills can be combined with patient check in. When a patient is checked in then the office team should mention any co-payments or unpaid bills should be reviewed. When a patient is done with his/her appointment they would just like to leave and not

Any time that an avenue can be explored which benefits both sides of the aisle, it should be covered completely, discussed, and questioned. One of those things is a Health Spending Account. This fringe benefit offering can help everyone! Here are some quick facts to spark your interest:

Balance billing is when the physician was able to bill the patient for any additional balance that was left over after Medicare paid. In order, for this to happen the patient needed to pay the full co-payment the doctor wanted and then submit a form to Medicare to reimburse them the amount they would have paid. This increases the financial risk with a Medicare patient because most Medicare patients can’t afford to lay out the full price of the co-payment right then and their, so they don’t pay their doctor bills. By not paying their doctor bills, they are gaining more debt in their life. Also the patients that can lay out the money can forget to submit the form and don’t receive their reimbursement. By doctors using balance billing, it can

Since I became a mother, I have always wanted a job that would allow me to work at home. I have an associate in accounting and tried doing bookkeeping from home but that did not really work out. I did some research and found that being an insurance medical biller and coder is one of the best jobs to have for working at home. Top Medical Billers can earn over $40,000 a year either at home or in the office. “Employment of billing and posting clerks and machine operators is expected to grow by about 4 percent from 2006 to 2016. In 2006, billing and posting clerks and machine operators held about 542,000 jobs; 566,000 jobs are projected by

Medical organizations looking to streamline their operations often turn to medical billing companies to help them achieve this goal. Doing so frees up valuable time and resources and can actually increase revenue for the organization. How should a medical practice go about making this crucial selection, however? What should they be looking for? Following are some tips to help make this process easier.

The role of finances for health care systems Inc. will be for managing the business’s finances. This ensures having cash available for expenses to ensure the business stays afloat and to ensures there is cash to provide a cushion for any costs that come up unexpectedly. Ensuring that the finances are managed means the company can make plans to ensure the future of the company (Brumley, 2015) and utilize the resources of the company to ensure its running at peak proficiency. The primary users for the financial information will be the finance department which consists of the chief financial officer, comptroller, treasurer and the personnel in charge of specific financial information within the company departments. This whole department reports to the chief executive officer who is responsible for all financial transactions for the company (Gapenski, 2013). There are many legal and regulatory issues that this business has to follow due to being in the health care industry. Some of these issues are that the health care industry is highly regulated for people entering the industry for the well-being of the public. The personnel working in the health care industry have to be licensed or state certified. The facilities themselves have to be licensed and inspected by state personnel that ensure the quality of the facility and the personnel. The legal concerns for this health care business are varied for the health care industry but the primary concern is professional

Account receivable is all of the patients records coming together to create account receivable, the money that is owed to a business by a customer in exchange for goods or services that have already been provided. In medical offices, AR refers to amounts owed by patients and their third-party payers (such as Medicare and insurance companies) for services provided to patients. AR is expressed as the total dollars owed by all patients on a specific date. Each time a service is provided and a bill is issued, the AR increases. Each time a payment is received, the AR decreases. A lower AR is better than a higher AR.