Professional Fees, Billing & Coding Hi-1011- Chapter 19

Explanation
Encouraging TOS (Terms of Service) payments is beneficial because it ensures that users comply with the terms and conditions set by a company or platform. By making these payments, users acknowledge and agree to abide by the rules, which helps maintain a fair and secure environment for all users. TOS payments also provide a source of revenue for the company, enabling them to continue offering their services and improving the platform for users.

Explanation
The term "allowable amount" refers to the total sum that an insurance company is willing to pay for a specific medical procedure. This amount is predetermined and agreed upon between the insurance company and the healthcare provider. It represents the maximum reimbursement that the insurance company will cover, and any additional costs beyond this amount would typically be the responsibility of the patient.

Explanation
Multiple collection letters should be sent to a patient prior to sending them to a collection agency service. This is because sending multiple letters gives the patient ample opportunity to settle their outstanding debts before resorting to involving a collection agency. It also ensures that the patient is aware of their financial obligations and provides them with a fair chance to address the issue before further actions are taken.

Explanation
Continuing to see patients who have filed bankruptcy is not prohibited or unethical. Bankruptcy is a legal process that allows individuals or businesses to reorganize or eliminate their debts. It does not affect a patient's ability to receive medical care or the healthcare provider's ability to treat them. Therefore, it is not necessary to stop seeing patients who have filed bankruptcy.

Explanation
The True answer is correct because the Truth in Lending Act requires that lenders provide clear and accurate information about the terms and costs of credit to borrowers. This includes disclosing any finance charges that will be applied to the account. By following this act, lenders ensure transparency and protect the rights of borrowers.

Explanation
True. Insurance companies should send claims daily to the insurance company to continue the financial flow within the office for services rendered.

Explanation
The statement suggests that face to face collection efforts are not effective, but the correct answer is False. This means that face to face collection efforts are actually effective.

Explanation
True. Any payment received needs to be turned over to the collection agency.

Explanation
The statement is false because in most cases, you cannot bill a minor without the parent's information. Minors are typically not legally responsible for their own medical bills, and healthcare providers require the parent's information to ensure proper billing and payment. Without the parent's information, it would be difficult to collect payment or communicate with the responsible party for the minor's healthcare expenses.

Explanation
The insurance contract exists between the insurance company and the insured. The insured refers to the person or entity that is covered by the insurance policy. They are the ones who purchase the insurance and are protected against potential financial losses or damages. The insurance company, on the other hand, is the provider of the insurance coverage and agrees to compensate the insured in case of covered events or risks. The insured pays premiums to the insurance company in exchange for this coverage.